Complementary health insurance in France (mutuelle) and your employer's plan

An example from Assurance Maladie's 2026 tariffs: a consultation with a sector 1 general practitioner costs €30. If you have declared a regular doctor (médecin traitant), public insurance reimburses 70 %, minus a €2 flat contribution (participation forfaitaire), so you get back €19. A complementary insurer typically covers most of the remaining patient's share (ticket modérateur).

Other costs you may face:

• Extra fees (dépassements d'honoraires) charged by sector 2 doctors above the reimbursement base; whether your complementary cover pays them depends on your contract.
• Deductibles on medicines and paramedical care (franchises médicales): €1 per box of medicine and per paramedical act, €4 per medical transport. Assurance Maladie lists an annual ceiling of €70 per person for these deductibles (October 2026); the €2 flat contributions have their own annual ceiling. Under-18s, pregnant women from the sixth month and Complémentaire santé solidaire beneficiaries are exempt.
• Glasses, dental crowns and hearing aids: public reimbursement outside the 100% Santé offers is low.
• Hospital stays: a daily hospital charge and any private-room supplements.

Private-sector employers must offer all employees a collective complementary health plan, whatever their length of service, and pay at least 50 % of the premium. The plan must at least cover:

• the full patient's share (ticket modérateur) for consultations and care reimbursed by public insurance;
• the daily hospital charge (forfait journalier hospitalier) without time limit;
• dental prosthetics and orthodontics up to 125 % of the public reimbursement base;
• glasses within set amounts (from €100 for simple correction up to €150–€200 for complex correction).

Many plans go further, and some cover your partner and children for an extra premium. Your employer gives you the plan's summary of benefits; read it to know your level of cover.

Membership is normally compulsory, but you can ask in writing for an exemption (dispense d'adhésion) in specific cases, usually when you are hired or when the plan is introduced. Examples include:

• you are already covered by another collective plan, for example as a dependant on your spouse's company plan;
• you have individual cover when you are hired (until that contract's expiry date);
• you receive the Complémentaire santé solidaire;
• you are on a fixed-term or temporary-agency contract, or work part-time, under the conditions set by the rules and your company's plan.

If your contract ends for a reason other than gross misconduct and you are entitled to unemployment benefit, you keep your company plan free of charge for the length of your benefit entitlement, up to 12 months (portabilité).

When that period ends, the insurer must offer you an individual continuation contract (under the loi Évin rules). You have six months to accept. Its price is capped for the first three years — the same as active employees in the first year, then at most 25 % and 50 % more — and is free after that.

If you are not covered through an employer, compare several offers from different types of providers. Points to check:

• Responsible contract (contrat responsable): needed to benefit from the 100% Santé offers with nothing left to pay.
• Levels of cover expressed as a percentage of the public reimbursement base (for example 100 %, 150 %, 200 %) or as a fixed amount per year, especially for glasses, dental care and specialists' extra fees.
• Waiting periods before some benefits apply, annual ceilings and exclusions.
• Third-party payment (tiers payant): many insurers provide a card so you do not have to pay their share at the pharmacy or laboratory.
• Price changes with age and whether family members can be added.

Under 100% Santé, a selection of glasses (frames and lenses), dental crowns, bridges and dentures, and class I hearing aids is reimbursed with nothing left to pay, when combined with a responsible complementary contract or the Complémentaire santé solidaire. Ask the optician, dentist or hearing-aid professional for a 100% Santé quote alongside any other offer. For adults, glasses can generally be renewed every two years.

The state-funded Complémentaire santé solidaire replaces a private policy for people with low incomes. It pays the patient's share in full within public tariffs, covers the daily hospital charge, includes the 100% Santé glasses, dental and hearing offers, and you do not pay up front at the doctor's.

2026 income ceilings for a single person (annual resources):

• free up to €10,421;
• with a monthly participation up to €14,069: €8 (age 29 or under), €14 (30–49), €21 (50–59), €25 (60–69) or €30 (70 and over) per person.

You must have lived in France for three months (or work or study here). Apply online through your ameli account or with form 12504 sent to your health insurance fund. It is granted for one year and can be renewed.