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Complementary health care is a device that enables people whose income is modest and/or irregular to benefit from coverage of their primary health care. Introduced on 1 November 2019, access to it has become easier and makes it possible to pay for health expenses that are not covered by health insurance.
It is the health insurance itself that confirms it: the joint supplementary health insurance is still a device that is still too little known. CNAM even presents a figure: only one in two eligible people know the device. It is therefore launching a national campaign to recall its existence and its benefits.
Free for the most modest
Complementary health insurance (CSS), what is it? It is, as the name suggests, a kind of solidarity “mutual” managed by Sygesikringen. It allows people on modest incomes not to defer healthcare costs, which are usually reimbursed later, and excess fees common among specialists are not imposed. Whether this is after a consultation with their attending physician or with a specialist, the covered person pays nothing at the end of their consultation.
CSS is free for all people earning less than 798 euros per month, and will cost one euro per day, or thirty euros per month, for those whose salary does not exceed 1,077 euros per month.
An essential cover
Although compulsory health insurance in France covers more than three-quarters of health costs, supplementary health insurance remains important, e.g. in case of hospitalization. For the most uncertain, CSS covers all members of the household. It allows for coverage of basic care, such as consultations, admissions, medicine, medical analyses, etc., but also certain glasses, hearing or dental prostheses. In addition, the daily fixed rate is covered for hospitalization without a time limit. Finally, the medical out-of-pocket payment and the fixed contribution of one euro (for consultations with general practitioners) are exempt.
A simplified request
For recipients of social minimums, the application and renewal are simplified:
- Since January 1, the allocation of complementary health solidarity to recipients of active solidarity income (RSA) is automatic, unless they expressly oppose;
- Since 1 April, recipients of the solidarity benefit for the elderly (Aspa) are supposed to fulfill the conditions to be entitled to supplementary health services with financial participation, which makes it possible to facilitate the application and simplify the procedures.
- Since April 2022, the renewal of the Supplementary health solidarity with financial participation has been simplified, in that the annual repayment of a membership document has been abolished if the financial participations are not changed.
If you want to know if you are eligible for this device, you can go to this simulator by first preparing the list of necessary documents to estimate your annual income. In addition, the ameli.fr website will give you more information about this help, who it is for and how to request it if you are eligible.