Top-up health insurance increasingly expensive for over-60s in France

The cost varies significantly depending on where you live, a new study finds

Not all healthcare costs in France are covered by the state reimbursements system
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Top-up health insurance for people aged 60 and over in France is becoming more expensive, a new study has found.

The latest annual study by Meilleurtaux Assurances found that on average, a couple aged 60 will pay around €3,000 per year, or €250 per month, in 2023, which was 5% more than in 2022. That rises to €300/month at age 70.

One retired driver, Claude, told FranceInfo: “It costs me €90 per month and my wife €120-130 per month, with my daughter on her policy.

“When you add it up, it’s a lot. I’m retired, on only €1,500 per month.” A former car technician said that he pays €308 per month for the highest level of coverage.

The rates have prompted French health economist Frédéric Bizard to brand the system “dysfunctional”.

Top-up health insurance is not obligatory in France, but most people have some form of it to cover the remainder of healthcare costs that are left after the amount paid by social security.

Top-up insurance can also pay for extras, such as more comfortable hospital rooms, some more complex and costly forms of dental work (eg. orthodontics), or higher-end glasses and corrective lenses.

Many people have a top-up through their work (employers are obliged to offer this). Others pay out of their own pocket for an individual policy.

Only around 5% of people in France do not have this extra coverage. However, during the Covid crisis, there were reports that up to 12% of older people did not have one, potentially exposing them to high hospital costs.

People who cannot afford top-up cover may be eligible for the complémentaire santé solidaire (CSS), which is intended to help low-income people. This replaced previous schemes called ACS and CMU-C,

Read more: Explainer: the CSS, France’s free or low cost top-up health insurance

Read more: 7 points to consider when choosing top-up health insurance in France

“The system is dysfunctional,” said Mr Bizard, economist and president of health research institute l'Institut Santé, in an interview with FranceInfo.

He said that the new study “reminds us that health is not free”, and denounced a system that “separates the ‘good’ insurance risks, e.g. working people, from the less good risks, e.g. retired people”.

He added that these contracts “cost an awful lot of money”, including €10billion in public subsidies, €10billion for businesses, and €10billion for private households.

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