A mutuelle is a private, top-up health insurance policy that reimburses all or part of the costs not covered by state health insurance (Assurance Maladie).
How much the state pays depends on the treatment. For example, it will reimburse 70% of the cost of a GP visit. The remaining 30% will be covered by the mutuelle top-up insurance (or the patient themselves if they do not have top-up insurance).
Top-up insurance also pays for extras such as more complicated dental work, more expensive glasses or more comfortable hospital rooms.
All employees of private firms must have a mutuelle, provided by the company. Others, including freelancers and retirees do not have to have mutuelle insurance, but most do. The idea is that the insurance will reduce costs if you need healthcare treatment. Only around 5% of people in France do not have a mutuelle.
Read more: French top-up insurance to increase by 6% in 2025
Rising costs
A Senate report in September 2024 criticised mutuelles for their soaring prices, which have outpaced inflation and left over-65s particularly vulnerable to rising costs.
The average price of a mutuelle top-up insurance rose by 8.1% in 2024 and 6% in 2023. In 2025, providers are expected to increase their charges by an average of 6%, according to a survey published in December by Mutualité Française, the federation representing them.
Individual contracts, taken out in particular by retired people, will increase by an average of 5.3%, Mutualité française said, based on figures from 41 mutuelle insurers, representing 19.9 million people who are covered.
Compulsory group contracts covering employees through their company will increase by an average of 7.3%, and optional group contracts by 6.8%, the Mutualité added.
The rise has been attributed to a number of factors, including the ‘structural’ rise in healthcare spending in France, an ageing population, and access to new treatments and medical technologies. Many supplementary health insurance companies are also now contributing more to the funding of certain expenses, such as dental costs.
So, how can you go about saving money when it is time to renew your coverage?
Do your research
Online price comparison tools can help you compare all the available policies, while online forums and review sites can let you know what current policy holders think of the service.
Remember to tick the option for no marketing, or you could be inundated with emails from insurers.
Be wary of the very cheapest, too-good-to-be-true deals. Consumer organisation UFC-Que Choisir warns the cheapest deals may also be the ones with the biggest price increases later.
The association has said savings can be as much as €6,000 for a 75-year-old retiree when comparing the most expensive offers to the cheapest. You can use its comparison tool to look at different offers according to your needs:
You can cancel your current policy at any time after the first year, so if yours has gone up, it could be time to look for a new deal.
“Mutuelles have gone up a lot,” said The Connexion reader Jane Dimba, 69, who pays €80 a month. “If you need hospitalisation, make sure you are well reimbursed for op and stay.”
Remove unnecessary cover
One key to ensuring you do not pay too much for your health insurance is to check you are not covered for things that you are unlikely to use.
Some policies allow you to remove certain coverage e.g. retired people do not need coverage for childbirth, while someone who does not need glasses may not require a high level of optical coverage.
“If you are of an age when you are not likely to be hospitalised, why pay every month for the benefit of a private room you may never need? Better to save the extra monthly premium and just pay for the room in the unlikely event that you need one,” said reader Chris Karen.
Choose the correct level of insurance for your needs. This could end up saving you money.
Read more: Rising cost of French top-up insurance targeted by Senate report
Choose a family plan
Some policies offer packages that include the whole family, including children – known as a ‘family contract’. Grouping coverage in this way can often be a money saver.
Do not forget to check the small print, though – some policies only include children for free after the second or third child.
Some mutuelles are aimed at couples and these work particularly well when you have similar needs, e.g. will both need to use an optician for glasses.
Similarly, some insurers may have offers for customers who have taken out other forms of insurance with them.
“Companies may have offers to maintain your loyalty such as reduced subscriptions if you take out other insurance with them e.g. car or house,” said reader Simon Croxson.
Take out a complémentaire santé solidaire policy
This complémentaire santé solidaire (CSS) scheme, which has been in place since 2022, is geared towards people on low incomes. You must have a taxable income of below €9,719 for the previous year to qualify for the free, or low-price mutuelle. If your earnings exceed that, you will have to pay a top-up fee, which ranges from €8 per month for under-29s to €30 per month for over-70s.
Look for local offers
Insurance provided by local mutuelles can sometimes be a cheaper option, as the cost of health insurance can vary from region to region.
Use a broker
An insurance broker could help you find the best deal that is specific to your needs. They are also useful in making sense of the jargon that often accompanies insurance offers.
“It all appears very confusing at first glance. It pays to consider carefully just what you think you are likely to need in the future related to your health history, personal finances and age,” said reader Robin Weston.
“Discussion with a reliable insurance consultant can help, always bearing in mind they have a vested interest in promoting the companies they often represent.”
Your company’s insurance may not be the best option
When you retire, do not automatically stay on your company’s insurance. Do a price comparison and you may well find much better deals from competitors.
The policy you had when working may not be the best deal for retirees, and it is common for prices to rise.
“If you are a senior, use the mutuelles that cater for you,” said reader Patricia Hale, 84. “I use April and find them excellent. I pay €120 and that includes everything – doctor, medicine etc.”
Take out municipal mutuelle insurance
Getting insurance through your local town can be a good way to save up to 30% the cost of an individual mutuelle.
Nearly 2,000 local communes take part in the Ma Commune, Ma Santé scheme, which allows people such as senior citizens and students to take out top-up insurance at an affordable price, equivalent to a group contract.
However, be aware that some local schemes may become more expensive over time.
“Our commune organised a collective for the mutuelle,” said reader Anthony Hall. “My partner took up the offer, I stayed with MMA. My partner made a saving straight away but four years later, she’s paying more than her old policy. Don’t forget it costs more as you get older, so read the contract well as we need treatment more often.”
Read more: More French mayors negotiate top-up health cover for residents
Choose your doctor wisely
The costs left to pay after the state health insurance can sometimes depend on which doctor you see. Doctors do not all apply the same rates.
A study by UFC-Que Choisir found more than half of specialists were charging above the standard rate in France. The higher fees were especially prevalent in departments that are home to major cities and around Paris, with appointments in cities sometimes costing twice as much as those in rural departments.
“The mutuelles may have preferred providers e.g. for dentists and opticians, with reduced costs, so it is worthwhile checking this,” said Mr Croxson.
Consider using the 100% Santé scheme
Introduced in 2020, the 100% Santé scheme helps provide 100% coverage for certain dental, auditory and optical care for people who have mutuelle top-up healthcare insurance. It was put in place to give people access to treatment and equipment that previously may have been too costly.
This can cover treatment including hearing aids, dental work (such as crowns and dentures) and prescription glasses.
Ask your doctor what is included in the scheme, or you can check with your insurer. Specialists have to offer certain treatment under the scheme.
