Health Insurance. Is it really worth the high cost?

Now in our 70’s our Insurance premiums are going up every year to the point where when we really need it we won’t be able to afford the high premiums. I have had 3 operations in the last 3 years, one for cancer so that was covered 100% so we’re the other two to my surprise.
My question is. Why would you want to pay regular high premiums into old age when, if you have a medical problem you can take out immediate cover at any age as there are no underwriting requirements. Therefore no matter how bad the maladie you can get almost instant cover anywhere.
I would be interested in any comments.


The Secu.

Yes, health care is not just for individuals but is meant to give everyone
good cover. All sorts of ghastly unexpected things might happen!

Hi John,
I assume that you are referring to the cost of a ‘Mutuelle’ (top up) policy.
I think you will find that once you turn 80 it will be difficult to find an insurer who will take you on as a new client, so you may care to factor that in to your considerations, and also it would be a good idea to check with your existing insurer that they will continue cover past the age of 80.
As with any insurance it’s always a good idea to shop around and obtain competitive quotes by using one of the online comparison sites such as this one:-
Each person’s needs are different of course, and if you are in good health and do not foresee a need for treatment for a non (100%) ALD condition, then you might opt to ‘self insure’ and forego having a ‘Mutuelle’ altogether.
If it helps, the list of ALD (100%) conditions is to be found here :-
Good luck in your calculations,

I think the only answer is, peace of mind.
If you’re in agony or semi-conscious or even not conscious at all, you’re not going to want or be able to sit down and start googling for a suitable insurer and filling in forms on the computer. But you could argue that if you’re in that state, it’ll be classed as an emergency in any case.
I have to say I have thought along those same lines myself.

Not true, by law a mutuelle can’t turn down anyone who has a carte vitale.
Of course if you use a private insurer not a mutuelle, it’s different.


@John Alderson, have you looked for better quotes? In your position the big dilemma is, having paid in so much already and never needed to call it in, it would be sod’s law to need to call it in as soon as you cancel it - so the worst of both worlds, all that money down the drain and still not protected when you need it most.

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You will not be the only one, wondering about the need for expensive health cover… have you talked it through with your Mutuelle provider… to see if it can be trimmed down a little without losing out on the most important bits… ???

If your income falls below a certain level, I believe you can get aid towards a Mutuelle…someone will know more about that than I do, I am sure…

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We have some articles worth reading John, and @fabien will be happy to answer any questions you may have.

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Some good points made there and thanks for the responses. My main issue that there so many operations and emergencies are covered 100% and not only the normal ALD conditions. Also I have been on one of the online comparison sites and if you put your phone number down, you are pestered day and night by telesales people non stop. This seems to prove that they are a big money spinner for the companies. I calculate that I paid in over 2400 € last per year and over the past 5 years have received payouts of between 250/400 per year max. Perhaps better to put that away in a special fund for health care.
Another option is to take out hospitalization only which is considerable cheaper and if the need arises, increase the cover to a higher level.


Not wishing to be argumentative… but I think you need professional advice… as, from my own experiences… apart from ALD, the State only covers 70 or 80% of hospital bits and bobs…

But the whole thing is complicated, hence the need for someone you can trust ie @fabien

Sorry but that’s just not true.
I had a hernia operation in March. covered 100% of Br. Also regular bi monthly eye injections at Libourne Ophthalmology 100%. Neither of those are classified as AD


As I said… you need professional advice…if you really think that this was all paid for by the State…

Hi John, the surgery itself is always refunded 100% by the social security except for the ‘forfait hospitalier’ (which is 18e per day) and some extra costs that can vary from an hospital to a clinic (like the anesthetist fees for example).

Just to put that straight regarding your injections, it really depends on why you are doing that. I assume these injections are ‘Injections intravitréennes (IVT)’ probably for DMLA or OMD which are both refunded at a fixed rate instead of a percentage and which is actually 83,60€ so if these injections cost less than that well… that’s a 100% refund rate without classifying it as an ALD :wink:

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Thanks Fabien.
You are correct on the second paragraph they are intravitreennes for rvo. paid 100% by the pharmacy and full cost by the surgery.
You say that surgery is always refunded 100% by the social security, that was my original point, although I didn’t realize that it included all surgery, or have I misunderstood that part?


Of course… the Pharmacy

will actually have been paid by the State and your Mutuelle (whichever bit the State did not pay)… :grin: It’s wonderful when the Mutuelle covers all these extra bits and bobs… makes illness (almost) painless…:smiley:

You’re right, about getting help with the cost of a mutuelle, Stella. Here’s the link .

and , of course, the State only reimburses agreed medical costs… so it depends where one goes for an operation, hospitals can differ (conventionné or non-conventionné) as can clinics…and whether or not the fees charged by the specialist/surgeon are within the levels accepted by the State…it can be quite a minefield. A good Mutuelle is worth its weight in gold…

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We paid 140€ a month for health insurance complementaire when we lived in France 6 yrs ago for the two of us, money well spent and false economy not to have some sort of cover if it is only basic. Now living in Ireland as pensioners, we are fortunate enough to have medical cards which give. us access to health care very similar to that of the NHS but with very long waits for most proceedures. For us here for similar cover to the French Mutuelle, it would cost us somewhere around 6K€ a year. The French system is good, stay in it.

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Well, by surgery I mean the surgeon’s fee (if in an hospital) and the room (what they call the ‘bloc’ at the hospital). Beware though as many ‘small’ fees aren’t covered most of the time like the anesthetist’s fees or the private room.

To be accurate, not all surgery are covered, only the one the social security deem refundable (for example they obviously not refund plastic surgery).

It always amazes me that the anaesthetist fees are separate, it’s not like it is an optional, unnecessary, extra!

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ha ha… I’ve had a wide variety of anaesthetics these past few years… nothing to do with costs though… I’ve now told OH to simply hit me on the head with a brick, next time…:heart_eyes:

True but equally, it’s not like the surgeon is also going to administer the anaesthetic as part of his job. He’s too busy sharpening his knives…:scream: