Mutuelle Must-haves: What's Essential when Taking out Health Insurance?

Been doing the rounds of the insurance bureaux to find complimentary health cover now that we have our carte vitale. It is immensely complicated and trying to work out which one is the best for us is giving me a headache! Please could you help me by sharing your experiences:

  • What is the key thing I need to include? (eg frais réel for hospitalisation)?

  • Which categories is it advisable to increase the percentage reimbursement (eg medicine, pharmacie, dentaire or optique) in order to avoid being clobbered by extra charges?

  • What do you appreciate about your cover and

  • what do you wish you had taken?

Thank you so much for all advice and suggestions

online £50+ (mine were £150, but my lenses are necessarily about as expensive as they come)

In our case, the optical element is very good (100 for frames and then 180 per lens for varifocal plus 200 per year for lenses) So that alone makes up our costs. Plus a pinched nerve for the OH means we are starting to take advantage of it already.

But yes you are right, the maths sometimes don't work out. Hence the recommendation about the hospital policy.

Of course this is where despite how 'wonderful' folks say the French system is, it goes to show the worry that you did not have under the NHS.

It's always my attitude to insurance, cover an absolute disaster, but nothing else. So for a car, the legal minimum has always done (never bought a car for more than 5 grand mind), never bother with damage insurance for the telly and windows, just for if the house burns down.

I hope I'm proved right and that you don't have another nasty health scare this year. or ever of course, sorry.

Can you actually confirm how much the mutuelle reimbursed in the most expensive year; sorry to be picky, but I've heard such sad tales before but nobody ever confirmed how much the mutuelle forked out (as opposed to the headline cost)?


Yes but a family mutuelle is 100€ + per month less something like 30€ average reimbursements (can't find source but read it somewhere), so to stay ahead you'd have to be stung about 5 times in the year

It's actually a list of 30;

thanks Steve

I meant what Dick Smith wrote viz:

the big 5 are reimbursed at 100% - cancer, heart, diabetes, stroke and alzheimers.

Take the case of my wife who fell down the stairs and broke her leg (very badly and just where the shin meets the knee) she needed a operation immediately followed by 1 month in hospital and then followed by 3 months in an excellent recovery center not to far from us with private room and physio 3 times every day. Without full complimentary insurance ( we have 400% cover) this would have cost us a small fortune. Also take me, fell out of tree (I always wanted to know what it is like to fly) and broke 5 ribs and ended up in hospital for 1 week, stung by a wasp and had a massive allergic reaction and in hospital for 1 week on a heart monitor 24x7. Over the past year I have had dozens of Xrays, 5 CT scans, 4 MRI scans..not a penny needed to be paid by me.

Until 4 years ago I had never even had so much as a cold, I am ex military and was until things went downhill rapidly very never know when you will need all that insurance cover.

Rgds, Mike L

Well if you count when a hornet stings OH as an 'accident' with two district nurses (fortunately at do and provided first aid and dealt with '15'), four SAMU, an ambulance, a doctor and another two nurses.

TBH, the hostpital costs were reasonable (about 30 euros to pay), the ambulance was another 150€ - So 180€ for a trip to casualty for a hornet sting.

Fortunately as I am now on a CDI, we got mutuelle at beginning of the year. Used it for the first time at the pharmacy and was presented with a receipt for 0€s :-)

Though I am sure I will be unpleasantly surprised next time when they recoupe the PFs :-(

Whilst I am glad we now have it, it does go to show what an unnecessarily complex system it is. And I suppose your mutuelle does in fact become another 'tax' , albeit an optional one.

I should have said that accidents that involve calling the SAMU - eg car crash/fall in the street etc are normally not charged

No, Doreen if you have an ALD then it is only costs relationg to the ALD that are covered.

This has been covered many times before (do a search) and it appears that the sensible/economic option for singles/couples in good health is to have hospital cover and pay the rest yourself. I never heard that accidents were treated for free though! is a good place to start.

Bear in mind that many medicaments are now reimbursed at 35% not 70% although they are peanuts compared tothe cost of hospitalisation. Minimum charge in a state hospital is about 700€ thats just the charge for the bed. What is useful to know is where the hospitals and clinics around you are conventionee or non-conventionee and go from there.

Personally with young children I feel insurance is a good thing - just like house insurance, hopefully you are paying it for nothing and will never have to claim. However, if you do need it it's good to know it's there giving you one less thing to worry about if you or your family are ill. This comes after the fifth trip to a medical establishment this morning since Christmas! Grr and my kids are relatively healthy fortunately.

Said after my

Hi Steve -could you please expand on 'the nasties listed below' which I could not find?

How expensive is really expensive, bearing in mind that the secu pay 70% (100% if you have one of the nasties listed below), and also 100% after a month. What do you think is the biggest bill you could be faced with?

Try these my parents have just signed with them and we will be too when our current top up contract finishes. The price works out very similar to other quotes but has the added advantage of up to 50% of your cotisation returned each year if you don't claim all that amout back,

For example if you only claim 30 euros back in top up insurance and you pay 1000 Euros in the year you get 50% minus your 30 euros back .

Ask yourself the questions:

How often do I go to the doctor?

How often do I need medicaments?

How often do I need glasses?

How often do I go to the dentist?

Reimbursement for doctor and medicaments are 70% - cost to you for a doctor is about 5€

Dentists and glasses are reimbursed at about 15%.

Do the maths on the cost of a mutuelle. For me the basic cover of hospitalisation is plenty - I have used it twice in 10 years. Bear in mind that accidents are not usually charged and the big 5 are reimbursed at 100% - cancer, heart, diabetes, stroke and alzheimers.

Hope that informs your decision.

Hello, sorry to raise the question, but I paid complimentary health insurance for a year before I realized that I did not need to. I found out through my bank (La Poste)

If you are working, your professional associations probably provide a 'complementaire' if you are not but your revenues for a couple are below 15 000 or 16 000 Euros (check the amount) a year you are entitled to the CMU-C .

If nothing of that apply, take all the possible covers as only 70% is paid by the CMU and hospital can get really expensive.