The remaining cost , also called the " co-payment ," corresponds to the portion of health costs that remains your responsibility after reimbursement by social security . A mutual or supplementary health insurance company can intervene to reduce or even eliminate this amount. Find out everything you need to know about the remaining cost 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 your 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 costing €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 aim of the co-payment is to limit health insurance costs while encouraging policyholders to adopt responsible behavior, such as choosing care within the coordinated care pathway or favoring healthcare professionals who charge agreed rates.
3. How to Reduce the Out-of-Pocket Cost with Mutual Insurance?
Mutual or supplementary health insurance can help cover all or part of the remaining costs. Here are the key points to optimize your coverage:
a. Choose a Mutual Insurance Company Adapted to Your Needs
- For frequent consultations, opt for enhanced 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, in particular:
- Optics : Glasses and lenses can be expensive, especially if they are high quality.
- Dental : Implants and dental prostheses are not always well reimbursed.
- Hospitalization : Individual 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 effectively reduce your remaining costs:
- 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.
- Complete transparency : No surprises regarding reimbursements, our advisors will support you throughout all your procedures.
Conclusion
Out-of-pocket expenses can be a significant expense, especially for certain types of care. Taking out appropriate insurance is 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.