The essentials in 30 seconds
- The supplementary health insurance covers what the Social Security does not (optics, dental, hospitalization, hearing aids)
- It exists in two forms: individual (subscribed freely) or collective (offered by the employer)
- At retirement, the company mutual insurance stops: it is essential to anticipate this transition
- The choice of a contract must be made by comparing guarantees, services, waiting periods, and price
- Malakoff Humanis offers modular plans tailored to individuals, seniors, and families
What is supplementary health insurance?
Supplementary health insurance, also called mutual insurance, is a private insurance contract that covers all or part of medical expenses not reimbursed by compulsory health insurance. In France, Social Security covers on average only about 77% of health expenses according to DREES. The remaining charge (consultations, medications, dental care, glasses, hospitalizations) falls on the patient, unless they are covered by a supplementary health insurance.
It intervenes on three levels:
- The co-payment: the share of care left to the insured after reimbursement by Social Security
- The daily hospital charge: billed for each day of hospitalization
- Excess fees: charged by sector 2 and 3 doctors, particularly frequent in urban areas
Why is it important to have supplementary health insurance?
Without supplementary health insurance, some expense items can quickly weigh on a household’s budget. Here are the main ones:
| Expense item | Social Security reimbursement | Average out-of-pocket cost without mutual insurance |
|---|---|---|
| Dental prosthesis | 70% of the conventional rate | €300 to €800 per crown |
| Glasses (progressive lenses) | Small allowance (between €2 and €30) | €200 to €600 |
| Hearing aid | Capped (€950 per ear) | Up to €1,500 per device |
| Hospitalization (private room) | Not covered | €60 to €120 per night |
| Sector 2 specialist consultation | Partial | €20 to €80 in excess fees |
For families, seniors, and people suffering from chronic diseases, these amounts can represent several thousand euros per year. Supplementary health insurance is therefore less a luxury than a concrete financial protection.
What are the main differences between individual supplementary health insurance and group supplementary health insurance?
It is one of the most frequent questions. Both types of contracts cover the same expense items, but their functioning differs significantly.
| Criteria | Individual supplementary | Collective supplementary (company) |
|---|---|---|
| Employer contribution | None | Minimum 50% (ANI law 2016) |
| Price | Calculated according to age, region, guarantees | Mutualized at the company scale |
| Personalization | Strong, modular contract | Base imposed by employer, with possible options depending on contracts |
| Coverage at retirement | Yes, without interruption | No, stops at retirement |
| Portability | Individual options may be provided depending on contracts | Possible via Évin law (under conditions) |
The collective mutual insurance presents an obvious financial advantage thanks to the employer’s contribution. However, it disappears at retirement, which requires subscribing to a new individual contract, often at an age when prices are higher.
What are the best supplementary health insurance options for a 65-year-old retiree after losing their company mutual insurance?
It is a pivotal moment. At 65, health needs increase (optics, dental, audiology, hospitalization) while income decreases with retirement. Here are the main avenues to explore:
1. Activate Évin portability
The Évin law allows you to maintain your former company mutual insurance after retirement, with a regulated price for three years by decree no. 2017-372: identical to active employees the first year (but you now pay 100% of the contribution, the employer’s share disappearing), then capped at +25% the second year and +50% the third. Beyond that, prices become free. It is a useful transition solution, but rarely competitive in the long term.
2. Subscribe to a dedicated senior mutual plan
These contracts are specifically designed for the needs of people aged 60 and over. They generally include enhancements on:
- Dental prostheses and implants
- Optical equipment (progressive lenses, frames)
- Hearing aids
- Long-term hospitalization
3. Compare guarantee levels
| Level of plan | Indicative monthly price (65 years old) | Suitable if… |
|---|---|---|
| Entry-level | From €60 | Good health, few specialized treatments |
| Mid-range | €60 to €90 | Regular optical or dental needs |
| High-end | €90 to €150 and more | Frequent care, high excess fees, hearing aids |
Indicative prices, variable according to region, insurer, and exact guarantees chosen.
4. Verify family coverage
If you have a spouse or dependents, check that the contract allows including them and at what cost. Some senior contracts also cover grandchildren in joint custody.
5. Check waiting periods
Some contracts impose a waiting period before reimbursing certain care, notably in optics and audiology. This must be checked carefully before subscription.
How to choose your supplementary health insurance: essential criteria
Whatever your profile, here are the points to consider before signing:
- Actual guarantees: compare the effective reimbursement on your 3 main expense items, not just the displayed percentages
- Annual caps: some contracts limit reimbursements to a fixed yearly amount
- Partner care network: an extensive network allows access to negotiated rates at opticians, dentists, and hearing aid specialists
- Associated services: teleconsultation, home assistance, coverage of complementary medicines
- Insurer’s reliability: prefer a recognized player, with a transparent management history
Malakoff Humanis: a benchmark for individuals and retirees
Born from the merger of Malakoff Médéric and Humanis in 2019, Malakoff Humanis is today the leading mutual social protection group in France, covering more than 10 million people. Its non-profit mutualist model allows it to reinvest its surplus in the service of its members.
For individuals and retirees, the group offers modular supplementary health insurance plans, without waiting periods, with a quick online quote and no medical questionnaire. Members also benefit from a partner care network with negotiated rates, a teleconsultation service, assistance in case of hospitalization, and social support for vulnerable situations.
4 mistakes to avoid when choosing your supplementary health insurance
- Focusing only on price without checking the actual guarantees
- Ignoring waiting periods, especially in optics and audiology
- Forgetting to anticipate the evolution of your needs in 5 years
- Ignoring associated services (teleconsultation, care network, assistance)
