Mutual health reform in 2020: towards change at any time

The proposal of law relating to the termination of his mutual health insurance at any time was passed in the Senate on July 4, 2019 and will come into force on December 1, 2020. The latter will allow members to change mutual health insurance free of charge. after one year of membership. It concerns both individuals and companies with their mutual company. Let’s decipher how this new provision will be implemented and what it will really change for policyholders.

What does this new law say about the termination of mutual health insurance?

Real progress, this law will allow members to terminate their mutual insurance contract at any time and free of charge after a first year of membership.

Until then, insurers sent by mail a notice of expiry as well as the deadline for termination to their policyholders. This deadline for termination is still today set at 2 months before the anniversary of the contract. However, the mail being generally sent 15 days before the deadline for termination, the time to start the process was intended to be reduced. With the measure that will come into force, it will no longer be necessary to wait to terminate.

Termination at any time is not the only measure that will be put in place with this law. Indeed, insurance contracts will also have to be more readable. Organizations (mutual funds, insurance companies and provident institutions) must be transparent as to the reversion rate. The latter represents the percentage of contribution intended for the reimbursement of care. This information must be given at the time of subscription.

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In practice, a redistribution rate of 75% means that an insured receives €75 in reimbursement for €100 in premium.

Who is the reform for?

The reform is valid for individuals with their individual health insurance and for companies with their mutual company. It concerns the both insurers, mutuals and provident institutions.

The French will be free to obtain quotes from other companies to change complementary health insurance for one that suits them in order to complete reimbursements from Social Security. In a few months, you will be able to start finding out about the offers offered by complementary health insurance. Health insurance must be able to adapt to your situation to allow you to benefit from a personalized contract. Regarding the mutual health of the eovi-mcd.fr site, for example, you have access to the various guarantees offered according to your age, family situation, job, etc.

Why simplify the termination conditions?

This measure aims to encourage insurance companies to revise their tariffs and allow the French to gain purchasing power.

By simplifying the conditions for terminating contracts, the government hopes encourage organizations to lower management fees. Indeed, a gain in purchasing power would save nearly 1.2 billion euros for policyholders according to the consumer association UFC-Que Choisir.

However, the reform is still controversial on this subject. Many people think that it will, on the contrary, encourage an increase in management costs and therefore in the price of contributions.

What about the 100% health reform?

The 100% health reform is one of the government’s action points to provide the French population with access to quality care and equipment. At the heart of the reform, the remains at zero charge is one of the key measures. Its purpose is to gradually eliminate the remainder of the baskets of hearing, optical and dental care after reimbursements from Social Security and complementary health insurance, in particular for the purchase of glasses, dental prostheses or even hearing aids.

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It is, in fact, in optical, dental and audiology that the rest to be paid is the most important. According to the Ministry of Solidarity and Health, the remaining charge is €850 on average per ear for a hearing aid, €650 for optical equipment (frames and lenses) and €195 for a ceramic crown. Optimal care will make it easier to equip yourself, in particular to protect your eyes from blue light or to repair a broken tooth.

This reform has been in place since January 1, 2019. Policyholders benefit from better reimbursements for care until full reimbursement, with no remaining costs, scheduled for 2021.

The Minister of Solidarity and Health also recalled the importance of this reform not becoming a reason for raising prices in 2020 during a meeting with representatives of mutual insurance companies and provident institutions. The president of the Mutualité, Thierry Beaudet, had subsequently promised that the contributions of the mutuals would increase in the same proportions as in previous years. The government will have to remain attentive on this point.


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