Economy What happens when your right to mutual health insurance...

What happens when your right to mutual health insurance is not renewed?

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648x415 mutuelle solidaire une fin de droit encadree1

When your rights to Solidarity Health Supplement expire, you can benefit from a supervised exit contract. – IStock / City Presse

To allow all French people to be able to take care of themselves at a lower cost, the State has set up several financial aids. Among them, the Solidarity Supplementary Health (CSS), which since autumn 2019 replaces the complementary universal health coverage (CMU-C) and the Supplementary health assistance (ACS).

Thanks to this, the bills of general practitioners, dentists and registered nurses, as well as your medications, are fully or mostly covered.

An annual request

To benefit from this system, you must make the request to the Health Insurance, attaching the supporting documents showing that you respect the required resource ceiling. But beware of surprises, because its attribution is not permanent. This assistance is granted for a period of one year, from the date indicated on your certificate of entitlement.

To continue to benefit from it thereafter, you will have to send your renewal request each year, taking it between two and four months before the expiry date and again providing all the proof of resources. It is only if you receive the active solidarity income (RSA) or the solidarity allowance for the elderly (Aspa) that the renewal is automatic.

Choose an authorized body

When filling out your aid request form, you will have to choose the manager in charge of your complementary health and solidarity. This can be your health insurance fund or one of the authorized organizations. However, if the guarantees are the same, this decision will have a significant impact if your rights expire.

Indeed, if your resources have increased and your renewal request is refused, the mutual partner will be obliged to offer you an “exit contract” for a period of one year. The goal? Allow a smoother financial transition. This specific formula is equivalent to the so-called responsible supplements, which cover the co-payment for all procedures reimbursed by Social Security and apply 100% Health to certain treatments and equipment. All for a controlled price varying between 16 and 60 euros per month depending on the age of the insured.

Conversely, if you choose your health insurance fund as manager, no exit contract will be offered to you and you will have to turn directly to a classic private offer and necessarily more expensive.

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