Rising cost of French top-up insurance targeted by Senate report

Mutuelles have far outpaced inflation, leaving over-65s particularly exposed

Most people use mutuelle or complémentaire santé top-up insurance in France
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The cost of French top-up insurance mutuelles has outpaced inflation leading to mounting health costs, particularly for over-65s. A new report to the Senate says the prices need to be reined in.

The average price of a mutuelle top-up insurance increased by 8.1% in 2024 and by 6% in 2023 at a time when inflation and the cost of living have been under particular scrutiny. 

While many working people are covered by top-up insurance through their work, it is often retired people who get insurance through a mutuelle.

Private mutuelles certainly offer advantages, such as individualised plans, but they also come with higher management fees or frais de gestion, than the grouped offers that working people tend to use.

Read more: Does French mutuelle insurance provide cover when abroad?

Report recommends changes

It is the increase in these management fees that drew particular criticism in the 278 page report for the French Senate released on September 26.

According this report, entitled 'Hausse des tarifs des complémentaires santé: l’impact sur le pouvoir d’achat des Français' (Increase in top-up health insurance rates: the impact on French purchasing power), an increase of between 4.5% and 6.5% would have been enough to cover the rising cost of healthcare in 2024.

The additional rise is explained by management costs, which are disproportionately borne by retired people who already pay more for their top-up insurance than younger people.

Indeed, between 2011 and 2022, management costs have risen by 33%.

The report concludes with 15 recommendations to reduce the burden of top-up mutuelles on retired people.

In particular it suggests:

  • Publishing an annual breakdown of mutuelle costs on the national healthcare website Ameli.fr

  • Limiting the personal information available to mutuelles 

  • Making contracts more readable

  • Work with top-up providers to reduce management costs

  • Improve the software used by medical practitioners to reduce overheads

  • Reducing the coverage for alternative medicine

In defence of the rising costs, Séverine Salgado, head of national federation la Mutualité Française, told FranceInfo that the management costs were “useful expenses” for clients.

‘The management fees of mutual insurers are first and foremost services rendered to members,” she said. “They are a key part of the pathway to care”.