mutuelle frais medicaux 100%

[sofia]

Can anyone please advice me if "frais medicaux 100%" in a top up insurance policy really means that they will cover the cost of the medication entierly or is it 100% of some "tarif" like for consultations.

[cooperlola]

Afaik, medicines are normally reimbursed in total by top-up insurance  companies and are not affected by variations in tarif, like doctors and other medical practitioners can be.  However, there is a small prescription charge which is not reimbursed (franchise) of 50c (up to a total of 50€ a year) which goes direct to the French exchequer.  But check your policy to be sure!

[Polly]

The 'franchise' is not paid out by the mutuelle, they repay you in full and then sneak it back by only paying some of your GP's fee back to you for example.

You might also want to check if the policies you are looking at cover the costs of staying in hospital, ie the daily rate for accommodation & food, or even the cost of a TV in your room, aside from medical costs. Obviouly the more the policy covers, the higher the premiums. You choose!

[Sunday Driver]

If your top-up gives you 100% of medical fees, then that pays for the part of the charge not covered by the state (ie, the ticket moderator) but only up to the limit of the tariff. If a dépassement is involved (ie, a medical fee chargeable in excess of the tariff) then your top-up will cover up to the tariff, leaving you to pay the excess.

 

[cooperlola]

Sorry Sofia, I thought you were asking about medicines specifically.  But of course Polly and Mr Driver are correct.[:)]

[sofia]

Thank you all and thank you cooperlola. You are right, I was asking about prescription medicins specifically.

I have inquired about mutuelles in general before and received good answers and I think I have a good grasp on what the percentages in the secteur non-conventionné means, ie not much. :)

[sofia]

My bad. I meant "Pharmacie 100%" not "frais medicaux 100%". No wonder I confused you all. Sorry.