Supplementary health insurance, more commonly known as "Mutuelle", reimburses health expenses in addition to Social Security. These expenses are covered according to the guarantee provided for in the contract.
The contract can be taken out by a company for its employees. This is known as a group or collective contract with optional or compulsory membership.
The contract can also be taken out on an individual basis for persons who are not covered by a compulsory group contract.

You're not advancing any money. The health professional is reimbursed by Social Security and by your Management Centre.

You do not benefit from the Third Party payer: you advance the sum. With your Carte Vitale and the Noémie service, Social Security is immediately informed of your payment. They will reimburse you their share. You must then send the payment receipt given by the health professional to your management centre.

To benefit from teletransmission, send your management centre a photocopy of the vital paper certificate of your compulsory plan and your beneficiaries accompanied by a bank statement.
If the statements of your compulsory scheme (Social Security, Mutualité Sociale Agricole, etc.) include the message "sent directly to your complementary organisation", you benefit from this service. You do not have to send the statements for the compulsory scheme as your management centre receives them directly by computer flow. If proof is required, you can send it to us without waiting for your compulsory scheme to be reimbursed.

To calculate the reimbursements, the Social Security uses the Reimbursement Base, to which it applies a rate that differs according to the acts and benefits of care. The co-payment represents the difference between the Reimbursement Basis and this rate.
EXAMPLE:
The General Practitioner's Reimbursement Base is 25 € (price of his consultation).
Social Security reimburses 70% of the convention fee, i.e. €17.50 (excluding the euro deductible).
The difference is the co-payment: 25 - 17.50 = €7.50.
This sum can be reimbursed, depending on your contract, in whole or in part.

A provident fund contract aims to compensate for the financial consequences of life's hazards (death, work stoppage, disability, etc.) following an accident or illness.

An individual is declared permanently totally disabled when he is recognised as being permanently incapable of engaging in any professional activity that provides him with gain or profit, with a functional disability rate equal to 100% by reference to the scale provided for by the legislation on work accidents.

Yes, simply indicate this to us to register the two different accounts, one for the transfer of your benefits and the other for the deduction of your contributions.

Yes, simply send us a letter requesting this with the corresponding bank statements.
IMPORTANT: this letter must be signed by the hand of the main insured.

Agreements between health professionals and Social Security organisations govern the rates of healthcare benefits. This is known as the Basis of Reimbursement.
It is this rate that is used as the basis for calculating the Social Security reimbursement.

Certain doctors who refuse to adhere to the conventions (non-registered practitioners) can practice free fees.
The Social Security bodies then calculate their reimbursements on the basis of a specific tariff: the authority tariff.

Some doctors under contract may charge more than the convention rate. These are called sector 2 doctors.
You are responsible for these fee overruns or they are covered in part or in full by your contract, depending on the cover provided.

The Daily Hospitalisation Package corresponds to your financial contribution to the accommodation, food and room maintenance costs associated with your hospitalisation.

An education allowance is a provident guarantee intended to help finance the education of children in the event of a serious event (death, permanent total disability) of the insured parent. A regular amount is thus paid under certain conditions.

The individual is declared in absolute and definitive disability if he is recognized as permanently unable to carry out any professional activity and if his state of health requires the assistance of a third person to carry out the ordinary acts of life.

For any claim or request for further information on how the site works, go to the Contact section of the site.
Mercer undertakes to acknowledge receipt of the complaint within ten days and to reply as soon as possible and within two months at the latest.
If this fails, the customer may resort to the Mediation procedure.

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