Top-up health insurance: what distinguishes it from its mutual health counterpart?

Mutual health insurance has often been confused with health insurance. While the services and objectives they offer are similar and they both provide you with individual cover and guarantee broader reimbursements relative to those offered by the Social Security, they are considered different in legal terms.

Top-up health insurance

Top-up or complementary health insurance aims to supplement the refunds of the compulsory Social Security schemes and is offered by different insurers. The legal texts governing them are not identical. Therefore, their internal workings are not the same. These are institutions, mutual provident societies and insurance companies which are entitled to authorise or not this health cover. The role of complementary health insurance is to reduce any excess fees and out-of-pocket expenses. It will take care of all the services that are not refunded by Social Security and can provide support and assistance benefits such as psychological support, food coaching and other related services, including prevention campaigns and retirement. The rate of refund will obviously depend on the contract you have selected.

Mutual health insurance

A mutual health insurance company is a legal entity governed by the mutual health regulations. It aims to manage all or part of the health expenses that are not covered by your Social Security. It is therefore based on financing, which is largely carried out by members' contributions and is run by volunteer managers, appointed by the aforementioned members. It can also develop supplementary pension and provident schemes, including dependency, disability, temporary work incapacity or death. Like any other insurer, the mutual health insurance company in France is supervised by the prudential control and resolution authority (ACPR). For compulsory, optional or collective operations, each member is free to join the contract he or she chooses.

Taking out complementary health insurance

Unlike with a group contract enforced by an employer, you are free to choose the establishment with which you would like to take out your complementary health insurance. Every insurance company offers its particular formulas, rates and support. Before subscribing, check that the AMC number of your complementary health insurance complies with the law. This is a guarantee that you will find a reliable organisation. We recommend you compare several quotes by asking several entities that market this product, such as complementary organisations, health insurance companies or mutual health insurance companies. To do so, use personalised simulations and check the offered level of cover as well as the price.

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