France health mutuelles: retirees face higher bills in 2027

Retirees, the self-employed and others who pay for their own health top-up insurance are set to be among those most exposed to higher healthcare costs next year.

Four decrees published on August 22 will reduce the state’s share of costs for dental care, some medicines, medical devices and medical transport.

Most of the reimbursement changes will take effect on January 1, 2027, although new eligibility rules for certain medical transport will apply from October 1, 2026.

A planned measure to double the annual ceiling on certain charges deducted from patients’ reimbursements – known as franchises médicales – has been dropped.

“People will pay more out of pocket and some may start trying to manage their health on their own rather than consult a GP,” Féreuze Aziza, a health advocate for France Assos Santé, told The Connexion.

“The government has chosen short-term savings over people’s long-term health. It is idiotic.”

What healthcare reimbursements will change?

The new measures will reduce the proportion of some healthcare costs covered by France’s state health insurance, leaving complementary insurers and patients to cover more.

For dental care, the decree sets the patient’s share at between 50% and 60%, meaning the state reimbursement could fall from the current 60% to as low as 40%. The precise rate will be set by Uncam, France's national health insurance union.

Reimbursement for some medical devices will fall, with certain rates dropping from 60% to 50%.

For medical transport, new eligibility rules for certain forms of transport will apply from October 1, 2026. The reimbursement rate will then fall from 55% to 50% from January 1, 2027.

Some medicines will also have lower reimbursement rates.

The government says the 100% Santé dental package will remain fully covered, but other treatments will become more dependent on complementary insurance.

The Mutualité Française estimates the changes will transfer €1.5-1.7billion in costs to complementary insurers.

Health Minister Stéphanie Rist has said higher mutuelle premiums are not automatic and that the government is negotiating with insurers to limit increases. However, she acknowledged that she could not impose a price freeze.

A legal freeze on premiums was passed for 2026 but insurance firms argued that it was unconstitutional and almost all raised prices this year, mostly by 3-10%. Ms Aziza said policyholders will feel the impact.

“Health top-ups will get more expensive in 2027,” she said, citing a UFC-Que Choisir estimate of a further 4-8% increase after a 4.7% rise in 2026.

“And the reduced reimbursement rates are just the tip of the iceberg since there are lots of hidden expenses on treatments that are not reimbursed by the state - and these are always becoming more expensive.”

Retirees and S1 holders among those affected

The changes are particularly relevant to retirees, self-employed people and foreign residents who may pay for their own mutuelle, rather than benefiting from an employer contribution.

Foreign retirees with an S1 form are also exposed.

The S1 gives them access to French state healthcare under reciprocal arrangements, but does not provide complementary insurance.

Those who take out a mutuelle themselves can therefore face higher premiums in 2027 if more costs move to insurers, while people without one will have to pay the additional costs themselves.

However, the changes do not apply to people covered by Complémentaire santé solidaire (CSS), France’s subsidised complementary health cover for people on low incomes. Around eight million people benefit from CSS.

People in long-term care with an affection de longue durée (ALD) are also protected from the dental reimbursement change for care related to their condition, which will continue to be covered at 100% by the state health insurance system.

“Older people already pay more so will be more at risk of rising costs,” said Ms Aziza.

“And these figures only cover reimbursed healthcare costs – there are many other costs that are not reimbursed at all.”

She said the government could have looked elsewhere for savings, including cutting down on over-prescribing and unnecessary tests.

What is the mutuelle system?  

As a reminder, a mutuelle is supplementary health insurance that reimburses some or all of the healthcare costs not covered by France’s state system, Assurance Maladie.

The state generally pays a set percentage of an approved medical tariff, while the mutuelle can cover the remaining co-payment, hospital charges, as well as some dental, optical or hearing costs.

The level of cover depends on the particular policy, and many employees receive a workplace mutuelle partly funded by their employer.

Check your mutuelle cover

The government says the new measures are intended to control healthcare spending and help fund hospitals, access to care and new medicines.

Ms Aziza urged people to review their mutuelle cover.

“It is vital that people check they are not paying too much,” she said.

It may also be worth checking whether your policy will absorb the additional costs when the 2027 changes take effect. Contracts can be cancelled penalty-free after the first year.