Health insurance, or complementary health insurance, is an insurance contract that allows covered persons to receive, in addition to the reimbursements guaranteed by health insurance, a supplement to cover expensive health expenses. The list of interventions covered by Social Security and their reimbursement rate tending to fall in recent years, recourse to health insurance has become increasingly necessary in the face of soaring health costs.
Collective or individual contract?
It is not uncommon that in addition to your classic individual supplementary health contract, your company itself has its own mutual insurance solution to cover part of the health expenses of its employees. The advantage of these contracts for employers is to pool health risks and obtain, for equivalent contributions, more attractive benefits.
The principle is simple: companies negotiate lower prices for all employees, the reimbursements of employees having more frequent use of their complementary being compensated by the savings of employees in good health. Knowing that it is common for the employer to cover up to fifty or sixty percent of the contributions payable by him, the complementary collective company health insurance is an often very advantageous solution for the most common health costs. But check nevertheless that certain particular clauses relating to your own state of health do not nevertheless require the subscription of a more advantageous individual complementary. And don’t forget that company mutual insurance often only covers the employee, and not his or her spouse.
Beware of false good ideas
If you have to choose an individual health insurance contract, beware of some false good ideas and reflexes that can be unfortunate. First of all, you should not necessarily rush to the main big names in the market, simply on the pretext of their popularity. Some less renowned insurers sometimes stand out by offering guarantees that are at least as advantageous, and this for premiums that are sometimes up to thirty percent cheaper.
Bringing the competition into play therefore remains the best possible option. Also beware of insurers who may require you to complete a medical questionnaire to better understand your profile. Because behind the good intention sometimes hides a less rosy practice: potentially being able to increase your insurance premium by considering yourself as a patient at risk for the care you are targeting in particular. It is also not necessary, at the time of your subscription, to accumulate the guarantees on your contract if your state of health does not underline the need for it. The principle of a health insurance contract is to be scalable, even cancellableand nothing will prevent you from subsequently changing your contract according to your needs.
Which clauses for which needs?
Even more than the amount of your contributions, it is your needs and those of the beneficiaries of your health insurance that must guide your thinking above all. Opt for the best possible optical guarantee if you wear glasses, or the best dental guarantee for your children’s dental appliances. A good health insurance is less a versatile supplement than a supplement that addresses your most important needs first. But beware, some ready-made packages not only do not include certain guarantees, but even automatically exclude others.
While most concern “comfort” care, such as cosmetic surgery or spa treatments, others can sometimes be more important, such as medical cases resulting from your responsibility, such as suicide attempts. Similarly, pay close attention to the wording of the clauses with regard to reimbursements: some speak of a percentage reimbursed (particularly for optics and dental, in relation to the moderating ticket), others of ceilings in euros, and still others of annual packages. Always choose the solution that seems most satisfactory and transparent to you.
Compare according to your budget
The simplest method to make a choice therefore remains to use online comparators, which are often complete and which will allow you to have an exhaustive table of all the treatments covered and the associated reimbursement rates. These comparators can also lead you to address points that you did not initially think of, such as the whether or not third-party payment is supported if your status does not oblige you to do so.
Comparators can also lead you to take an interest in repayment and waiting periods so that you can optimally benefit from compensation as soon as possible. Reimbursements within a maximum of forty-eight hours are now widely democratized, so you should be entitled to benefit from them on your health insurance contract.
By the editorial staff of the hREF agency