Top-up Health Insurance in France

The healthcare insurance system is mixed, with the generality of cover provided by the public system and top-up insurance provided by mutual societies, insurance companies and jointly-managed social protection funds. Companies with more than 50 employees usually negotiate top-up health insurance coverage for them, and individuals may buy top-up coverage from any of its many providers. Many of the top-up insurance polices are issued with a white card [carte blanche] of the same size and format as a bank payment card as well as the national Social Security Card, so complementaire sante and carte blanche are synonymous in everyday usage. The purpose of top-up insurance is to provide coverage of the difference between the actual costs of healthcare and the reimbursements for them. Hence, together, a national Carte d'assurance maladie and a top-up insurance policy carte blanche provide full coverage. There are almost as many different packages of fees and coverage as there are companies providing top-up insurance, so it's wise to compare offerings before buying. Almost all insurance companies provide extensive information on complementaire sante, both in print and online, and the approximately 43,000 professionals involved are affiliated in Carte blanche sante, a portal for top-up insurance, 38 rue La Bruyere, 75009 Paris, Tel: 01 53212425, www.carteblanchesante.com.

Universal Healthcare Insurance

In effect since January 2000, Couverture maladie universelle (CMU) ensures that all residents have adequate healthcare insurance and consequently have access to healthcare, regardless of their ability to pay. CMU is both a right and an obligation, as all residents are legally obliged to be members of the national health insurance system. In practice, this means that a resident must be a member of the local Health Insurance Office.

For most people, CMU covers an average of 75% of medical expenses, through a scheme of reimbursement against outlays according to official rates. A resident may buy top-up insurance and thereby be covered 100%.

Upon application to a local CPAM, low-income families are eligible for increased coverage percentages. CMU provides the six million most disadvantaged people in the country with free top-up insurance so they enjoy free healthcare. Moreover, it provides basic health insurance for some 150,000 people not covered by older schemes, either because they were ineligible or more often because they were unable to assert their eligibility.