
The remaining charge , also called " co-payment ", corresponds to the portion of health costs that remains your responsibility after reimbursement by social security . A mutual or supplementary health insurance can intervene to reduce or even eliminate this amount. Find out everything you need to know about the remaining charge and how to optimize your health coverage.
1. What is the Remaining Charge in Health?
The remaining amount is the amount you have to pay after Social Security has reimbursed part of the medical expenses. It includes costs not covered by health insurance, such as:
- The excess : Portion not covered by Social Security.
- Excess fees : Amount billed beyond the agreed rates.
- Non-reimbursed care or equipment : Certain medical procedures or specific equipment (alternative medicines, high-end glasses).
Example: For a consultation with a general practitioner at €25, Social Security reimburses 70% (€17.50). The remaining cost is therefore €7.50, excluding excess fees.
2. Why does the remaining charge exist?
The remaining cost aims to limit health insurance expenses while encouraging policyholders to adopt responsible behavior, such as choosing care as part of the coordinated care pathway or favoring health professionals practicing agreed rates.
3. How to Reduce the Out-of-Pocket Cost with Mutual Insurance?
The mutual or supplementary health insurance intervenes to cover all or part of the remaining costs. Here are the essential points to optimize your coverage:
a. Choose a Mutual Insurance Company Adapted to Your Needs
- For frequent consultations, opt for increased coverage for excess fees and excess charges.
- For glasses or dental care, choose guarantees specific to optical and dental costs.
b. Check Reimbursement Levels
Mutual insurance companies express their guarantees as a percentage of the basic Social Security rate or as a fixed amount. For example:
- 100% BRSS (Social Security Reimbursement Base) covers the excess but not the excess.
- 200% BRSS includes excess fees up to 2 times the agreed rate.
c. Consult the Care Networks
Some mutual insurance companies offer discounts or zero out-of-pocket costs by working with networks of partner professionals (opticians, dentists).
4. Care with a High Out-of-Pocket Cost
Certain health expenses often result in a significant out-of-pocket cost, including:
- Optics : Glasses and lenses can be expensive, especially if they are high quality.
- Dental : Dental implants and prostheses are not always well reimbursed.
- Hospitalization : Single rooms or certain specialized surgical procedures.
- Alternative medicines : Not covered by Social Security, these practices (osteopathy, acupuncture) can represent a high cost.
5. Why Choose KT Assur&Bank to Reduce Your Out-of-Pocket Costs?
At KT Assur&Bank , we offer you personalized mutual insurance to reduce your remaining costs effectively:
- Customized analysis : We identify your specific needs and offer tailored guarantees.
- Flexible offers : Whether for basic or enhanced coverage, we have solutions to suit all budgets.
- Access to healthcare networks : Take advantage of preferential rates for dental, optical and hospital care.
- Total transparency : No surprises on reimbursements, our advisors support you in all your procedures.
Conclusion
The remaining cost can represent a significant expense, especially for certain types of care. Taking out suitable mutual insurance is therefore essential to reduce these costs and access quality care without sacrificing your budget.
Contact KT Assur&Bank today to get a personalized quote and benefit from optimal health coverage.