Soil ideal for planting a series of ideas

Product consumer, insurance supplementary health did nevertheless overlooked in its operation. Soil ideal for planting a series of ideas. Such body touting you his contract concludes without medical selection This is normal, it is the... Act! Another de jure you that never it does put you out The Act still... Everything you need know to separate the wheat from the chaff.

1 / Where can I buy a complementary health

Everywhere where you buy other products of insurance: insurers, mutual companies, provident institutions, brokers online or not, to the position, in a number of banks (Crédit Mutuel, Crédit Agricole, Banques Populaires, Caisse d'Epargne, etc.).

2 / The medical selection still exists

Anyone can now agree a contract without having to create health or medical questionnaire. In mutual health, the medical selection is purely prohibited by the Code of mutuality. Among insurers, it is permitted but it is very rarely performed (in a few very high contracts range) because, otherwise, they must pay a tax. "More than 98 of our contracts are entered into without health questionnaire," confirms Alain Rouché of the French Federation of insurance (FFSA) companies.

3 / A body of insurance may terminate the contract health of an insured person who consumes too much

Normally, no. Once the contract is purchased, the guarantees have an immediate life nature. Therefore, the contract cannot be terminated by the Organization of insurance (mutual, insurer or provident institution).

4 / How is changing the tariff from one year to the other

An insurer may not increase the rate of a contract in particular, on the pretext that the State of health of the insured is degraded. The tariff increase should apply to all contracts of the same type or of the same generation. Clearly, a person who consumes little will suffer the same tariff increase than its neighbour, which consumes a lot. There is no customisation of prices on medical consumption.

Two parameters are however tariff increases: first age of the insured, then the General increase in applied to an entire category of contracts. The initial tariff is based on the age of the insured at the time of subscription, it evolves then every year with the ageing of the insured, either every five years for example (by age-classes). The two schools share. At this individual growth, linked to the progress in age, typically associated with a general increase in applicable to an entire class of contracts, which is a function of general medical use of the insured portfolio or the weight of loads of social security transfers to complementary insurance for example.

5 / The tariff may increase during the year

This is very rare, but it can happen. It is often linked to an element of external environment to the mechanisms of the contract itself, such as a sudden and brutal of health expenditure drift, for example, or a disengagement of social security, which would place a burden much more heavy on complementary insurers.

6 / The insurer or the mutual are free to modify their rates from one year to the other

A priori, Yes. Tariff increases are however reflected carefully. The being more and more competition on the market of supplementary health insurance agencies that are reported to practise too strong increases risk losing customers. Conversely, those who would not increase tariffs could wipe financial losses.

7 / Is it possible to agree a contract health at any age

Everything depends on the contracts. Most of them require a maximum age limit to purchase: 65 years on average in the unmarked forms and 80 years on average in the forms dedicated to senior citizens.

Groupama ("Groupama health Active") or to the AG2R ("Flexeo health", dedicated to the seniors) for example, there is no limit of age to the membership. In Novalis, the distinction on the basis of the level of guarantee: there is no age limit, except for the purchase of the formula high range.

8 / Guarantees play immediately or is there a waiting period

Here again, there are as many situations as contracts. AXA or Crédit Mutuel, for example, impose no timeout: all health-care costs are immediately supported after accession, including optical and dental costs.

Other insurance organizations, however, apply delays, according to the guarantees, ranging from 3 to 12 months. They are generally applied on care spending maternity, the dental, optical, appliances... but the hospital rarely. These timeouts are typically removed when the insured person was previously covered by another health contract.

9 / When an employee enters a company a contract may further compulsory health, refuse to join

Non. If the undertaking in which it is has a complementary compulsory health, the newcomer will be necessarily covered by this agreement: every month its assessment will be levied on his salary, without that he can oppose (to avoid double insurance, should then terminate the pre-existing individual contract). "Employees who were already in the company at the time where the compulsory scheme has been implemented can, escape, provided however that the regime the expressly provided", explains Bertrand Boivin-Champeaux, Director of the foresight in the technical Centre of provident institutions (CTIP).

10 / What happens to people who have a company health contract when they leave at retirement

The loi Evin of 31 December 1989 provides that, if the insured from retirement in fact the application, the insurer of his company must offer him a contract with similar guarantees and a premium of 50. This provision is sufficiently vague to let place to many interpretations. The rate increase of 50 applies the first year after retirement only or for the duration of the contract Must the new contract guarantees be strictly identical or only equivalent to those of the former contract Before these difficulties of application, insurance agencies prefer to propose any other contract to the new retired, then the loser... the protection of the law (see "Les Echos heritage", November 9, 2007).