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Health insurance in France: What you need to know about a mutuelle

Once you have your French Carte Vitale, you may want to look into getting a complementary healthcare plan, or a Mutuelle. Here is what you need to know about top-up insurance in France.

Published: 14 October 2019 16:12 CEST
Updated: 9 August 2023 16:16 CEST
Health insurance in France: What you need to know about a mutuelle
(Photo by DENIS CHARLET / AFP)

What are mutuelles?

France’s mutuelles are non-profit organisations which have been in operation in the country for at least 150 years.

Their main purpose is to ensure social welfare but not just through additional health cover, also in terms of pensions, disability benefits and other forms of cover.

READ MORE: How to get a carte vitale in France and why you need one

Mutuelles abide by the code de mutualité, which distinguishes them from health insurance companies in that members don’t have to pay premiums for pre-existing conditions and have a greater say in decision-making as part of this type of co-op or partnership.

While mutuelles are paid for by individuals, they are not private health insurance and don’t come up with preferential treatment or access to private clinics.

How does a mutuelle actually work?

If you go to the doctor or hospital in France or have an X-ray or some other kind of test, you’ll normally pay up front.

READ MORE: What you should know before having surgery in France

You are then refunded a percentage of the cost via the carte vitale system, usually within a week, either by the French government if you are working or your home government if you are a European or British pensioner qualifying under the S1 scheme.

In general terms the state covers around 70 per cent of the total, although for some serious conditions the percentage of state health cover is higher or even complete.

What a mutuelle does is cover, either partly or completely, the deficit or the part of the cost not covered by the state.

Essentially, a mutuelle is top-up health cover and one of the easiest ways of getting 100 percent health cover, although how much cover you get will depend on which mutuelle you have and how much you were charged.

Recent figures from 2023 for the French insurers’ group Mutualité française showed that the average resident in France will have to pay out €490 a year in medical costs not covered by the state – unless they have a mutuelle. And of course for the elderly or people with long term health conditions the figure can be a lot higher.

Not every mutuelle is the same

Depending on the policy chosen, mutuelles can cover most or all of the remaining costs not reimbursed by the state, as well as some selected medical services and the cost of medicines at the pharmacy.

In general terms basic mutuelles will take you up to 100 percent cover but often the next step up, a standard cover offering around 150-175, or 200 percent, won’t cost a lot more and could tie you over for a lot of expensive extras such as dental and optical treatments. 

Things are made more complicated by the fact that doctors in France can charge more than the base rates set by the state (tarif de convention) based on their category. 

This is known as dépassements d’honoraires and are added on by many specialist doctors.

As for general practitioners, they typically fall into the group of ‘category 1’ doctors who charge the government-agreed amount (which is most of them) of €25 for an appointment. However, this is set to go up to €26.50 toward the end of 2023.

For a specialist, rates were set at €30 in August 2023, and were expected to go up to €31.50 by the end of the year.

For ‘complex’ consultations with a specialist, the rate normally would be about €46, but this was expected to go up to €47.50.

When it comes to mutuelles, if you have one that reimburses at 100 percent, this means that it will only cover the base rate (tariff de convention) or €25. To cover up to €40 per appointment, you’ll need a mutuelle that reimburses at 200 percent. And the same applies to all medical treatment. Note that more expensive mutuelles will reimburse to 400 percent. More info here.

The mutuelles and complémentaire santé market is fairly flexible in this regard so it’s worth having a search online for the policy that best suits your needs and budget.

And make sure you look carefully at the rate of reimbursement.

There are plenty if not too many to choose from, so also ask French friends or your local doctor for recommendations to get a better idea and more honest opinion. 

Your company might foot the bill

Since 2016, private companies in France have been required to provide employees with a private health insurance policy known as a mutuelle collective.

By law they have to cover a minimum 50 percent of the mutuelle’s cost and some companies offer workers extended medical cover for their family members as a perk. 

However, if you work in the public sector, you’re job seeker, student, self-employed or a pensioner, this law doesn’t apply to you and you’ll have to opt for a mutuelle individuelle.

So what’s the cost?

Mutuelles are more affordable than private health cover, hence why most people in France have one.

However unlike in Britain, it doesn’t guarantee faster treatment at the hospital or get you access to private doctors and clinics either. It just assists financing the personal contribution element of France’s healthcare.

According to MeilleurTaux Assurances, a family bundle for two adults and two children came out to an average of €1172 in 2022, which represented a rise of six percent due to inflation when compared with 2021. This meant a monthly expenditure of approximately €98.

Data from French insurance comparison site Selectra.Info estimated costs for the year 2023 down for seniors – those between 66 and 75 were expected to pay about €124 per month, or €1,490 per year. Those 75 and older were expected to see a higher bill, closer to €173 per month or €2,070 per year on average.

Average mutuelle costs for workers aged 25 tended to be lower, averaging at around €28 per month. 

Another consideration worth noting is that different regions of France have higher and lower mutuelles prices, although this generally affects the rate by around 10 per cent. 

Read the small print

The mutuelles and complémantaire santé market is a competitive one so as mentioned earlier it’s best to ignore the sale pitches and cut to the real deal.

Make sure you read carefully through what your prospective mutuelle offers, in particular the small print of your contract, as this is often convoluted but still very telling.

Watch out for what calculation they use to actually reimburse you. 

Keep an eye out for the cancellation clauses too as they can be quite specific and require notice to be given several months in advance.

If you’re not a mutuelle member already, you should probably become one

Unless you’ve got private health insurance or plenty of money stashed away which you’re willing to burn in case of a medical emergency, you’d be better off paying for a mutuelle or top-up health cover in France.

Keep in mind that healthcare isn’t completely free in France, so fees can run into the thousands of euros if you have to go to hospital.

It’s a case of being better safe than sorry…or in debt.

Member comments

  1. We are Brits, with a carte vitale and mutuelle – is this enough in the event of a no-deal or will the French withdraw the carte vitalle?

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TRAVEL NEWS

What’s the deal with passport stamping in France?

There are clear guidelines in place about who should have their passport stamped when they enter or leave France - but the letter of the law doesn't always seem to be applied on the ground. Here's what you need to know.

Published: 17 May 2024 14:24 CEST
What's the deal with passport stamping in France?

When you pass through a French border control post, officers will check your passport and – in some cases – stamp the date of your entry or exit of the country onto one of the blank pages in the booklet.

Although the system should be clear and simple, it becomes complicated when conflicting information is given on the ground.

Here’s what the rules say, and whether it’s really a problem if your passport is incorrectly stamped.

Who should be stamped?

The purpose of the date stamps for entry and exit is to calculate how long you have been in France, and therefore whether you have overstayed your allowed time – whether that is the time allowed by a short-stay Schengen visa or the visa-free 90-day allowance that certain non-EU nationals benefit from. 

Those people who are exempt from 90-day restrictions should therefore not have their passports stamped.

EU passport – people who have an EU passport should not have it stamped, because they have the right to unlimited stays due to EU freedom of movement.

Dual nationals – people who have passports of both EU and non-EU countries should not be stamped when they are travelling on their EU passport. However, because the passports of dual nationals are not ‘linked’, those travelling on their non-EU passports will be stamped, unless they have other proof of residency.

READ ALSO What are the rules for dual-nationals travelling in France?

French residents – the passports of non-EU citizens who have a residency permit in France (carte de séjour) should not be stamped, because they have the right to stay in France for as long as their permit is valid.

Visa holders – people who have a long-stay visa or a short-stay visitor visa should not be stamped, because they have the right to stay in France for as long as their visa is valid. 

Tourists/visitors – people making short visits to France who do not have a visa should be stamped, with the stamps keeping track of their 90-day allowance. Visitors from nationalities who do not benefit from the 90-day rule (eg Indians) are also stamped.

Travel practicalities

When crossing a French border, you should present your passport along with other documents – visa or carte de séjour – if relevant. Don’t wait for border guards to ask whether you are a resident.

It should be noted that the carte de séjour is not a travel document and cannot be used to cross borders, not even internal Schengen zone borders. The only valid travel documents for entering France are a passport or national ID card. Any other forms of ID – driving licence, residency card etc – cannot be used for travel purposes.

Border problems

While the rules on stamping are simple in theory, many readers of The Local have reported having their passports incorrectly stamped at the border, and this seems to be a particular problem for non-EU nationals who are resident in France.

Travellers are also often given incorrect information by border guards – for example being told that only holders of the post-Brexit Article 50 TUE carte de séjour are exempt from stamping, that all non-EU nationals must have their passports stamped or that only being married to a French national exempts you from stamping.

None of these are correct.

It’s also sometimes the case that people whose passports should be stamped – tourists, visitors and second-home owners who don’t have a visa – do not receive the stamp. For frequent visitors this can be a problem because it looks as though they have had a long stay in France, due to their exit not being recorded.

The system of stamping itself is also a bit haphazard with stamps scattered throughout the passport book in random order, so border guards sometimes make mistakes and miss an entry or exit stamp and therefore think that people have overstayed when they haven’t.

So how much of a problem actually is it if your passport is wrongly stamped?

It’s one thing to know the rules yourself, it’s quite another to have an argument with a border guard, in French, when a long queue is building behind you. Numerous Local readers have reported feeling that they had no choice but to accept a stamp when an implacable guard insisted upon it.

But is this really a problem?

One thing is clear – if you are a resident of France then you have the right to re-enter, and your proof of residency (visa or carte de séjour) takes precedence over any passport stamps. So it’s not a question of being barred from the country – it can, however, be inconvenient as it might lead to delays at the border while your passport record is queried.

Meanwhile people who did not receive correct exit stamps can be incorrectly told that they have over-stayed and even be liable for a fine. 

Will the new EES passport control system improve this?

Theoretically, the EU’s new Entry & Exit System – which does away with the manual stamping of passports – should get rid of these problems.

However, as we have seen, theory and what actually happens on the ground are two different things.

The EES system, due to come into effect later this year, brings in two main changes – it makes passport checks more secure by adding diometric data such as fingerprints and facial scans and it does away with manual stamping of passports and replaces it with scans which automatically calculate how long people have been in France.

You can read full details of how it works HERE. 

So that should eliminate the problems of unclear stamps, stamps being read wrongly or passports not getting the stamps they need.

Residents in France – carte de séjour and visa holders – are not required to complete EES checks and should have a separate system at ports, airports and railway terminals.

However, at present it’s pretty common for border guards to give incorrect information to non-EU residents who are resident in the EU – let’s hope that they are properly briefed before EES is deployed.

Have you had problems with passports being incorrectly stamped? Please share your experiences in the comments section below

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