Mutuelle cost 22% increase this year

[Iceni]

We have just had our annual mutuelle increase - it is over 20%. This it seems is due to the changes brought in by the French gov to move some charges over to them. We have maximum cover for hospital and ancillary charges and if a consultant charges 500% of the norm we are covered. It does not cover specs or teeth. My specs are very expensive but most of that is down to the design and 'made to measure' need that I have. Teeth, well we are used to paying for them and I would imagine that mutuelle cover for the £1200 cost I racked up in the UK in one year on the supposedly NHS would be even more expensive.

Has anyone else had such a nasty shock? I have to say though that cover for both of us is less than my annual BUPA cover in the UK with all the restrictions that had.

[Val_2]

Mutuelles have been creeping up steadily over the past couple of years anyway so those people looking to relocate here along the lines of thinking its cheap to live in France,do your sums well because its a lot of money to find monthly especially for families with very little or no proper income and without it,you run the risk of losing all you own. Its not just mutuelles either that are going up, our work and deçennal insurance has already increased by over13% since last July to Jan 1st this year and this with no claims by us whatsoever in 10years and I understand it will go up again later. URSSAF have already sent warnings out to artisans that our charges are going up by some 2000€ this year on top of what we already pay quarterly. Ho happy days!

[Iceni]

A friend went to the doctor over here with a chesty cold - same cold I had. He got 4 items on his prescription, I have carried on with over the counter painkillers and drinking lots. He has just got his mutuelle sorted out and to his horror found that 2 of the 4 items are not in the gov. list and the pharmacy wanted payment from him. He assumed that the mutuelle paid for everything . So just because you have a mutuelle you may well find that less and less items are actually covered and you have to pay in full for more than you bargained for.

I have to say Val that insurance is going up by leaps and bounds all over Europe - not much comfort to those of us in business but a sad fact. No, this is not a cheap place to retire to but for many, us included, there are some major things that are cheaper if you choose your area well and so it can be swings and roundabouts.

I always hope that any form of medical insurance I take out is money down the drain. When I started BUPA I was supposedly in good health - my GP attested to this. I made a profit from BUPA in all the many years I had it and although I would not be here without the speed of service it gave me, I would much rather regard it as something I never got any benefit from.

[Teamedup]

I was wondering if your 500% really does cover all the depassement d'honoraires. Have you any idea as to what the base tarif is. I have tried looking at amelie.fr and as usual can find lots of stuff, but not this.

We are lucky our mutualist is not too expensive as it is run via the CE. However, even ours has crept up and up over the years.

[ronadam]

This is the first indication I've read of levels of increases in premiums paid by others in France, whether Mutuelle or otherwise. We have been top-up insured by Generali for the last 3 and a bit years. Annual increases have been 11.8 %(April 2003), 10.9 %(April 2004), and now 15.6 %(April 2005). Before signing the policy in 2002 I asked the broker what the general level of annual increase was likely to be  - his answer - "In general, health policies usually increase by about 3 % each year". I will be contacting him imminently for his comments, but meanwhile would be pleased to hear of any other experiences.

[Iceni]

The policy increase was minimal last year - it has all come together in one huge chunk this year.

[Teamedup]

ronadam, the government has radically changed the amounts that they reimburse over the last year or so.  And the government is making us pay more for less too. I reckon your agent was probably right three years ago.

[Logan]

The most cost efficient way to provide health cover in France in my opinion is to have a hospital related policy with an insurance company, not a full mutuelle.These usually cover anything related to hospital care, ambulance and after care. Exclusive Health care have an excellent full refund contract. There are also other companies doing the same thing. You need a carte vital for this to work. You simply pay the other differential costs yourself, ie: Pharmacy and any laboratory tests etc. It works out over a period of 12 months much cheaper. Of course it depends on your state of health as well. I have regular medication and tests and find the overall costs much cheaper than a full mutuelle. It's a way of combatting the mutuelle price hikes which can only continue to increase as the state rolls back its healthcare burden.

[Jon 1]

Could you please indicate the cost for hospital only care, and contact details for the company you mention.

Thanks

[Logan]

Jon.

I have sent a private message in your box with the detail you requested.

 

[Deby]

Mutuelles are expensive and not very good value for money and only serve peace of mind and 'what if'!

Yes, France supposedly has the best health care in the world, mmhh - this is up to interpretation.  I despair at the doctors here.  A generalist is good at over-prescribing things for the common cold - always at least 5 items on the list.  I now cross them off if I don't think they are necessary.  I have recently forked out lots of dosh on 'women's stuff, only to be given the runaround by having unecessary radios (x-rays)! 

There is so much waste by over-prescribing - the French answer to this is CyclaMed - give your used/unused products to Third World (which I do btw). 

How much do we all pay in social charges, eh?

A friend of mine is a newly-qualified french GP, if he wants to set up his cabinet, he needs loads of dosh, he also has to payout loads to the Govt in charges.  How can he do this - ahh the drug companies will help him because he will over-prescribe.

And,!  The french culture is to blame too.  They expect at least five items on their ordnance otherwise they consider the GP is crap and go search for another one who will give them what they want. AND they are hypocondriacs, creams for this, snot-suckers for that.  I know some of my french friends think I am a bit permissive with my view of children's healthcare, but PLEASE the system is good in someways, but like anything else it is not and it is darn well expensive.  It will bankrupt France if they are not careful, hence the increases, I fear there will be alot more.

Pass me a glass of wine.... tis good for my heart!!!

Deby

[Miki]

".....snot-suckers for that"

What is that when its at home Duchess ! I feel a want for it whatever it might be, the name alone is worth a mutual coughing up for it, so I can have one!!

No need to say I agree with what you say about the general health service in France. We know all the good it can do and how it appears so much better and yes, for the most part, operations are performed a lot quicker but many of us here have surely noticed a slow down for certain rendezvous with specialists. The opthamologists are getting longer to wait, as well certain dental treatments and specialist ops.

We pay more now than ever and whenever you read in the papers about the French health service, it all indicates to an ever threatening crisis. Funny enough a few of us spoke on here about this some time ago and were told B******t, the health service is brilliant around here, well yes it has areas that are indeed excellent but so has the UK.

But the threat of a complete and costly overhaul are real and dare I say again, that the UK is being studied due to its thought of being excellent and well run ! Not my words but this is from the French government themselves.

[Logan]

I agree very much with the last 2 posts about the French health service. Mutulles may have been a good idea once but now they are getting very unaffordable. The prinicpal cost of health care in France is hospitalisation. Cover this with an insurance company who are profit making and not sharing their costs directly. I accept that in the end all costs are passed on to subcribers but mutulles have the burden of French hypocrondria to support. If you control your GP and not the other way round, do not run of to the labo every time you have a pain. Be sensible with the amount of drugs you need and pay the differentials yourself money is saved. It's common sense really. Taking responsibility for yourself not handing in over to somebody else.   

[Deby]

A snot-sucker was prescribed to me by a GP when my baby son was a few months old with a cold, he said I had to put this contraption up his nose and suck out his snot with it as he was far to young to blow his own nose......  Of course I didnt.  I have seen one as a friend had one and what a contraption it was too!

On the subject of Ohpthmologists (sp) we made an appt in Jan and have one for June.  Tried to make an appt with a dermotologist last week and told earliest was in June.

Deby

[Miki]

[quote]A snot-sucker was prescribed to me by a GP when my baby son was a few months old with a cold, he said I had to put this contraption up his nose and suck out his snot with it as he was far to young to ...[/quote]

OK Duchess, thanks, sounds too much like something from the Spanish inquisition, so I think it will be given a swerve.

Went to the Specs place last month in our local grand surface and I said I was interested in their two for one (not quite how it appeared but for France, not too bad !)I told them it had been around 18 months since my last visit to the Opthamologist and so as I would have to wait to get an appointment, I wanted to know how long the offer was on for ?

He said I could have my eyes tested by them within a couple of days but I forgot to ask whether he did the tests that the specialist did, Glucoma for instance.

I am going there on Tuesday and will see what they do in comparison to the specialist.

[Tourangelle]

Although I agree with the comments on the French health service in general I have to say my mutuel has not gone up significantly. Looking at those who have posted, I wonder whether it is the self employed who are losing out, those mutels which are within certain sectors, or only open to certain jobs seem to have their advantages. I have a friend who has an excellent mutuel, and who only pays a fraction because his company pays the rest.

[Owen]

Hello Logan

If I may so your posting is a little simplistic. I am not an insurance broker, I hasten to add. The difference between a commercial insurer and a "mutuelle" is there but is less distinct than it used to be. Certainly "mutuelles" put less emphasis on medical risk which obviously invites higher claims than what a commercial insurer may have to meet. But nothing is simple in France. "Mutuelles" receive favourable tax treatment. Since the rewriting of the "Code de Mutualité" they have been allowed to introduce some conditions of acceptance. Commercial insurers have to ignore medical conditions to obtain potentially lucrative group contracts. Commercial insurers generally apply more criteria than "mutuelles" in establishing premiums but not all insurers use the same criteria.. For example, some providers will take into account sex (women under 60 claim more than men!). A "mutuelle" would not make such a distinction. As for the provider of your choice they clearly meet your needs. But some people would rule them out immediately because their underwriters do not have (as far as I know) a rating by an independent agency such as Standard and Poors or A M Best. In short, both commercial insurers and "mutuelles" have a part to play in healthcare provision. In my opinion they will play an increasing part, in percentage terms, in healthcare funding in France so the choice of provider will take on greater importance.

Regards

Peter Owen

[email protected]

[Battypuss]

I unfortunately have various health issues that need to be addressed from time to time; thus have a mutuelle for both myself and the kiddiwinks. The price makes me cry, and has increased by 48% in three years since the CPAM decided to revise their rules about non-working people or those officially shoved in a box marked 'disabled'. The former get free everything, the latter sadly do not. Guess which box they shoved me in! Luckily, I gave up trying to understand the French years ago (does NOT mean I don't like them) but if they cart me off to the funny farm sometime in the future, I am of the understanding that the bloody mutuelle will cough up. Would not pay for my daughters' glasses however, and she is blind as the proverbial bat without them, until I hammered on the door and called them a lot of very rude names. A cheque arrived in the next post. Very odd.

[Iceni]

I have to say that after a very bad experience with health insurance in the UK we went down the mutuelle route. Anything which 'may' have exceptions written into the policy I avoid like the plague - because if there is a rule somewhere they will find it.

I had good experience of BUPA in the UK but our joint mutuelle (although the cost makes my eyes water) is not as much as a policy just for myself with BUPA. I was one of the unfortunates that made a profit in the years I had BUPA and I agree that women under a certain age because of their physical differences to men are quite likely to claim more.

How we will cope as we get older is a concern BUT as John's problem was not treated at all in the UK as 'we don't treat back problems in people over the age of 50 so he will probably never walk or be fully mobile again' was the NHS retort, for us it simply has to be better. He is downstairs doing his normal stint of building work and fully mobile - under advice he took a job as a temp postman in the UK and got better by lugging post around and more importantly cycling. We did not bring his Zimmer frame to France (and YES, he was given one - total treatment offered).

Sorry to go off-topic a bit but you have to compare systems and for us we currently have peace of mind. As Owen says, as things change and we get older, so we may well have to change how we cope with such issues/systems.

[Logan]

To Peter Owen.

Thanks for your post regarding this debate but I'm not really sure what your point is. My "simplistic" approach to healthcare insurance is based on common sense. If you have a carte vital and cover the full risks of hospitalisation cost and not just a percentage as with a mutuelle, what is left to pay? Visits to the doctor, pharmacy and laboratory tests, visits to a specialist as an out patient etc. All these costs are reimbursed between 60% to 70% by the state. So it does not take a great deal of brain power to calculate the annual financial risk to yourself by not having a mutuelle the costs of which disappear relentlessly from your bank account and rising every year that passes. I accept this may not work if you have severe health problems and require constant out patient treatment. I have chosen Exclusive Healthcare as my provider but there are others as you know in the market offering similar deals at similar costs. I am satisfied of my companies bona fides. As with any insurance provider you have to take a balanced risk assessment. In my opinion the mutuelles can only get more expensive in the future because the state is moving towards subsidised private healthcare in France. At least international insurance companies operate in the global market place and have more realistic contracts unfettered from protectionism and tax hand outs from the state. You pays your money and takes your choice.

 

 

[Owen]

Hello Logan,

Can I say that I am not pro mutuelle and/or anti commercial insurer. In fact I use almost identical criteria as you for my own healthcare provision.

But 30% - 40% for out-patient, lab tests etc can still be a lot to find out of your own pocket and of course the 60 - 70% proportion you quote is of the tarif which is not necessarily the full bill. Secteur 2 Specialists often charge up to double or more of the tarif. so you may receive 70% of 27 Euros by the state while actually being charged up to 50 Euros or more for the consultation. You receive almost nothing for a Specialist in Secteur 3 and some dental treatment but the cost can be picked up by a "mutuelle".

I do agree with you that the premiums of mutuelles are going to rise but so will those of the commercial insurers for the reasons you state and also because medical inflation rates are running at around 8% in France. We are all going to pay more for our healthcare; it is a question of how we, as individuals, choose to do it. Commercial insurers in France, by the way, are still subject to the "Code D'Assurance", which hardly lends itself to unfettered capitalism.

Regards

Peter Owen

[email protected]

[Logan]

Peter.

Lets face it the French health service and the mutuelles have for years had the burden of French cultural hypochondria to deal with. A degree of realism is only now starting to creep in and the massive costs faced. The blunt truth is if you have a mutuelle contract in France you take part in subsidising and prolonging this hypochondria and pay for that privilege. Its quite surprising to learn the French think it perfectly normal to run off to the doctor, laboratory or specialist every time they feel the slightest pain, twinge or imagined problem. They also almost always go and get second opinions from a duplicate list of the same professionals just in case they got the diaognosis wrong.The doctors et al also play their part and over prescribe oodles of drugs which are usually quite useless. The way mutuelles work is everyone generally shares the burden of costs equally, a sort of socialist haven, contributing to the well being of your fellow man. If you feel that's an acceptable system then fine. I personally prefer to take responsibility for myself and mine alone. Life is about risk. Without risk, correctly assessed we get value. In my opinion its value that in the end creates real efficiency and a positive effective delivery of health care.

[Owen]

Hello Logan,

I agree with just about all you say but my original point was that the difference between a "mutuelle" and a commercial insurer in France is not as great as it may seem and I hope that I have gone some way to establishing this.

Actually I am appalled at the waste, over prescribing of medication etc and am still mystified by the national pastime of hypochondria. But I am sufficiently realistic to accept things as they are and, not being a French national, as I would like them to be in my adopted country.

Regards

Peter Owen

[email protected]

[Logan]

Peter.

We seem to occupy almost common ground on this subject. However I disagree that the differences are not that great between a commercial insurer and the mutuelles. As a matter of interest the difference in financial terms between an average mutuelle and my current hospital only full costs contract is about 850 euros per year. That difference will go a long way in financing my average 30% personal costs for out patient care.

Examples: Laboratory blood tests costs about 75 euros and 70% refunded - cost to me is 22.50 euros. Visit to doctor cost 20 euros and 70% refunded - cost to me 6 euros. Specialist heart consultant cost 30 euros and 70% refunded -  cost to me 9 euros. I could go on.

Total cost to me 37.50. Even if I was doing this every month of the year, (which I am most certainly not) I would be still 400 euros a year better off. I occasionally go to the pharmacy and generally strike out three quarters of the drugs the doctor will prescribe. Its not that I think I know more than the doctor, I don't, its just that I apply a little common sense and logic and not blind deference to medicos.

When you are paying some of the costs yourself there is a motive to question a little more. I often wonder if the real reason the French overburden their system is because they feel they are getting something for their monthly mutuelle payment and it makes them feel better to have cupboards stacked to the gunnels with drugs.

[Owen]

Hello Logan,

You have made the decision that all you require from your "top up" is hospitalisation cover and any other medical costs that you may incur, and not covered by the CPAM, you will fund yourself. You are comfortable with that. Equally there are many who want more from their insurance and it is not obligatory for them to be pathological hypochondriacs to make such a choice.

For example, in the event of an accident that results in a broken arm hospitalisation may not be necessary. But from seeing a doctor, pain killers,

X- Rays, perhaps referral to an orthopaedic specialist and 10 - 20 sessions of physio the bill can soon mount up even with 60 - 70% cover by the CPAM. Of course this sort of scenario or other extended out-patient treatment may never occur and over 5,10 years or more, premiums paid may well exceed costs reimbursed. But the insured has had peace of mind and, as such a plan may well include routine visits to doctors, pharmacy, dental etc, he may well consider the money well spent.

I would agree that for hospitalisation only cover, a commercial insurer is the best bet but after that, as I have maintained from the start, the distinction between them and the "mutuelles" is less clear. Many commercial insurers do not require medical questionnaires at all for their lower to medium level plans and there is a very good reason for this - they are competing with the "mutuelles".

Regards

Peter Owen

[email protected]