Top-Up Health Insurance in France: What you need to know

France’s health system is one of the best in the world – however, it can be a daunting bureaucratic maze. Here is what you need to know about Top-Up health insurance (the ‘mutuelle’) and French healthcare.

What is Top-Up health insurance?

Living in France, you will often hear the words Top-Up, mutuelle or complementary health insurance. Top-Up health insurance covers all or part of the difference between the total cost and the amount refunded by the French national insurance system, CPAM. 

In simple terms, CPAM will pay 70% of your basic healthcare costs; the Top-Up health insurance will pay the other 30%, as well as - depending on your level of cover - most of the cost for glasses, teeth, hearing aids, prescriptions and hospital stays. 

How does it work?

Once registered into the French healthcare system, CPAM will issue you with a green card – called a carte vitale. The mutelle will issue you with a paper card - Attestation de Tiers Payant Santé - proof that you also have Top-Up health insurance. You will need to give these to the health professional so they can pass your details on to CPAM and the mutelle for payment. 

Most health professionals will collect 70% of the total due directly from CPAM. Depending on their system they may also collect automatically the 30% due from the mutuelle; a system used in most chemists, for example. 

There are other exceptions; e.g. Clinics are private and may charge over and above the standard fees, these may not be covered by the Top-Up health policy. Generally, osteopaths, Kiné and chiropractors are private - so expect to pay something to this treatment. 

Useful information

It is worth remembering that if CPAM do not reimburse you then the top-up insurance will not reimburse you either.

100% Santé

This new initiative aims to improve healthcare access for everyone. For example, with a responsible mutuelle provider, 100% Santé will give you a free pair of basic glasses, essential dentistry and money towards hearing aids. 

The Régime Obligatoire

The Régime Obligatoire is the minimum state social health cover that will take care of medical expenses in case of illness, accident or maternity. Everyone living in France must have some form of cover; otherwise, you will need full private healthcare insurance.

Choosing your Top-Up health insurance cover

All of us will need to go to the doctor occasionally – and nobody can say they will never have an accident resulting in needing hospital treatment. However, the number of times we visit a dentist or eye doctor can vary; so think carefully about the type of health cover you require. For example, if you have the eyes of a hawk it is pointless paying for a service that you will probably not use. Likewise, if you know you need to change your glasses every two years you should choose a policy that gives you a good reimbursement. 
Want to change your policy from another provider? If you have had the policy for more than 12 months you can change at any time.

We hope that this article helped you!


Image used is provided by Getty Images.
First published: 20th December 2023