mutuelle

A mutuelle is a supplementary health insurance plan offered by mutual societies or mutual insurance companies, commonly used in Francophone countries. It is designed to complement the basic reimbursement provided by the public health system (assurance maladie) by covering part or all of the remaining costs for medical care, medicines and related services.

Most individuals obtain a mutuelle through an employer as part of a collective agreement (mutuelle d'entreprise), with the premium often shared between the employer and the employee. People can also purchase an individual mutuelle. Coverage levels and options vary by contract and can include hospital stays, specialist consultations, dental care, optical costs, medications, transport, and preventive services. Many plans offer additional options and sometimes a tier-payant feature, which can reduce or eliminate upfront payments at the point of service.

Mutuelles are typically non-profit or member-owned organizations and are governed by the Code de la mutualité. They operate on solidaristic principles, aiming to keep costs reasonable while expanding reimbursement. In France, there is a legal framework that encourages employers to offer a mutuelle to employees, and some arrangements include portability of cover for a limited period after leaving a job.

Beyond France, the term mutuelle also refers to mutual aid and mutual insurance organizations in other French-speaking countries. While structures and benefits differ by country, mutuelles generally seek to reduce out-of-pocket spending and improve access to care by providing complementary coverage to public insurance.