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Complementary health care is a device allowing people whose income is modest and/or irregular to benefit from coverage of their main health care. Introduced on November 1, 2019, access to it has been made easier and makes it possible to pay for health expenses not covered by health insurance.
It is the Health Insurance itself which affirms it: the solidarity complementary health insurance remains a device still too little known. The CNAM even puts forward a figure: only one out of two eligible people knows the device. It is therefore launching a national campaign to recall its existence and its advantages.
Free for the most modest
Complementary health insurance (CSS), what is it? It is, as its name suggests, a kind of solidarity “mutual” managed by the Health Insurance. It allows people with modest incomes not to advance health costs usually reimbursed later and excess fees, common among specialists, are not applied. Whether this is after a consultation with their attending physician or with a specialist, the covered person will pay nothing at the end of their consultation.
The CSS is free for all people earning less than 798 euros monthly and will cost one euro per day, or thirty euros per month, for those whose salary does not exceed 1,077 euros monthly.
An essential cover
Although in France, compulsory health insurance covers more than three-quarters of health expenses, complementary health insurance remains essential, in the event of hospitalization, for example. For the most precarious, the CSS covers all members of the household. It allows coverage of basic care, such as consultations, hospitalizations, medication, medical analyses, etc., but also certain glasses, hearing or dental prostheses. In addition, in the event of hospitalization, the daily flat rate is covered without any time limit. Finally, the medical deductible and the fixed contribution of one euro (for consultations with general practitioners) are exempt.
A simplified request
For recipients of social minima, the application and renewal are simplified:
- Since January 1, the allocation of complementary health solidarity to recipients of active solidarity income (RSA) is automatic, unless expressly opposed by them;
- Since April 1, beneficiaries of the Solidarity allowance for the elderly (Aspa) are presumed to fulfill the conditions for entitlement to complementary health care with financial participation, which makes it possible to lighten the application file and simplify the procedures. award;
- Since April 2022, the renewal of the Complementary health solidarity with financial participation has been simplified, the annual return of a membership document being abolished if the financial participations do not change.
If you want to know if you are entitled to this device, you can go to this simulator by preparing the list of supporting documents required in advance, in order to estimate your annual income. Furthermore, the site ameli.fr will give you more information about this help, who it is for and how to apply for it if you are entitled to it.