Is top-up health insurance really necessary?

Health

Is top-up health insurance really necessary?

Blossom 09/05/2008, 19:54
My partner and I (early 50s) are looking at the different levels of top-up health insurance cover from various companies. We are happy to pay for the occasional visit to our doctor and to cover our own optical and dental costs. We are also happy to use state hospitals should the need arise.

We have noticed that the top-up premiums range from around 400 euros for 'hospitalisation' only cover to around 2000 euros for a more comprehensive policy.

Our question is: as we have a Carte Vitale and are in reasonably good health, is complementary health cover really necessary?

Re: Is top-up health insurance really necessary?

NormanH 09/05/2008, 20:04
"State" hopitals will still charge for the part not covered by the Assurance Maladie. There isn't the same distiction between "cliniques" which are privately run, but where the payments are made from the 'Sécu' and the Hospital Publique as there is in the UK.
Both are state-funded.
Can you afford to pay 20% of a major operation, not to mention all the ancillary charges ?

I pay 800 euros a year for a mutuelle which covers me for everything 'normal' except for certain expenses in the dental and optical field.

You can never be certain to remain in good health, either.

My advice would be to pay for the peace of mind, and the fact that at an awful moment you wouldn't have to be bothered about being able to pay.

Re: Is top-up health insurance really necessary?

Clair 09/05/2008, 20:06
This was discussed fairly recently here:
http://www.completefrance.com/cs/forums/3/1179568/ShowPost.aspx#1179568

Clair, a Real Virtual French Person

Ma Plus Belle Histoire d'Amour

Re: Is top-up health insurance really necessary?

Weedon 09/05/2008, 20:10
Like all insurance premiums, they are a complete waste of money. That is, except when you need to make a claim, then they are worth every penny. If only you could guarantee never to become ill you might be able to save yourself a bit of money.

Re: Is top-up health insurance really necessary?

NormanH 09/05/2008, 20:44
In the thread to which Claire refers there seems to be a belief that the patient doesn't have to pay the 20% of treatment for things that are life-threatening.
This is not my understanding.
Certainly if you already covered at 100% for an ALD, or in some other specific circumstances

Le montant du ticket modérateur varie en fonction de votre situation, notamment selon :

la nature du risque (maladie, maternité, accident du travail, etc.) ;
l'acte ou le traitement ;
si vous souffrez d'une affection de longue durée exonérante ;
si vous relevez du régime d'Alsace-Moselle ;
le respect ou non du parcours de soins coordonnés ;
si vous percevez une pension d'invalidité

you don't pay the 20%, but I believe that if you have fairly standard surgery you would.
Logan had a particular experience with ab operation from which I think a dangerous assumption is being drawn.

Re: Is top-up health insurance really necessary?

sweet 17 09/05/2008, 21:08

Of course we all have different priorities and we choose to spend our money on what we think is most important.

In the case of top-up insurance, I thought long and hard about it and, in the end, decided that, in an ideal world, I'd be able to afford to pay it all my life and never have to claim off it for any major health problems.

Re: Is top-up health insurance really necessary?

Blossom 09/05/2008, 22:55
Thanks to everyone for your replies. (I have also read the thread that Clair kindly pointed out – apologies for not spotting it!). What I found most frustrating while reading the discussion, was that no one gave any real figures on how much any particular hospital operation cost or a definitive list of what is classed as a life threatening condition.

While it is certainly true that it is better to err on the side of caution, without the appropriate information it is difficult to assess any risk. For example, if a major operation and all the ancillary charges came to 10,000 euros, 20% would still only be just over two years of NormanH’s premium.

I realise that medical conditions are not always cut and dried, but does anyone know of a website that outlines French hospital costs?

Re: Is top-up health insurance really necessary?

NormanH 10/05/2008, 5:10
There is a list of ALD conditions which are covered at 100% on this thread:
http://www.completefrance.com/cs/forums/1180182/ShowPost.aspx

A few other points to consider are:
The Sarkozy government is trying to save money on health care, in making people behave more "responsibly". That is to pay more and more of the costs themselves.
Recently the idea that all optical care should be paid by the Mutuelles ( or the patient if you don't have one) was floated by Rosalyne Bachelot (the Minister)

"la ministre de la santé, Roselyne Bachelot, n'a pas écarté, dimanche, l'éventualité que l'Etat se désengage dans certains secteurs de la Sécurité sociale, comme l'optique, au profit des assurances complémentaires. La ministre de la santé, Roselyne Bachelot, n'a pas écarté, dimanche 13 avril, la possibilité que la Sécurité sociale se désengage complètement de certains secteurs, notamment l'optique, au profit des assurances complémentaires, provoquant l'incompréhension des responsables de la Mutualité française et la colère de l'opposition, qui dénonce "une privatisation annoncée" du système de santé."

( From 'le Monde 14th April)

( The Health Minister didn't rule out the possibility when she spoke on Sunday that the State would pull out of certain sectors of Health Cover, such as Optical care, leaving them to be paid for by 'Top-up' Insurance.
This made those responsible for the Mutuelles claim that they didn't understand what she was talking about, and the opposition denounced a 'privatisation' of the Health Service...) My very free translation

It might be assumed that this won't be the last such initiative
If you read French easily there is much to learn here

Secondly there is also a move afoot to re-examine the 100% cover.

Nor can it be assumed that the CMU as it exists will remain untouched. It has only been in place since 2000 and was the brainchild of a Socialist government (the same one that brought in the 35 hour week)

Given this general drift towards having to pay more towards Health Care I am happy to have Mutuelle which enables me to pay monthly rather than in a large sum just when I am least able to pay.

As a last point, don't just assume one health problem.
My payments top up several things at the same time: last year I broke my ankle, had to have a number of fillings in my teeth, an eye test, and 3 Xrays.

None of these are 'life-threatening', but the costs mount up.

Re: Is top-up health insurance really necessary?

Blossom 10/05/2008, 7:52
I am very grateful for the additional information, NormanH (the excellent ALD list will be very useful).

On your first point, as I said at the outset, we are happy to cover our dental and optical costs as we do not think that Mutuelles offer value for money here.

Your second point is well made. However, we have to make our decision based on things as they exist now. If at some time in the future reforms are made to the CMU and 100% cover then we may have to revise our thinking.

Your last example is interesting because it coincides with the starting point of our own discussion on health cover. As such, it would be useful to have a breakdown of the costs for the broken ankle and the 3 Xrays. In other words, the total amount charged by the hospital; how much was reimbursed by the state; how much was covered by your Mutuelle; and how much (if any) you paid yourself.

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