What is supplemental health?
Have you just paid an excess fee with a specialist? A significant remaining charge on your contact lenses? Taking out additional health insurance can be a good option to supplement the coverage of your mutual health insurance. Focus on this type of insurance contract.
We hear more and more often about "supplementary health" or "supplementary health insurance". Perhaps your employer has already offered you one? These insurance contracts have won many members since 2016. The reason: the entry into force of the National Interprofessional Agreement (ANI) which requires employers to offer complementary health insurance with compulsory membership to their employees. The proposed contract must provide for a minimum level of guarantees, and the employer must bear at least 50% of the contribution. For employees who had not taken out a supplement until then for financial reasons, the new rule allows them to cover themselves at a lower cost. But some employees benefited from a contract with more advantageous guarantees than the new contract offered by their employer. To keep guarantees that are no longer part of their complementary company health insurance, some employees have opted for supplemental health insurance. Thus in 2017, a quarter of employees in the private sector who benefit from complementary health insurance through their company declared having subscribed to a reinforcement to supplement it: either a more covering option of their complementary health contract, or an additional supplement ( 1).
What is supplemental health insurance?
A supplemental is a health insurance contract to which you can voluntarily subscribe in addition to your supplemental health contract. Its role: to strengthen your coverage, especially on expenditure items for which the remaining charges are the most important.
For example :
Dental costs: dental prostheses, etc.
Optical costs: lenses and glasses
Hospital costs
Fee overruns for consultations with sector physicians 2.
Spa stays
Alternative medicine treatments: osteopaths ...
The supplementary mutual insurance represents a third and final level in your reimbursement journey. As a reminder :
The first level is Health Insurance (social security), compulsory coverage that reimburses your health costs at different rates. The part of your health expenses that remains at your expense is called the "user fee", to which are added other types of out-of-pocket expenses: hospital package, medical deductibles, etc.
The second is complementary health insurance, sometimes called mutual insurance, which supplements the reimbursement of social security. It covers part or all of your outstanding expenses, depending on the guarantees in your contract.
If a sum is still payable by you, thirdly, it is the additional charge that comes into play. It reimburses all or part of your outstanding charges, according to the guarantees in your contract.
How do you know if you need supplemental health insurance?
You hesitate to take out an additional contract? To make the right choice, start by taking stock of your health expenses. While it is of course impossible to predict the future precisely, some questions may help you in your thinking:
How much have your annual remaining expenses been in recent years?
What health expenses can you already plan for the coming year?
Will they be fully covered by your complementary health insurance?
Do you find one of the reimbursement levels of your complementary health insurance insufficient in view of your needs?
Do your main out-of-pocket expenses relate to specific items such as the cost of contact lenses, excess fees or hospital stays?
Once this assessment has been carried out, you can compare different offers of supplemental health insurance contracts. Compare their contribution / compensation ratio: is the annual cost of the contract less than the sums it will reimburse you? If so, taking out this contract is good for your budget. If not, continuing to fund your out-of-pocket expenses may still be the best solution.
Good to know: Your supplementary health insurance may be specialized
Dental or hearing prostheses, contact lenses, orthodontics, hospitalizations, etc. The out-of-pocket costs for certain care stations can be high, including when you have taken out additional health insurance. This is why some supplementaries are specialized. They offer targeted guarantees, for example on optics, dentistry or hospitalization
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