The guarantees offered by mutual health insurance

A mutual health insurance aims to guarantee a complementary social protection quality to all its members. It is therefore important to know how the different guarantees what your complementary health insurance can offer you in order to best meet your needs.

How does mutual health insurance work?

A good mutual is a mutual health insurance suitable for all. This means that it must be able to offer the best guarantees based on the profile of its members. Indeed, the aim of a complementary health will be to reimburse in full or in part medical expenses which are not covered by social security. Also read: Why use an insurance broker for your business?

The guarantees automatically offered by your mutual insurance company

It is important to know the guarantees offered by your mutual health insurance upon subscription. All mutual health insurance companies offer basic coverage, only the amounts reimbursed will be different. It is indeed important to know that your complementary health will be based on the statement of benefits provided by Social Security. In addition, these will always respect the conventional rate (which can also be called TC, or Reimbursement Base or BR). Your mutual health insurance will therefore generally guarantee reimbursement in part or in full of the following costs:

• Medical appointments (whether with general practitioners or specialists)
• Hospitalization costs (such as surgery, or a daily fee, etc.)
• Drugs
• Biological analyzes
• Optical costs (such as frames, glasses, lenses, etc.)
• Dental care
• Dentures and orthodontics
• Medical procedures (physiotherapists, nursing, or even speech therapists, etc.)
• Orthopedics
• Prosthetics other than dental (e.g. hearing aids)
• Thermal cures
• Health assistance services
• Third-party payment service (so you will not have to advance your mutual insurance)

As soon as you take out your contract and as long as you pay your contributions, you will be covered for these health costs. Also read: Compare before you buy: Here’s why!

Additional guarantees from your mutual health insurance

Your mutual health insurance can offer you additional guarantees according to your needs and your budget. For example, you can benefit from the following services:

• Birth bonus for child
• Protection, such as disability guarantee (with payment of capital or an annuity) or temporary incapacity (with daily allowances)
• Assistance, whether in terms of advice, housekeeping, repatriation, or even pet care, etc.
• Funeral package
• Reimbursement of “medical” procedures not recognized and reimbursed by Social Security (such as an osteopath, an acupuncturist, or even a sophrologist)
• Vision surgery reimbursement
• Reimbursement of non-nomenclature dental prostheses (such as implants)

Also read: Why take out school insurance for your children?

The level of guarantees: a difference between mutual health insurance companies

The price of your mutual health insurance will vary depending on your profile (taking into account your age, your profession or your place of residence). However, it will also take into account level of complementary health guarantees that you have chosen. Indeed, very often, your mutual health insurance will offer you different “packaged” offers with selected guarantees which cannot be personalized. It is therefore important to know that the cheapest plan most often covers the co-payment as well as a basic package for optics and dental care. On the other hand, more expensive plans will cover many more costs, such as fee overruns for example. They can even offer you packages for procedures not reimbursed by social security, such as osteopathy, alternative medicine, or even orthodontics for adults and dental implants. You will therefore have to adapt your formula according to your needs but also your budget. If you have to regularly visit the dentist or ophthalmologist, it will be preferable to opt for an intermediate or even high-end plan with attractive reimbursements. Remember that some plans will be completely customizable. They will give you the possibility to add options according to your expectations. If your finances allow it, you should not hesitate to choose this type of contract.

Conclusion :

In summary, even if the majority of mutual health insurance offer basic guarantees interesting, it is important to choose the contract that best suits your needs and which will best cover all of your healthcare costs. To do this, do not hesitate to use a comparator to find the best value for money. Read also: What is a health supplement?