Comparing Mutuelles

[Ron Avery]

I am looking at taking out a mutuelle.  I know its about time

Have had a look on the internet for cost comparisons  looked at Asuriane.fr and been to see Groupama and AXA.  There is a vast array of policies out there of course age  does make a big difference to premiums, and all the options seem to be tailored for those who have dentures and/or glasses.  Three questions.

1) Is there an internet site that compares Mutuelles costs/benefits  etc like the Electricity one in the UK called U Switch?

2) If I have a policy that pays 200% does that mean the cost gets paid and I get the cost of the treatment/service reimbursed to me as well( A bit like h HSA in the UK?)  If not, what does 200% mean?

3 )Is there a mutuelle that allows a couple to have a different policy, Groupama told me that although I don't have dentures if my wife does I have to have the same policy.

PS Will the change in the cost of some "traitementes superiores?", announced yesterday (was it just blood tests?) have an affect on premiums? 

Any recommendations, for mutuelles,  perhaps by PM so as not to block the site up, gratefully received

[derf]

If you haven't done so already you could look at this site, I have not checked it out but it looks interesting.

http://www.123-assurances.com/fr/mutuelle+assurance?adword=mutuelle

Q If I have a policy that pays 200% does that mean the cost gets paid and I get the cost of the treatment/service reimbursed to me as well( A bit like h HSA in the UK?)  If not, what does 200% mean?

Doctors, Hospitals/clinics and most health care professionals normally have an agreement with CPAM and the Mutuels to charge in a certain band structure "conventioné", for example go to a doctor charging the agreed €20 per consultation who is "conventioné"  and you would get reimbursed according to that scale ie. around 70% of €20 by CPAM and the other 30% by your mutuel if you have one, that's €20 back in your pocket.

However some medical professionals, Hospitals, Clinics, can charge over the set base tariff and that could be 200% 300% 400% etc. but CPAM  would still only reimburse you around 70%  of the agreed base tariff   The mutuel if you have one, would pay the other 30% of the agreed base tariff, you could be left with a large bill to pay yourself.

For example: The doctor/surgeon now charges say €60 for a consultation you would only receive 70% of €20 by CPAM and 30% of €20 by your Mutuel, to get the difference you would need to increase your Mutuel to 200,300,400% etc. to offset the extra

For instance some surgeons,Hospitals and specialists have an agreed rate over and above the normal base rate they are allowed to charge a little extra for their skills and some are (non conventioné) they make up their own fees and unless you have increased your mutuel to cover the extra then you would have to pay for any excess payments over and above the base rate, That's why the mutuels offer the different Tariffs 100,200,300,400% etc so you would be fully covered in most circumstances.

I am sure you would not get a rebate if you don't have to pay the full amount you are covered up to.

I hope this makes some sense, it looks quite complicated and I am sure someone else could have said the same thing in a couple of sentences.  

[Teamedup]

Well our mutualist most defineately does not offset 'any old' over charging. We saw a GP who specialises in back problems a few weeks ago and as he is only conventionne as a GP we got 19 euros back in total, because we have to pay the 1euro ourselves these days. He charges 35 euros, as does our accupuncturist who is a GP.

IF he had been say a specialist surgeon conventionee we would have been covered to 300 or 350% can't remember which we have.

None of this is easy. In general the more you pay the better cover you get, but ofcourse if you don't need anything it is money down the drain too. And I don't know where there is a good comparitive, last time I saw one it made my head spin.

[Ron Avery]

"I hope this makes some sense, it looks quite complicated and I am sure someone else could have said the same thing in a couple of sentences"

No it is now very clear how the % system works, Les.  Thank you for taking the time to explain it.  

[Chrissie]

Our AGF policies allow totally different set-up for husband and wife.

Chrissie (81)