Civil servant mutual, public service mutual: how to choose it?

Is mutual insurance compulsory in the civil service?

Since January 1, 2016, the ANI law has made the mandatory company mutual for private sector employees.

Employees of the public and territorial service, for their part, are not affected by the system and can choose whether or not to subscribe to a supplementary health insurance on an individual basis.

However, ensuring the coverage of health expenses through a civil servant mutual fund is widely recommended given the reimbursement rates of Social Security.

As a civil servant, you have three options:

  • Accept collective health insurance offered by your employer;
  • Subscribe to an individual civil servant mutual fund;
  • Be attached to your spouse’s mutual insurance company as a beneficiary.

If you wish to choose your complementary health insurance yourself, it may be wise to consult a comparison of mutual health insurance for civil servants to find the formula that meets your specific needs.

Need large dental or optical reimbursements? Know that a good complementary health insurance facilitates the management of your care.

Moreover, it is possible to include your family members – spouse and children – in your contract and to allow them to benefit from the same level of guarantee and reimbursements. We then speak of a family mutual insurance contract.

Who is concerned by the specialized mutual insurance for civil servants?

The term civil servant designates all permanent or contractual agents working in the public sector. It can therefore be the State civil service (FPE), local authorities (FPT) or even the hospital civil service (FPH).

State officials

This category includes all agents working within the ministriesof the central state administration as well as decentralized services.

The latter include the gendarmes, the national police officers (excluding municipal police officers) or even the teachers of the National Education.

Territorial employees

Territorial agents correspond to people working within the local authoritiesof the intermunicipal structuresof the public establishments and public housing offices.

Hospital officials

The staff of the hospital public service includes all the jobs officiating in the following establishments:

  • Public hospital establishments (AP-HP, for example);
  • public retirement homes;
  • Public or public establishments under the departmental child welfare services;
  • Public establishments for disabled or unsuited minors or adults;
  • Public or public accommodation and social rehabilitation centres.

Namely: medical personnel (doctors, biologists, pharmacists and orthodontists) are not included in this category.

Retired civil servants

When a public sector employee retires, they may continue to receive the support and benefits of their provident scheme.

Nevertheless, the needs of retirees in terms of reimbursement are changing. This is why it is recommended to opt for a more complete mutual pension.

Who pays the civil servant mutual fund?

In theory, it is up to you, as an employee, to settle the contributions from your complementary health insurance.

However, since January 1, 2022, the law has provided for a compulsory lump-sum reimbursement of up to 15€ per month to help you reimburse part of your health insurance costs.

This is a first step towards the 50% coverage of your complementary health contract from 2024.

This financial assistance is paid to you by your employer, whether you are employed full-time, full-time or part-time.

Good to know

  • You can only benefit from the lump-sum reimbursement if you contribute to a mutual fund covering your medical costs and your risk cover costs as well as the costs related to maternity.
  • In effect, this system does not apply to contributions to a pension contract.

You do not yet benefit from the fixed reimbursement of your complementary health insurance? Make a request to your employer now, attaching your mutual insurance certificate. Once your request has been accepted, the reimbursement will be directly entered on your payslip.

What are the guarantees of the civil servant mutual?

A good civil servant mutual insurance contract must include solid guarantees but also reimbursements adapted to your specific needs.

As a reminder, your mutual supplements reimbursements from Social Security, which are often insufficient.

For choose the best complementary health offerthe following should be considered:

Keep in mind that mutual insurance must above all correspond to your health needs and those of your household.

For example, it is not wise to take out a high guarantee for optical care if you have never needed a correction. As regards the health insurance rates for civil servantsthese may vary depending on the formula chosen and the extent of the guarantees selected.

Which health insurance to choose when you are a civil servant?

As a person working in the public service, you have the choice of subscribing to a general mutual fund or a specialized health insurance for civil servants (certified mutual).

Generalist mutuals

Opting for a classic mutual is entirely possible and sometimes even recommended depending on your profile.

Indeed, it is possible to find very complete contracts including all the guarantees you need. To know which mutual to choose, pay attention:

  • to price according to your budget ;
  • to level of coverage of your contract (level of health coverage);
  • to refund of co-payment (i.e. the amount remaining at your expense after reimbursement from Social Security)

Labeled mutuals

These health insurance policies have been designed to meet the needs of public sector employees and offer services accordingly, depending on the trades.

In addition, some insurance companies offer preferential rates (with a very small remaining charge) on a network of partner practitioners.

Here are the different existing mutuals for civil servants:

  • MGEN (General Mutual Fund for National Education): intended for teachers and staff of National Education;
  • MHN (National Mutual Humanis): for agents of the health and social sector;
  • DTM (National Territorial Mutual Fund) / Interior / MNFCT (National Mutual Fund for Local Government Civil Servants): for territorial agents;
  • MAEE (European Foreign Affairs Mutual): intended for expatriate agents;
  • MGEFI (General Mutual Economy, Finance and Industry): specialized for agents of the Ministry of Economy and Finance.
  • UNIPH: for hospital civil servants

In the endbe aware that the choice of a mutual civil servant or a general mutual fund belongs to you!

Do you want to quickly find the ideal formula adapted to your health profile?

Our mutual insurance comparator is free and offers non-binding quotes: do not hesitate to make a simulation to obtain your comparative study.

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