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ESSENTIALS: MOVING TO FRANCE

MOVING TO FRANCE

Health insurance in France: What you need to know about a mutuelle

In the case of a no-deal Brexit, certain groups of British people will need to prove that they have full health insurance. With the government's new residency site now up and running, we take a look at what exactly a French mutuelle involves.

Health insurance in France: What you need to know about a mutuelle
Photos: AFP

What are mutuelles?

France’s mutuelles are non-profit organisations which have been in operation in the country for at least 150 years.

Their main purpose is to ensure social welfare but not just through additional health cover, also in terms of pensions, disability benefits and other forms of cover.

Mutuelles abide by the code de mutualité, which distinguishes them from health insurance companies in that members don’t have to pay premiums for pre-existing conditions and have a greater say in decision-making as part of this type of co-op or partnership.

READ ALSO France's new carte de séjour website: How does it work and what do I need?

While mutuelles are paid for by individuals they are not private health insurance and don't come up with preferential treatment or access to private clinics.

How does a mutuelle actually work?

If you go to the doctor or hospital in France or have an x-ray or some other kind of test, you'll normally pay up front.

You are then refunded a percentage of the cost via the carte vitale system, usually within a week, either by the French government if you are working or your home government if you are a pensioner (under the S1 scheme for British people).

In general terms the state covers around 70 per cent of the total, although for some serious conditions the percentage of state health cover is higher or even complete.

What a mutuelle does is cover, either partly or completely, the deficit or the part of the cost not covered by the state.

Essentially, a mutuelle is top-up health cover and one of the easiest ways of getting 100 percent health cover, although how much cover you get will depend on which mutuelle you have and how much you were charged (read on).

Recent figures for the French insurers' group Mutualité française showed that the average resident in France will have to pay out €235 a year in medical costs not covered by the state – unless they have a mutuelle. And of course for the elderly or people with long term health conditions the figure can be a lot higher.

Not every mutuelle is the same

Depending on the policy chosen, mutuelles can cover most or all of the remaining costs not reimbursed by the state, as well as some selected medical services and the cost of medicines at the pharmacy.

In general terms basic mutuelles will take you up to 100 per cent cover but often the next step up, a standard cover offering around 150-175, or 200 percent, won’t cost a lot more and could tie you over for a lot of expensive extras such as dental and optical treatments. 

Things are made more complicated by the fact that doctors in France can charge more than the base rates set by the state (tarif de convention).

This is known as dépassements d’honoraires and are added on by many specialist doctors. For example while most GPs will charge the base rate for appointment of €25 some will charge €40.

If you have a mutuelle that reimburses at 100 per cent that will only cover the €25 tariff de convention. To cover all of the €40 you'll need a mutuelle that reimburses at 200 per cent. And the same applies to all medical treatment. Note that more expensive mutuelles will reimburse to 400 percent. More info here.

The mutuelles and complémentaite santé market is fairly flexible in this regard so it’s worth having a search online for the policy that best suits your needs and budget.

And make sure you look carefully at the rate of reimbursement.

There are plenty if not too many to choose from, so also ask French friends or your local doctor for recommendations to get a better idea and more honest opinion. 

Your company might foot the bill

Since 2016 private companies in France have to provide employees with a private health insurance policy known as a mutuelle collective.

By law they have to cover a minimum 50 percent of the mutuelle’s cost and companies also tend to offer workers extended medical cover for their family members as a perk.

Employees are in fact expected to join the scheme unless they have a valid reason for not doing so.

However, if you work in the public sector, you’re job seeker, student, self-employed or a pensioner, this law doesn’t apply to you and you’ll have to opt for a mutuelle individuelle, which tend to offer less cover.

So what’s the cost?

Mutuelles are more affordable than private health cover in the UK, hence why most people in France have one.

However unlike in Britain, it doesn’t guarantee faster treatment at the hospital or get you access to private doctors and clinics either. It just assists financing the personal contribution element of France’s healthcare.

According to 2016 results by France’s Personal Insurance Price Index (IPAP), average yearly mutuelle costs range from €350 to more than €1,200.

Data from French insurance comparison site lecomparateurassurance.com found that for over 60s average annual expenditure is €2,500, roughly €212 a month.

For families where the parents are around 35 and their two children are between the ages of 7 and 3, a family bundle costs around € 90 a month, or €1083 per year.

For a 25-year-old worker on the other hand monthly mutuelle spending is around €26.

Another consideration worth noting is that different regions of France have higher and lower mutuelles prices, although this generally affects the rate by around 10 per cent. 

Read the small print

The mutuelles and complémantaire santé market is a competitive one so as mentioned earlier it’s best to ignore the sale pitches and cut to the real deal.

Make sure you read carefully through what your prospective mutuelle offers, in particular the small print of your contract, as this is often convoluted but still very telling.

Watch out for what calculation they use to actually reimburse you. 

Keep an eye out for the cancellation clauses too as they can be quite specific and require notice to be given several months in advance.

If you're not a mutuelle member already, you should probably become one

Unless you’ve got private health insurance or plenty of money stashed away which you’re willing to burn in case of a medical emergency, you’d be better off paying for a mutuelle or top-up health cover in France.

Keep in mind that healthcare isn’t completely free in France (as in the case of the NHS in the UK), so fees can run into the thousands of euros if you have to go to hospital.

It’s a case of being better safe than sorry…or in debt.


 

 
 

Member comments

  1. We are Brits, with a carte vitale and mutuelle – is this enough in the event of a no-deal or will the French withdraw the carte vitalle?

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PROPERTY

Garant: How the French guarantor system works for property rental

If you're looking to rent an apartment in a larger city in France, you're likely to see announcements that require a 'garant'. Here is what you need to know about finding a guarantor in France.

Garant: How the French guarantor system works for property rental

Renting in large cities in France – particularly in Paris – is a known challenge for foreigners, especially new arrivals. In the countryside, it’s a bit easier, with less competition properties, but in the big cities compiling your dossier and landing the right place can be a challenge.

One of the biggest surprises for many people is that most landlords ask for a guarantor (garant) in order to sign a lease for an apartment. It is not a legal requirement, but in competitive real estate markets, it certainly feels like one.

Though asking for a garant might feel a bit juvenile, it is quite common, and applies to a lot more people than you might realise. Here is what you need to know:

Who typically needs a guarantor?

The most common group to need guarantors are students. However, if you are a foreigner who is not employed with a CDI (indefinite contract) and if you do not make over three times your monthly rent, you will likely need a guarantor as well.

If you don’t collect your income in France (or if you don’t have an income) you will need a guarantor.

You will also likely need one if you are still in the probationary period of your CDI, or if you cannot show three months worth of pay stubs from your job yet (even if you pay meets the three times a month requirement). If you do have a CDI, you could ask your employer to sign you an attestation d’employeur which verifies your monthly income. 

If your income is not steady or consistent (perhaps you are a freelancer). Typically, if you use an agency during the leasing process, they will require a guarantor, especially if any of these conditions apply to you. 

It is worth noting that showing bank statements typically do not suffice – landlords are looking for proof of ongoing income, not savings.

Who can count as a guarantor?

The guarantor should be a third party, such as a parent or close relative who agrees to pay your rent if you fail to pay.

This person must fulfil all the requirements outlined above (ie earning more than three times your rent with an indefinite contract).

The other tricky part is that this person must work and live in France, and usually it’s best that they are French themselves.

However, this can pose a problem for foreigners who might not know anyone that fits that description, so thankfully there are some other options fill this requirement, like taking out a caution bancaire or using an online agency. We explained the ins-and-outs of these bellow.

What does my guarantor need to show?

The guarantor needs to put together a dossier of documents including;

  • Proof of identification (a passport or French ID card)
  • Proof of residence that is less than three months old (eg utility bills).
  • Most recent tax returns
  • Employment contract and typically three months worth of payslips
  • If they earn money via real estate, they must also provide documentation for this
  • If the person in question is retired, they must provide proof of pension (again, this must exceed your monthly rent threefold). 

So, what if I don’t have a French person who can be my guarantor? There are a few options for you:

Use an online service

There are two main online services that can act as guarantors for foreigners in France.

The first is Visale, which is accessible primarily to foreign students.

This is a programme offered via the French state through “Action Logement” and it covers up to three years of unpaid rent. You must be between 18 and 30 years old to apply, and you must hold a long-stay visa (VLS-TS) – either a student visa or a ‘talent’ one.

For students who are already citizens of a European Union country, then simply presenting a student card and a valid passport will be sufficient. It can be applied to private housing and student residences, but it is ultimately up to the landlord as to whether they will accept a tenant who uses Visale as their guarantor. The main benefit to Visale is that it is free for the user.

Visale does come with some restrictions, however. Your rent (including charges) cannot exceed €1,500 in Paris, and €1,300 in the rest of the country. In addition, the lease must be for a primary residence, and your rent should not exceed 50 percent of your total income.

Another option is GarantMe, a paid online website that can also serve as an official guarantor.

Landlords might actually prefer this service over a physical guarantor who might refuse to pay or for whatever reason not have the funds to do so. The benefit to GarantMe is that they accept a wider range of tenants for their service, but the downside is that there is a fee. The minimum payment (per year) is €150, but the fee is normally 3.5 percent of the annual rent (including charges) and it renews automatically.

The nice thing about GarantMe, is that in order to apply for the service, you basically need to create a full dossier that will be identical to what you’ll need for your apartment search anyways.

Take out a Caution Bancaire

Basically, a caution bancaire is a bank guarantee, and typically its a bit more of a last resort option because it is quite restrictive for the tenant. It involves blocking off a large sum of money to be used to pay rent if you fail to do so.

Depending on the landlord (and the bank), they might ask you to block between six months worth of rent to sometimes up to two years. This would be used as guarantee during the duration of your lease, but it takes a bit of administrative coordination and obviously requires a large sum of liquid funds.

Sometimes activating a bank guarantee can take a few weeks, and for foreigners, of course, this would require already having a French bank account. There can also be fees, depending on the bank, for using a caution bancaire, and simply closing of caution bancaire account in itself can involve fees.

The other downside to this is that not all landlords will accept it, which is why this option might be best served as a last resort.

Attempt to find an apartment that does not require a garant

This is quite difficult in Paris (and other large cities around France). It is possible sometimes if you stick to foreigner-oriented sites like NY Habitat or Paris Attitude. Another possible loophole could be to see if your insurance plan offers coverage of unpaid rent. This is quite uncommon, but could be a possible option. If you rent specifically particulier-à-particulier (meaning you do not use an agency at all) you might be able to negotiate with the landlord, or if you have a sub-lease you might not need to show proof of a guarantor.

Ultimately, however, in most cases when renting in France’s large cities, you’ll likely need a guarantor.

What should I be aware of when it comes to guarantor websites?

As mentioned previously, Visale is only for people in the 18-30 age group, so unfortunately it does not apply to everyone. It is also intended for lower income people or students, so if you are a high earner you might be rejected.

Regarding using a website like GarantMe, beware that they will charge you every year – it is not a one time fee. This will be deducted from the card you put on the site and the only way to cancel the charge will be to show proof that you have moved out (i.e. an état des lieux or letter releasing you from the obligation signed from your landlord)

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