Health Insurance when pregnant?

[overmonnow]

I read somewhere that you can't get health insurance if you are pregnant before you apply for insurance - is this true?

Also, for a young married couple with no visible ailments, what insurance providers would people recommend?

Thanks

Alistair

[Owen]

Hello,

As far as I am aware all complementary health insurance policies in France will apply an exclusion on pregancy/maternity claims, usually 9 - 12 Months. However if you are affilaited to the system you will probably obtain 100% cover from CPAM anyway. You will have to pay out for a private room and if, for example, the expectant mother needs more ante-natal checks than normal. But it is reasonable to expect around 95% cover by the state. But the complementary insurance will meet claims for those other than pregnancy/maternity.

As far as a recommendation of providers is concerned there are one or two things you need to bear in mind. At this point I would emphasise that I am not an insurance broker. These policies are loosely described as "mutuelles". Actually there are two principal types of policy that are available to most expats. Firstly there are indeed the "mutuelles" and secondly the plans offered by the commercial insurers eg; Groupama (no beneficial interest in this outfit by the way). They are different in underlying philosophy, legislation by which they are regulated and tax treatment.

"Mutuelles" are non-profit organisations and have been in existence for some 150 years. Their philosophy is one of "solidarity" whereby individual medical risk is not a priority and members benefit regardless of individual medical condition. Commercial insurers have only been very active in this market for 20 years or so. There was obviously a market for those who were in general good health and to whom policies could be offered to reflect this diminished risk. In return the insurer could offer lower premiums and still be profitable.

The apparent advantage to the commercial insurer is nowadays less distinct. "Mutuelles" have been allowed to introduce some exclusions without violating their status. On the other hand commercial insurers have modified some of their plans in order to qualify for the favourable tax treatment enjoyed by the "mutuelles". Nevertheless, if you are usually healthy and only require cover for say, the expensive stuff eg; hospitalisation. then a commercial insurer may have the edge over a "mutuelle".

Regards

Peter Owen
pjowen@expathealthdirect.co.uk