In France, basic healthcare protection is guaranteed by the Health Insurance branch of Social Security. This system is funded by employee and employer contributions.
Health Insurance reimburses the employee (known as the insured person), based on a liability fee (tarif de responsabilité), which partially covers the fees incurred. The insured person thus pays the remaining balance, which is called the co-payment (ticket modérateur).
A doctor who abides by the liability fee, charges a standard fee (tarif de convention). If the practitioner is not government-regulated (non conventionné), the total that surpasses the standard fee is considered extra-billing (dépassement d’honoraires), and must be covered by the insured person.
Generally speaking, the insured person will pay the remainder, whose amount depends on the type of health expenditures and the price charged by the practitioner.
The complementary healthcare scheme, whether it be individual or collective, allows the insured person to minimize the remainder to be paid by fully or partially reimbursing him the co-payment and extra-billing.
The collective contract offers numerous advantages :
- negotiated fees for a high level of coverage
- better compensation for health expenditures
- a simplified process and easy access to healthcare via the direct payment system (
tiers payant)
- deduction of the contribution base from taxed income, for mandatory membership contracts subscribed to by the employer, within the limits of fiscal regulation. This is automatically deducted from the payroll by the employer.
NOVALIS information:
In France, NOVALIS Group offers complementary healthcare solutions through the intermediary social protection institutions of NOVALIS Prévoyance and La BOETIE Prévoyance.
Complementary services, in accordance with relevant institutions and supplementary to subscribed coverage, also adhere to the standards of NOVALIS contracts :
-
direct payment system (tiers payant) pharmacy: so that you don't have to pay in advance the part that is not reimbursed by Social Security (according to the contract in force),
- dental and ophthalmologic estimates, in order to evaluate reimbursements related to dental or ophthalmologic work,
- guidance
and counseling,
- preventative actions and information on the areas of health and health expenditures,
- online personalized and secure services.
