Why the price of your complementary health insurance is likely to increase (again)

Mutual insurance prices could still be revised upwards. In question? A possible downward review of the share covered by Social Security at the expense of supplementary health insurance.

It’s hot for the wallet. In 2024, already, the price of complementary health insurance has increased by 8.1%, according to a senatorial report published September 24. This increase could continue next year. According to estimates from the specialist firm Addactis, based on a survey carried out among around twenty mutual societies, provident institutions and insurers, prices could increase by 5.5% to 9.5% for collective contracts taken out in particular by companies. , and 4.5% and 8.5% for individual contracts in 2025. For the senators who wrote the report, the increases practiced in 2024 are “incommensurable” with real needs. The study’s rapporteur, Senator Xavier Iacovelli, recommends “remain attentive to the financial statements of complementary health over the years to come in order to verify the strictly proportionate nature of the increases in contributions to the increases in benefits”.

According to the report, the increase in complementary health contributions is primarily linked to “the progression of their costs, mainly determined by the evolution of health expenditure per capita”. The aging of the population is particularly to blame but it is also linked “the breakdown of the coverage of health expenses between compulsory health insurance, supplementary health insurance and households”.

Towards a reduction in consultation costs covered by Social Security?

Faced with the increase in the Social Security deficit, which could reach 17 billion euros by 2027 according to a report from the Court of Auditors citing a “loss of control”the State sometimes opts for a review of the reimbursement arrangements for medical consultations. In 2023, for example, it was decided to increase the portion reimbursed by complementary health insurance during a dental consultation. The part of the bill supposed to be paid by the patient but reimbursed most often by mutual insurance companies – this is the “moderatory ticket” – has increased from 30 to 40% for an appointment with the dentist. Supplementary health insurance organizations (OCAM) estimate this additional cost between 350 and 500 million euros, reports the senatorial study. According to the Social Security Department, “further transfers may be necessary“. According to Les Echosthe government could in particular choose to increase the co-payment of medical consultations from 30% to 40%. This measure could generate more than a billion euros for Social Security.

At the same time, the price of medical consultations should soon increase from 26.50 euros to 30 euros at the request of certain unions. The senators believe that this measure should “increasing the costs of complementary health insurance by an additional 200 million euros over a full year”. Furthermore, prices are also changing for certain specialists: the consultation with medical gynecologists goes from 31.50 euros to 40 euros, the consultation with the psychiatrist is increased to 57 euros and the screening for melanoma at the dermatologist goes from 47.50 euros. at 60 euros. Senators plan to increase spending on complementary health insurance “100 million euros” additional.

Faced with the increase in mutual prices, Eric Chenut, the president of the French Mutuality, believes that it is necessary “that the responsible and united contract returns to its original goal, which was to make it accessible” essential care. For him, “the first thing would be to stop adding things to the basket” care, reports AFP. The senators also stand up against “increasingly comprehensive guarantees for osteopathy, naturopathy or sophrology costs” with packages that “establish a logic of credits encouraging consumption”. For them, the coverage of these benefits should be “optional” And “exit from the responsible contract in order to reduce the cost of complementary health insurance for policyholders who do not use it”. In the report, the senators also note a “imperfect anticipation of the scale of the new measures to be financed” which could explain an increase in the prices of complementary health insurance. They also mention “a movement to intensify the tax pressure”.