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The Mutuelle System

You may or may not have read our blog on Registering With The French Healthcare System. If you haven’t, it’s where we talk our readers through the main questions we get asked on a regular basis regarding the process of registering with the French healthcare system.

To re-cap the basics - healthcare in France is not free at the point of need (like the NHS in the UK). If you're on the social security system, healthcare costs are partially covered by your social security regime (CPAM or MSA).

Today we’ll be talking about the option of upgrading or ‘topping up’ your French healthcare insurance, called healthcare Mutuelle system. You can sign up for a mutuelle privately or through your employer, depending on your profession once you have a social security number. Please note that if you are an employee of a French company, your employer is legally obliged to offer a Mutuelle cover, for which they either pay everything or a contribution. You can also opt to have your whole family covered under your employer's Mutuelle offer. If you’re a self-employed individual, on the other hand, it’s up to you to organise Mutuelle to cover yourself. Whilst it’s not a legal obligation to have it, we highly recommend investing for the following reasons…

Whilst the basic healthcare system CPAM includes all essential healthcare and a large percentage of the necessary medicine, hospital stays and consultations, it doesn’t cover the following:

  • Dental care;

  • Eyecare;

  • All medicine;

  • Private rooms in hospitals, and;

  • Rehabilitation centres (after an injury for example). Whilst CPAM covers physio visits for rehab purposes, it will not cover your stay in a specialist centre for example.

These ‘non-essential healthcare options’ are what will be covered by your Mutuelle, should you decide to invest, in varying capacities depending on what level of cover you chose.

Top tip

If you find yourself in a compromised medical situation and end up with a hefty bill - you can actually backdate your Mutuelle cover for up to 30 days. This means that after the fact, you can sign up to a Mutuelle contract (provided it’s within 30 days of the medical situation) and still claim back the costs from your new insurer. Please bear in mind that if you’re taking this approach, you must request reimbursement within 15 days of signing the contract.

How does Chomage affect the Mutuel System?

Chomage is the French version of unemployment benefits. When you leave employment and go on chomage, you become eligible for “portability” (something that is also available for pension schemes). This means that your Mutuelle cover continues for a certain period of time, up to one year, calculated on the time you worked for that employer. Your family's cover (if you’ve insured them on your policy) is also continued during this time period.

In order to benefit from the portability benefits, you’ll need to inform your insurer after your work contract ends and provide them with both the “certificate de travail” (a document provided by your employer at the end of the work contract), and an “attestation d’ouverture de droits” document for the chomage.

We hope this has been helpful and you understand a little more about the benefits associated with entering into a Mutuelle policy.

As always, any questions please don’t hesitate to ask.

The Aster Team


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