Top-up health insurance in France: is it worth it?

[dreamingbohemian]

We have been living in France since May (DH is French), we have our carte vitale sorted and are trying to decide whether to get the top-up insurance.

The cheapest quote we have is 700 euros a year for very basic cover. We are on 70% reimbursement anyway, so we would need 100 GP visits to break even! We are all in good health so it doesn't really seem worth it (although we are looking into how much hospital costs could be). Obviously we would reconsider if one of us developed health problems.

BIL and SIL don't have the top-up because they think it's too much. We are also leaning against it but is this a bad idea?

Thanks for any advice!

Yes, definitely worth it. Look into the benefits for glasses etc.

Are you likely to get pregnant? If so it's definitely worth it!

Thanks!

Not likely to get pregnant in near future (otherwise would definitely consider).

The glasses benefit is not that much, it only reimburses 35 euro a year. To get a policy that reimburses a decent amount for this is even more expensive.

Yes. I live in the Moselle area of France where social security pays back 90% and still have top up insurance.

A couple of years ago I broke my back. I was either going to have to stay in my hospital bed for 6weeks or wear a very expensive back brace not covered by the social security. The back brace was covered by my top up and I had it and was out and about after just five days.

There are all kinds of little extras which are covered by top up. Dental care, optician stuff, preganncy stuff, and your own room if you end up being hospitalised. Depends on the cover but I wouldn't risk being without. You really need to shop around depending on your needs.

Hmmm thanks for that! This is basically what I'm worried about, not the smaller charges but something catastropic that costs a lot. I'm still trying to find out more about hospital costs and the like, but it's sounding like top-up is a good idea.

Do you know what an average amount to pay is? I was a bit surprised it's 60-70? a month, I paid not much more than that in the US but that was for the full amount of coverage, not top-up.

Hope your back healed up okay!

I'm sorry I don't know. I haven't looked at the bills in quite a while. I'd guess about 40/50 a month but because the social security reimburses more here we have discounted premiums.

It did thank you :)

Hmm I guess we should shop around a bit more.

I did think it was funny that GMF was offering a 15% discount on policies this month in honour of the Rugby World Cup!

To me one of the differences that not having a top up makes is that you question tests that you are sent for.

If you have top up insurance, you can go for any scan, x-ray, blood test your doctors suggests without questioning the cost, if you don't have top up there may be a tendancy to think - I can't afford it this month.

Hmm. I only have carte vitale and tbh I haven't felt that it's not enough. True, it reimburses only a part of dental work (and maybe none if it's done for cosmetic reasons) and is crap for glasses. I had tests done like bloodwork, mammogram, ultrasound etc and it reimburses between 50-70% afair. Didn't have to pay for the midwife appts or stay in hospital for birth. Reimburses most of medication costs. Seems pretty ok to me.

Yes, that's why most of my inlaws don't have it (except for FIL who is diabetic and has loads of medical expenses).

I'm mostly just worried about the potential for big hospital expenses -- maybe there's a policy that's cheaper and just covers that? Hmm.

You can get hospitalisation only policies which would cover the biggest expenses.

I'm not sure how it works with hospital tbh. Birth is free...not sure what happens when you have appendicitis or similar. Is it still 70% reimbursed?

Thing is if you wait until you really need it - ie if you developed diabetes - you'd have to declare your illness on application, and they'll whack the premiums up.

I spent a couple of weeks in intensive care back in April for another problem. The hospital bill was just under 40k however as it was an emergency everything was covered by the social security. My top up only had to pay 90EUR for the night I wasn't in intensive care and had a private room up on the ward.

So it looks like emergency hospital trips are well covered by the social security. But imagine I had needed follow up care of some kind that would only have been reimbursed at the usual amount.

Insurance companies are not allowed to ask questions about your health for top up health cover. Perhaps things are different in Alsace Moselle.

Hmm that's surprising. When mine was set up I was in Paris and they did ask questions. This was years ago though. I know a lot don't - ie when you get it trhough work - but I definitely remember answering questions over the phone. About smoking, weight and a couple of other leading questions.

That mught have been my insurance company being sneaky buggers. They're sneaky about a lot of other things. Ie I asked them over the phone if they would cover the surplus costs when I gave birth in Luxembourg. Yes yes we cover you for your treatment abroad, they said (I work in Lux). And when it came to it they refused. Was not amused, as in Lux social security covered only 90% but with the surgery and epidurals the surplus was still not a nice amount. But it's complex as I am covered by two systems so maybe I'm not relevant.

Are we talking about a mutuelle? If so, if either you or your DH work, OP, most companies will just get it for you automatically. I'm paying 13? a month for mine; my employer pays 43?. And I'm putting DP on mine (it's a little bit more, but not much) as soon as we get PACSed as he's currently on a contract that doesn't include it.

I've just checked. They are allowed to ask questions but most don't. I have never come across one that does ask questions though.

Thanks everyone! Just got home and catching up now.

This is all incredibly informative, thank you! I didn't realise there was a 'preexisting conditions' thing that might happen -- that's definitely a concern.

Theala my DH works but his employer doesn't contribute for this unfortunately (small family business).

sommewhere thanks for the PM

I've worked in several companies in France and never had employer mutuelle - they have all been too stingy small

Dd was in hospital 2 years ago - just an ordinary hospital, not a swanky university one. She had basic nursing care and a blood test, that's all. The total bill was ?8000. Yes, ?800 per day. Our top up for the 3 of us is ?1800, and on that basis, well worth it.

I was going to suggest employeur mutuelle - mine's obligatory and really cheap.

I would still get a mutuelle though. I use the health system loads and if I didn't have my mutuelle I would be well out of pocket. I've never had anything serious (unless you count pregnancy ) but I get migraines so I have tonnes of doctors appointments, medicines and even my acupuncture was partly covered by my mutuelle : out of 90 euros per session (!), the secu paid 20, and my mutuelle 60....

8000? !!

Okay you lot have definitely convinced me -- DH is going to sign up for something tomorrow

Nice to know about the acupuncture too, I've been thinking of trying it

Merci beaucoup!

Shop around for sure. When we 1st arrived we were talked into the all bells and whistles one, which we were tied into for a year before we could change. I forget exactly how much it was, but I know it covered for a stay in a thalassotherapie spa if you were suffering "stress"

I don't know what thalassotherapie is but it sounds divine