In 2025, we will not change bad habits with an increase in the prices of complementary health insurance of 6% on average. This is the third year in a row that prices will increase. The French Mutuality justifies this by the “structural” increase in health spending in France, of + 5.2% in 2023. And the consultation of a general practitioner, which increases from next Monday from 26.5 to 30 euros , does not risk reducing expenses.
One question remains: who will pay for this increase? We explain everything to you.
To begin with, what is mutual health insurance?
In France, most medical and hospital costs are covered by Social Security and Health Insurance, coverage which concerns the entire population. “80% of costs are thus covered,” explains Arthur Martiano, CEO of Lynx.fr, an insurance comparison site. Mutual insurance is a paid supplement for adults, whether employed or not, which will cover part of the remaining amount. “It takes into account 12 to 13% of health costs, which leaves around 7-8% to be paid, in other words paid out of your pocket.”
Having mutual insurance is not obligatory in France, you can choose to do without it, but this option remains in the extremely minority. “95% of the population that can have mutual insurance has one,” says Arthur Martiano. However, there are strong disparities.
How does mutual insurance work?
Mutual societies are divided into two cases: individual and collective, explains Nathalie Coutinet, professor of health economics at Sorbonne Paris Nord University. The latter concerns private sector employees. Since the National Interprofessional Agreement (ANI) voted under François Hollande in 2013 and applicable from 2016, all private companies have the obligation to offer collective mutual insurance to these employees. This collective mutual insurance is covered at least 50% by the company.
“The company’s support can increase to 60%, 70%, 80%… The larger the company, the more likely it is to take more than the minimum,” explains Nicolas Da Silva, economist. of health. “There is a clear threshold from 100 employees where the gap widens greatly in the rate of support by companies. » Note that an employee can refuse collective mutual insurance and take an individual collective if he finds advantages there (for example better management of his specific care).
For individual mutual insurance… well you pay everything. This concerns students, liberals, unemployed people, retirees and employees of territorial and public hospital services. The price of mutual insurance varies with age. The older you get, the more expensive it is, because the more likely you are to have health care. Thus, a student’s mutual insurance costs on average 460 euros per year, compared to 1,670 euros for a retiree, indicates Arthur Martiano.
So, who will pay for the 2025 increase?
For collective mutual societies, “a company will always be obliged to take 50%”, recalls Nathalie Coutinet, so if your company only covers the strict minimum of costs, it will be obliged to take at least half of the increase incurred. And a company with more coverage – 60%, 70% – is unlikely to pass the entire increase on to you.
If it’s an individual mutual, it’s entirely for your apple. Which makes the increases more difficult to absorb financially. In 2025, of course, collective mutual societies will increase on average by 7.3%, compared to “only” 5.3% for individual mutual societies, “but the latter will have to be borne alone by the people, which makes the increase more important,” explains Nathalie Coutinet.
“That makes it all the more important to choose your mutual insurance carefully,” says Arthur Martiano. For example, if you don’t have glasses, “there’s no point in taking out health insurance that covers them and look into a cheaper model.”
Why is it criticized?
“By moving reimbursement from Social Security to mutual insurance, we increase inequalities,” explains Nathalie Coutinet, given that there is a big difference in reimbursement depending on the case and standard of living. “The higher the employee’s salary, the more likely he is to be part of a large company, the less he will have to pay more for his mutual insurance. This creates a double financial inequality,” continues Nicolas Da Silva.
But be careful “not to demonize mutual societies”, specifies the economist. “We are far from an American-style system, and mutual societies are for the most part not profitable, or very unprofitable. They are just trying not to lose money by increasing prices, but are not making any margin. »
