Notice of fever on the prices of complementary health. A study conducted by Meilleurtaux Assurances and published on Tuesday highlights the significant increase in rates this year, especially for seniors. A 60-year-old insured couple in enhanced guarantees must now pay on average more than 250 euros per month (or more than 3000 euros per year) to benefit from additional coverage. An increase of nearly 5% over one year.
If the health budget of the French occupies a growing and particularly inflationary place on the 55-60 age group, it can reach sometimes exorbitant rates on the 60-70 age group, "notes the study of the insurance comparator. For a couple of 70-year-old seniors in enhanced guarantees, the average price of a complementary health reaches more than 300 euros per month. On the side of the youngest, if the rates logically have nothing to do, they also remain on the rise. Count 34 euros per month on average for a young single worker of 25 years in classic guarantees (+34% in one year), and 100 euros monthly (+2.5%) for a couple of thirty-year-old employees, with two dependent children aged 3 and 7, and a classic level of guarantees.
Read alsoSeniors: how to find a good mutual?
Wide variations depending on the territory
Price increases that do not surprise Carine Milcent. The CNRS research director and professor at the Paris School of Economics (PSE) justifies them by the growing weight of mutual insurance companies in the healthcare reimbursement policy. "Complementary health has taken an increasingly important part in recent years in relation to compulsory health insurance, explains the health economist, citing in particular the reform of the "100% Health", which came into force in 2021. As the basket of coverage expands, the complementary ones increase their level of contributions.»
It is important to understand that the figures of the Meilleurtaux Assurances study - from internal data collected for the month of August 2023 among 900,000 rates - are national averages. Because the prices of complementary health vary widely depending on the territories, notes the study. This "may be due to a different consumption of care and a more or less systematic practice of fee overruns," observes the insurance comparator. "The supply of care and the share of practitioners in sectors 1, 2 or 3 is different depending on the territory," confirms Carine Milcent.
It is thus in Île-de-France and in the Bouches-du-Rhône that we find the highest monthly payments. And, conversely, in the three departments of Alsace-Moselle (Bas-Rhin, Haut-Rhin, Moselle) that they are the weakest, "given the health regime specific to the departments of the East," says the study. The Territory benefits from its own local scheme, which pays its beneficiaries additional reimbursement, in addition to what the basic social security scheme covers. For example, in the case of a 60-year-old senior couple in enhanced guarantees, the highest rates are in Paris (285 euros per month, +6% compared to 2022). Then come Hauts-de-Seine (284 euros, +8%), Alpes-Maritimes (280 euros, +9%), and Val-de-Marne (278 euros, +6%) and Bouches-du-Rhône (278 euros, +7%). In the three departments of Alsace-Moselle, rates fall to less than 200 euros per month - although they are up 8 to 10% in one year.
See alsoHealth: with its mandatory mutuals, the France is an exception in Europe
Load transfers to add-ons
And the soaring tariffs are unlikely to subside in the future. For 2024, "the first projections point to strong revaluations to come with indexations between 9 and 11%," reports the study. "If there is the continuation of this mechanism of communicating vessels between compulsory health insurance and supplementary health insurance, it is obvious that we will have to expect an increase in premiums," confirms Carine Milcent.
That is exactly what the government is working towards. "Transfers of burden from health insurance to complementary health insurance are planned as part of an extension of 100% Health," says Samuel Bansard, president of Meilleurtaux Assurances. On 1 January 2024, the rest at zero charge could indeed be extended to hair prostheses and wheelchairs, as part of this reform launched in 2021 and which currently concerns only optical, dental and audiology care. To this will be added from 1 October the reduction in the coverage of dental care by the Health Insurance, which will go from 70% to 60%, placing an additional burden of 500 million euros in a full year on mutual insurance companies.
Beyond these public policy choices, the prices of complementary health insurance are also driven up by the evolution of French demographics. "The aging of the population leads to an increase in the share of the population that requires care, leading mutuals to increase the amount of premiums," says Carine Milcent. To remedy this problem of out-of-pocket expenses, which will become more and more prevalent in the future, an idea comes up regularly in the public debate, that of establishing a "health shield". It was even mentioned in a report by the High Council for the Future of Health Insurance (HCAAM), published in January 2022. "Schematically, this mechanism consists in capping the accumulation of out-of-pocket expenses: from the moment this accumulation reaches a certain level or "ceiling", health expenses are covered 100% by Social Security," explained the independent body. For the time being, the executive has not seized this proposal.