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11/05/2008, 11:36 Logan Joined on 23/08/2004 Posts 721 Re: Is top-up health insurance really necessary?  Keith CHANNING wrote: For some the former makes sense, for others the latter. I agree Keith but for those on low incomes the state pays 100% of the costs not just the tarif de convention. If you pay a mutuelle why not set aside the premiums instead in a savings account on a monthly basis. Livret A is tax free up to a reasonable figure. Then you have the cash if it's needed. Example - Break a leg and require hospitalisation. Cost say 800 euros. State pays 70%, you pay 240 euros. That is on average 2-3 months premiums. Unless you are very unlucky I doubt you would need that more than once or twice in a lifetime. If you have a heart attack and require more hospitalisation it's life threatening therefore costs are paid by the state. I could give more examples but in essence the amounts paid out by a mutuelle contract are small. Dulce et decorum est Pro patria mori. (Horace).    Report

11/05/2008, 12:16 spg Joined on 23/08/2004 Southern Morbihan 56 Posts 1,047 Re: Is top-up health insurance really necessary?  Logan wrote: I could give more examples but in essence the amounts paid out by a mutuelle contract are small. Where you can break even with a mutuelle is if you need to take a number of medications, as does my OH following insertion of a stent during an angioplasty. He takes 3 tablets a day and our share of the cost is 45 euros a month after CPAM's contribution. This is because we only have hospitilisation cover at the moment so no cover for drugs. We are thinking of swapping to 100% cover for him as this will give give him greater cover for his drugs and in general, and re the dentist and the optician in particular, than hospitilisation alone does. Sue Computing - it's another world    Report

11/05/2008, 13:43 Gastines Joined on 23/08/2004 Les Gastines.St.Pere 5mins St.Malo Posts 771 Re: Is top-up health insurance really necessary? I suppose if you had just paid a couple of months premiums on your house,your top up health cover and car insurance you would be in a better financial position than those who think they can save for 10-20 years to pay any hospital/car repair and house rebuild costs especially if you came home to find the house on fire,the shock gave you a heart attack your wife crashed the car rushing you to the hospital and broke her leg preventing you from going on your world cruise. Sometimes fires and accidents don't wait untill you are in a strong financial position.That might be worth taking into your calculations.Having had 3non-insured drivers prang cars of mine,I do feel that insurance is what it says on the tin INSURANCE. Regards.    Report

11/05/2008, 13:57 Patf Joined on 23/08/2004 SW Gers Posts 2,100 Re: Is top-up health insurance really necessary? Logan - the example of the heart attack. The cost was  covered only 70%, for some reason. Possibly because it was done via SAMU, not the medecin traitante. The hip replacement was covered 100%.    Report

11/05/2008, 19:48 NormanH Joined on 10/04/2008 Posts 179 Re: Is top-up health insurance really necessary?  Patf wrote: Logan - the example of the heart attack. The cost was  covered only 70%, for some reason. Possibly because it was done via SAMU, not the medecin traitante. The hip replacement was covered 100%. I have already stated that I believe Logan's premise that 'life threatening' conditions are automatically covered at 100% to be incorrect. This seems to back that up. I stand to be corrected if someone can quote from the http://www.ameli.fr/  site where Logan's idea is stated. If I am right it tips the balence of the argument back the other way if you might have to meet 20% of a serious operation and aftercare    Report

12/05/2008, 9:55 Logan Joined on 23/08/2004 Posts 721 Re: Is top-up health insurance really necessary? My understanding is that the consultant in charge of a particular case of hospitalisation will certify the condition to be either life threatening or not. This then is related to the percentage the state will fund. It's hard to imagine a heart attack case not being regarded as life threatening. However when it comes down to a particular doctors opinion, differences are inevitable. Dulce et decorum est Pro patria mori. (Horace).    Report

12/05/2008, 15:01 osie Joined on 17/12/2007 South West France Posts 55 Re: Is top-up health insurance really necessary? The pro's and ***'s of life insurance is something that has gone round and round in my mind for years, much of which has been already discussed in the previous messages. My summary is that mandatory insurance is generally worth it as if the country has deemed it mandatory that it probably is a good idea.. i.e. house insurance Other insurances play on the fears of people and sometimes those people benefit financially and most times they are for the comfort factor... all good reasons to take it out. My opinion is that it is better to put money aside rather than to give it to a profit making company to put on their side.  However, this normally simple task is quite tricky for most.  Therefore insurance companies exist... and the world goes round. p.s. I have not yet got a top-up although I regularly re-access the variables. thanks osie www.le-murier.com    Report

12/05/2008, 16:55 Sunday Driver Joined on 07/10/2005 Deux Sevres (79) Posts 2,747 Re: Is top-up health insurance really necessary? Hospital fees are not automatically covered 100%. From the Assurance Maladie website: Hospital fees: You (or your mutuelle) are responsible for the ticket moderator (that's the shortfall from the state cover) except in the following cases: Vos frais d'hospitalisation seront intégralement remboursés si vous êtes dans l'une des situations suivantes : vous êtes hospitalisé(e) plus de trente jours consécutifs (votre prise en charge à 100 % débute alors le trente et unième jour) ; vous êtes enceinte et devez être hospitalisée pendant les quatre derniers mois de votre grossesse, pour votre accouchement, ou pendant douze jours après ; pour votre nouveau-né, s'il est hospitalisé dans les trente jours suivant sa naissance ; vous êtes hospitalisé(e) en raison d'un accident du travail ou d'une maladie professionnelle ; vous êtes hospitalisé(e) en raison d'une affection de longue durée ; pour votre enfant mineur, s'il est hospitalisé suite à des sévices sexuels ; vous percevez une rente pour un accident du travail (avec un taux d'incapacité égal ou supérieur à 66,66 %). Vos ayants droit bénéficient eux aussi de cette prise en charge à 100 % ; vous êtes titulaire d'une pension d'invalidité, d'une pension de veuf ou veuve invalide, d'une pension vieillesse qui a remplacé votre pension d'invalidité, ou d'une pension militaire ; vous dépendez du régime d'Alsace-Moselle ; vous bénéficiez de la Couverture maladie universelle ou de l'aide médicale de l'État. Note that if you hold an E106 or an E121, then you are not a beneficiary of CMU and therefore the last qualification does not apply.    Waddya mean it's only Saturday......    Report

12/05/2008, 19:42 Patf Joined on 23/08/2004 SW Gers Posts 2,100 Re: Is top-up health insurance really necessary? That's interesting SD. Perhaps I had to pay the 30% because I hadn't at that time been confirmed by my doctor as having an ALD.    Report

12/05/2008, 20:24 NormanH Joined on 10/04/2008 Posts 179 Re: Is top-up health insurance really necessary? I think so Patf. I would also point out that if you have one of the list of illnesses counting towards an ALD that isn't  an automatic guarantee of 100% cover, until your  your Géneraliste has sent in a 'formulaire de demande de prise en charge'  to your local Caisse, and you have the specific 'notification d'exoneration du ticket moderateur' and a list or 'protocole de soins' which shows which medicines and tests etc are covered. I mention this because it might be imagined that this is automatic.  You will be accepted if you apply , but it is much better to go through this rather long-winded process as soon as you are diagniosed  and have the right documents to produce in an emergency arising from your illness. Of course you are only covered at 100% for the things on that list.    Report

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