westland Posted November 18, 2006 Share Posted November 18, 2006 Well I know that there are lots of threads about top up health insurance but I am still prompted to look for any comments or up-to-date information in view of the fact that our insurance seems to have significantly "moved the goal posts" without letting us know.I know that there have been some changes to the Securite Social remboursements, but it's a bit difficult to get to grips with exactly what has changed. Things have started to happen such as paying towards a one off prescription which this time last year was totally reimbursed. In the scheme of things it was a few euros, but it did ring alarm bells that I should try and get to the bottom of what's changed.I decided to check out the website for our mutuelle top up insurance and found that not only have they changed the name of the scheme that we are signed up to, every single "module" has had it's level of reimbursements significantly lowered. They used to offer up to 450% for anyone who wanted to/could afford to pay the premiums but now the most that can be obtained is 200%.I am interested to know if other members have found this happening. We have also found that the premium has risen by 10% each year having just received the statement for next year's direct debits.We went with a "Mutuelle" rather than an insurance company having read up that the premiums should remain more stable in spite of getting older, but now I'm not so sure that this is the case.Thanks for any information re the above. Kate. Link to comment Share on other sites More sharing options...
Owen Posted November 20, 2006 Share Posted November 20, 2006 Hello,You have raised a couple of points here. First of all because there has been a move over the last 3 years particularly to move some of the health costs from the state to the individual or the complementary insurers, there has been an inevitable increase in premiums. For example,here was a hefty hike in routine dental costs this summer and as a result insurers are expected to pay out an extra 90 million Euros per year in reimbursements.I see very little substance in your reading of "mutuelle" premiums being more stable. For a start "mutuelles" do not put great emphasis on medical risk. Indeed the legislation by which they are regulated allows little scope for this. The other problem with "mutuelles" is that there are just to many of them (over 1000) and I forecast there will be massive consolidation in this business. So if you choose a "mutuelle" I would say that size matters.Commercial insurers do put more emphasis on medical risk because there is the profit motive. But actually many providers do not require medical questionnaires except for their plans which offer high levels of cover. Commercial insurers do use more criteria than "mutuelles" in assessing premiums and not all providers use the same criteria.High percentage cover in the order of 450% for most people will only be relevant when it comes to such things as dental and optical cover. In most areas of France 200% should be OK for most things.In choosing a provider, whether "mutuellle" or insurance company, your individual financial and health circumstances should determine your choice.RegardsOwenpjowen@expathealthdirect.co.uk Link to comment Share on other sites More sharing options...
westland Posted November 21, 2006 Author Share Posted November 21, 2006 Thank you Owen for your reply. I was concerned that with our current "mutuelle" provider we now do not have the option to upgrade our percentage cover much further, which is something we had thought of doing in a few years time in order to be better covered in advancing age. We didn't really want to start swopping around between providers. Your comment that 200% should be OK for most things is useful to know as it's the emergency /serious illness events that are the main concern. We have already had shock devis/bills for dental work as I know many other forum members have experienced. Just as an extra query we are now only covered 100% for white and blue labelled prescriptions, do you have an idea what impact this might have? Thanks. Kate Link to comment Share on other sites More sharing options...
Owen Posted November 21, 2006 Share Posted November 21, 2006 Hello Kate,I think you are correct in not wanting to go swapping around in your circumstances. In any case the older you are the less the choice of provider available. For the forseeable future, in my opinion, the cover for the serious stuff will be there and most of it covered by the CPAM. Dental work, other than routine stuff, has always been expensive and not particularly well covered by the CPAM either.Medicines. There is now an additional orange label medicine where the CPAM cover is only 15% compared to blue (35%) and white (65% or 100%). A plan that covers 100% is OK. It is rare that a tarif of more than 100% is charged for a prescribed medicine and even on those occasions, in my experience, any supplementary charge has been minimal.RegardsOwenpjowen@expathealthdirect.co.uk Link to comment Share on other sites More sharing options...
westland Posted November 21, 2006 Author Share Posted November 21, 2006 Thanks again for the useful information re. the different types of medicine cover. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.