4. Voluntary 'Top Up' Health Insurance in France

1. 4.1. Limits of Basic Health Cover
   4.2. Limits of Voluntary Insurance
   4.3. Cost of Voluntary Insurance Contributions
   4.4. Getting Voluntary Insurance

4.4. Getting Voluntary 'Top Up' Health Insurance in France

Before you can affiliate to a voluntary insurance scheme you must be registered with the health service.

If you are of retirement age, or you are being covered through E106 arrangements, you need to make application to register in the health service to your local Caisse Primaire d’Assurance Maladie.

If you are an employee, your affiliation to the health service will be handled by your employer, who may also offer a company based scheme of voluntary insurance, called prévoyance collective, covering you and your family. These schemes often provide, not only complementary health cover, but also offer additional insurance cover in relation to death, incapacity, unemployment and retirement. They are not generally offered by smaller employers.

If you are self-employed, your health service registration will be undertaken as part of the process of your business registration.

This insurance cover is provided either by a mutual non-profit organisation or a private company, of which there are about 1000 in France.

Approximately 60% of people are insured via a mutual insurance fund (mutuelle), with a further 24% insured via a private fund and 16% in employer/employee schemes.

In terms of finding a suitable insurer, in the first instance start by speaking to people in the area about the organisation they use.

Try thumbing through the yellow pages (pages jaunes) of the local telephone directory under Assurances. You might also want to contact a broker (courtier) who will be found in the same listings.

You can also find more information on the internet by typing in assurance complémentaire on your search engine.

In order to get some idea of your likely costs there are a couple of internet portals where you can compare the offers from different voluntary insurers.

In each case you will need to understand French and be capable of completing a simple questionnaire.

Broadly speaking, the level of the guarantee in the contracts is often expressed as a percentage of the official social security tariffs. So a basic contract might offer you 100% reimbursement of official rate, but as the charges imposed by the doctor or consultant might exceed this rate, you would still be left having to fund some of the costs.

A more expensive contract might offer you 200% to 400% of the official rate, which would cover a greater percentage of your actual costs.

You also need to check to what extent the policy will pick up excess charges (notably those of consultants), which are not covered by the social security system. Some policies will only cover charges at the official rate, leaving you to cover any excess.

If you have a pre-existing medical condition, then this may determine the route you take, as the mutuelles do not seek a medical questionnaire, whereas this is sometimes required by the private insurers.

Of course, whether a mutuelle or a private insurer, there is a trade-off between the level of cover you seek, and the premiums you are prepared to pay.

Some insurers set an age limit of 65 to take out a policy with them, although in the vast majority of cases, if you subscribe before you reach 65 years, you are permitted to remain with them.

For those 65+ there are specific policies designed for seniors.

As we develop these pages, we will endeavour to provide more detailed guidance on the different contracts and their rates.