4. Voluntary 'Top Up' Health Insurance in France

  1. Limits of State Health System
  2. How Much do you Pay?
  3. Does a Top-Up Policy Make Sense?
  4. Obtaining Voluntary Health Insurance
  5. Terminating Your Top-Up Policy

4.2. How Much do you Pay?

The contributions you make to a voluntary insurance scheme will be in addition to the social security health contributions you will pay, although those EEA expats with a S1 health exemption certificate do not pay into the State system.

In addition, the income exemption levels in PUMA, the main branch of the health system, are so high that few early retirees pay the statutory health insurance charge.

As the government seeks to make savings on the social security system some of the costs are being passed on to the voluntary/ complementary insurance system.

The cost of voluntary insurance will depend primarily on your age and the level of cover you require.

As a general rule, the insurers do not consider your health circumstances when considering your application, so the amount you pay is unlikely to be affected by your state of health.

This rule does not always apply in the case of the private insurers, but is universally applied by the non-profit mutuelles. Private insurers may also exclude cover for certain illnesses contracted prior to the insurance being taken out.

Neither can the insurer increase your premium because of illness. Thus, your premiums each year are completely unaffected by your state of health, or the treatment you may have received. In reviewing the level of the premium each year, the insurer must apply a uniform increase/decrease to all clients on the same basis.

In relation to age, some private insurers and the mutuelles do refuse cover to new applicants over 65 years of age, in some cases as low as 60 years of age. This is by no means a universal rule, and there are insurers who have tailored policies designed for those 65+.

Most insurers offer insurance cover on a scale of 1 to 5, with ‘5’ being the highest level of guarantee. It is rarely the best value for money to subscribe either at the lowest level or the top level.

To give some idea of costs, a couple aged 55 years, not in employment, seeking a guarantee level of 3 for all types of treatment would pay between €1,500 end to €2,500 a year at 2021 rates. Those aged 60+ would pay more.

We published an article on price movements in 2021, which you can find at Mutuelle Health Insurance Tariffs 2021.

Depending on the level of your income you may be entitled to assistance with these costs via the State. For more information read our page on Assistance with Health Costs.

Next: Does a Policy Make Sense?

Back: Limits of State System

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