What is complementary health or provident insurance?
Provident & complementary Health: What is it?
Health insurance is compulsory for companies. Discover a series of articles here to find out how to best choose the different possible contracts, whether you are in Arras or in another city ...
supplementary health and provident insurance
Definition of health provident insurance
How does complementary health care work?
The various possible complementary health insurance contracts
What are the guarantees ?
How to choose ?
Blog articles on complementary health and provident insurance
Definition of health provident insurance, explanations
In France, all workers are required to join one of the social security schemes corresponding to their socio-professional status. It’s like compulsory health insurance. However, this insurance only covers part of the reimbursement of treatment costs: 30 to 70%. The rest is the responsibility of the patient, unless the latter has subscribed to complementary health insurance.
Complementary health: functioning
The complementary health insurance is a health insurance contract whose main purpose is to cover part or all of the health expenses not covered (user fee) by the compulsory health insurance (General Regime, RSI, Alsace Regime- Moselle, Mutualité Sociale Agricole…). It can be offered by different types of organizations: public limited companies and insurance companies, provident institutions (IP) governed by the Social Security Code as well as mutual health organizations.
The costs covered by complementary health insurance may vary from one contract to another. In all cases, subscription to these contracts is optional except for certain group or company mutual insurance contracts.
The different types of complementary health insurance contracts
There are 2 types of complementary health insurance contracts:
Individual contracts which offer the subscriber the possibility of choosing the guarantees he wishes;
Collective contracts: it happens that companies take out an insurance contract on behalf of their employees. In this case, the company will bear part of the premium, usually 50%. The scope of reimbursements varies by contract. But there is still basic coverage. And if the employee wants to increase his coverage, he can add so-called "supplemental" insurance. The latter will cover some of the costs not foreseen by the company mutual.
Apart from that, know that today a good part of the complementary health contracts are said to be responsible. On these contracts, the amount of contributions is not set on the basis of the state of health of the persons covered. Established to empower patients and complementary health insurance, these contracts provide for the payment of:
At least 30% of the cost of the attending physician's consultations;
At least 30% of the basic price for drugs;
At least 35% of the cost of analyzes carried out as part of the treatment path;
Amount of user fees for at least 2 priority prevention services.
What are the possible guarantees?
The guarantees offered by complementary health insurance are numerous. It is therefore wise to compare the formulas offered by insurers in order to determine which ones best meet your needs. A supplement with basic coverage covers:
Consultations and medical care;
Medicines purchased from a pharmacy;
Hospital costs;
Dental care and prostheses (braces, bridges, etc.): be careful, remember that dental implants are not reimbursed by health insurance;
Optical care;
Hearing aids.
But in addition to the user fee (basic coverage), some contracts can provide full or partial coverage:
Fee overruns;
Alternative medicine (sophrology, reflexology, osteopathy, etc.);
Non-compulsory vaccines;
Additional services (personalized follow-up, assistance, etc.);
...
It goes without saying that the more the complementary health contract offers significant reimbursements, the more expensive it is.
How to choose your health insurance?
Choosing the complementary health insurance best suited to your needs is not an easy thing if you consider the size of the offer. To help you in the choice, proceed in stages:
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