Health insurance clarification.

[suej]

 

We have had medical assurance through GAN for a number of years and I'm afraid we have just gone on paying the premiums each year without giving it much thought or at least not thought about it in advance of the renewal date. It is due for renewal in January and we would like to check it out and perhaps change things this time.

First of all , so that I'm prepared for whatever questions I'll need to put , would someone please clarify the terminology for me:   Is a 'complémentaire'  the same as a 'mutuelle' and as 'a top-up insurance' ? So that I'm sure I'm asking for the right thing...

We need to work out what amount of cover we need.

Our current policy gives us 140% hospitalisation, chambre 60euros and  several other Frais medicaux at 140% but not much dental or optique.

We are both now in our 70's in , touch wood,comparatively good health . My husband has Type 2 Diabetes  which fortunately seems well controlled with Metformin but has not ALD status- (don't know why our doc seems a bit reluctant and appears to 'forget' to apply)

We have Carte Vitales

Our Gan premium this year was 2500euros and will no doubt increase by a couple of hundred at renewal in Jan.

We definitely want to keep some form of top-up but any thoughts or advice would be much appreciated.

Thanks Sue

 

[Sunday Driver]

Your GAN policy is marketed as Complémentaire Santé which is a top-up insurance, also commonly known as a 'mutuelle'.

Your current policy covers you for up to 100% of the standard tariff plus an additional margin of 40% to cover any dépassements.  As most treatment providers tend to be conventionnée, you could opt to reduce your cover to 100% and fund any occasional dépassement out of your own pocket.

We are insured with Groupama with 130% cover and apart from having to pay part of a dental bill this year, we've never had to pay anything to obtain treatment.

 

[suein56]

[quote user="Sunday Driver"]As most treatment providers tend to be conventionnée, you could opt to reduce your cover to 100% and fund any occasional dépassement out of your own pocket. [/quote]

This is what was recommended to us when we took out our cover with Groupama at 100%. Though we opted for greater cover in the optical and dentist sections as we both wear specs and change them every 18/24 months.

Sue

[EuroTrash]

The way I understand it - top-up insurance, or complémentaire, is available from 2 kinds of providers, either 'mutuelles' which are not-for-profit companies, or private insurance companies. Both are, I believe, tightly regulated by the state.

Beyond that I have a vague feeling that there are differences between the way the 2 sorts of company operate and are taxed, and traditionally I think they offered slightly different types of policy.

And that's all I know. Bye.

[tinabee]

You could check out some prices online at this price comparison website

http://www.assurland.com/

There are also some good guides on the site (what's included, how to cancel, etc)

http://www.assurland.com/assurance-blog.html

I do have a recollection that it can be more expensive to take out insurance with a new insurer the older you get, so do check carefully. I am sure GAN will have options to adjust your cover (and cost), especially if they know you are considering changing supplier.

[suej]

 

Thank you all for your replies, they have answered some of my queries and set me on the right road. Thanks for the link Tinabee, I'll have a good look at that in the morning. It'll be useful to have an idea of what is available and some likely premiums before we go out looking for devis.

As always I am amazed at the amount of help that is proffered on this forum- Thanks!

Sue

[NormanH]

There are a number of pitfalls with Mutuelles.

In short the small Print!

I have 3 ALDs, so much of my care is covered but where I do need Mutuelle cover is in the support for the extras, such as a single room, the 18 € a day 'forfait' etc.

Unfortunately as I said on another thread a while ago what you see in the large print when you buy may not be totally the case when you come to need them  ..

For example mine limit the number of days they pay some things, and don't cover them at all in Nursing homes, despite a site on which these limitations are not really clear.

With a Mutuelle,  and an ALD I paid out nearly 3000€ even so for my recent treatment, and I just got a demand today for 252 € which they paid the nursing home, but now reckon was over my allowance..

[Will]

In Britain thre is a clear division between mutual insurers and commercial companies, though the former may not necessarily be cheaper or more beneficial than the latter. In France, the divisions are rather more blurred, so 'mutelle' and 'complementaire' have come to mean much the same thing. Companies that describe themselves as 'mutuelle' may have been 'mutual', i.e. sharing profits among members/policyholders, in the past, but are probably just subsidiaries of  commercial insurers at present.

[EuroTrash]

I don't think a company can claim to ba a mutuelle if it's not.

This seems to sum it up quite well:

http://www.devismutuelle.com/guide/choisir-mutuelle-ou-assurance.asp

(the like probably won't linkify itself, they never do with Chrome, sorry)