Top-Up Health Insurance
France offers a comprehensive and high quality health care system consisting of both public and private hospitals. Unlike the UK, France has a combination of universal health care provision available to all French nationals and Top-Up or complementary health insurance. This system is referred to as the Protection Universelle Maladie (PUMA).
If you are a permanent resident in France, a Top-Up or complementary (‘mutuelle’) health care insurance plan is necessary to pay for the costs associated with your health and medical treatment or expenses, such as visits to the doctor, hospital or pharmacy.
What is Top-Up Health Insurance
Top-Up Health Insurance is a policy in the form of a health care insurance plan which pays the difference between the cost of the medical and health treatment and the contribution from the social security system (Caisse malade primaire assurance or CPAM).
Getting registered for French health care
In France it is essential to obtain a Carte Vitale that qualifies you for health care treatment, such as a visit to a GP or hospital. To get your Carte Vitale, there are different ways to register into the French health care system depending on your personal situation. Foreigners may qualify for French health care after a minimum of 3 months of residence and can be either a retiree, employed or in self-employment.
In all cases however the state pays only a proportion of the cost of health or medical expenses – generally around 70% for routine medical treatment. The remaining 30% (or more for prescribed medicines) of the health expenses or costs are paid by the patient; using a health insurance plan to provide cover is therefore necessary or you can be self-insured. If you are on a low income you may be eligible for 100% reimbursement under the CMU Protection Complémentaire without a Top-Up Health Insurance policy.
Why a Top-Up Health Insurance plan is important
The cost of health and medical treatments can be very expensive – and are rising. A visit to your doctor costs currently 25€ (2019 prices); if you need surgery in hospital this however may cost thousands of euros. The majority of medicines are not fully reimbursed. Therefore, if you do require hospital treatment you may receive a hefty bill to pay for the costs incurred during your stay. Other health treatments requiring regular medication can also add up to a tidy sum….
Proving that you have the means to pay for your health care (an attestation) is also required when you apply for a Carte de Séjour to guarantee your rights to live and work in France. A Top-Up Health Insurance plan will provide evidence of this.
In the event of an accident, is Top-Up Health Insurance required?
Accidents at work are reimbursed fully at 100% by the state and a Top-Up Health Insurance policy is not required. However, if you are admitted to hospital as an emergency due to an accident at home or for example in the car, you may be required to pay for a proportion of your medical treatment. This makes some form of health insurance a necessity.
Maternity health services and babies hospitalised in the first month are covered by the state health system and therefore you do not need Top Up Health Insurance cover to meet these costs.
What types of Top-Up Health Insurance are available?
There are different Top-Up Health Insurance policies available to suit your requirements and your budget. Although a small numbers of people prefer to self-insure rather than take out a health insurance policy, this is risky and could prove to be very expensive if you are hospitalised and do not have the means to pay for your medical treatment.
The health care system has an additional complication in that hospitals and health care providers are able to charge more than the base fees set by the French Government (tarif de convention). These range between 100% - 400% of the base fees for treatment.
The two types of Top-Up Health Insurance are:
- Basic health cover plans. This type of insurance policy covers the cost of hospitalisation, including paying for your stay in hospital and any treatment.
- Standard health cover plans. In addition to paying for hospital treatment, this insurance policy covers the cost of optical (e.g. lenses and frames) and dental work.
Critical illness cover is not a standard feature of Top-Up Health Insurance cover and is insured separately. Social care costs are also not included under this type of insurance.
Top-Up Health Insurance policies are offered according to varying levels of cover; for example if you live in Paris or an area with health care costs higher than the national average you can opt to pay a premium which covers 150%, 200% or more of the base fees to ensure you receive a higher reimbursement.
For most health or medical treatments there is also a contribution forfaitaire; normally €1. Your health insurance policy plan may also require a contribution depending on your cover.
Top-Up Health Insurance policies are provided by insurers and other finance organisations (e.g. Pacifica underwriters of all Credit Agricole Britline Top-Up Health Insurance policies).
Applying for Top-Up Health Insurance: Information Required
When applying for Top-Up Health Insurance the following basic information can be required:-
- Your age.
- Family situation (partners/spouse; children etc.).
- Health needs (e.g. how often you visit your doctor, medicines).
- Choice of cover.
Generally a health insurance plan will have no waiting period before you are able to make a claim against your Top-Up Health Insurance and there are no medical examinations.
The minimum age for most health insurance policies is 18 years. Top-Up Health Insurance policy cover does not have a maximum age.
Top-Up Health Insurance policies are not tax deductible.
Do second home owners need Top-Up Health Insurance?
No. If you own a second home in France your healthcare is covered under international reciprocal arrangements between France and your principal country of residence (e.g. the UK or Ireland) and you do not need a separate insurance policy. Temporary visitors to France from the EU/EEA/Switzerland can access public healthcare if they have a European Health Insurance Card (EHIC). It is advisable to take out Travel Insurance when travelling abroad to meet any unexpected medical costs as a result of rescue and repatriation which are not covered by the EHIC.
Private Healthcare Insurance plans
For residents living permanently in France and who do not qualify for French health care it is advisable to take out a private healthcare insurance plan.
How you claim for Top-Up Health Insurance
If you have medical expenses as a result of a visit to a doctor, hospital or pharmacy, present both your Carte Vitale and your mutuelle – your Top-Up Health Insurance card – when paying for your treatment. All health insurance claims are processed electronically and automatically and you will receive reimbursement directly into your bank account based upon your plan and insurance policy. You may have to request the link be made between the state insurance and the Top- Up insurance company for the reimbursements to automatically take place.
Getting Insured for Top-Up Health Insurance
Credit Agricole Britline’s friendly bilingual English speaking team can create a tailor-made Top-Up Health Insurance policy with a health care plan that meets the needs of you and your family. Our health insurance policies come with a competitive premium and excellent health care coverage. Contact us today.
The Health insurance contract is provided by PACIFICA, the insurance company, subsidiary of Crédit Agricole SA. PACIFICA: Company regulated by the "Code des Assurances". Limited company with a consolidated capital of 252,432,825€ untied funds. Head office: 8-10 boulevard de Vaugirard - 75724 Paris cedex 15.352 358 865 RCS Paris. The events guaranteed and the conditons figure in the contract.
This contract is issued by your regional head office Crédit Agricole Normandie, registered with the ORIAS as a broker. Crédit Agricole Mutuel de Normandie co-operative company with variable capital, approved bank – Head office situated 15 Esplanade de Brillaud de Laujardière – CS25041, 14050 CAEN CEDEX 4 – Registered in CAEN under the company number 478 834 930 - Brokering company registered on the « registre des intérmediares d’assurance » n° 07 022 868.
Contact your CA Britline advisor to find out the full details and conditions of this offer in your regional office of Crédit Agricole.