A health mutual, or complementary health insurance, reimburses the portion of medical expenses not covered by Health Insurance. The co-payment, excess fees, optical or dental care that is poorly reimbursed: all of this depends on the contract you subscribe to. Choosing a suitable mutual requires understanding what each level of coverage actually includes and anticipating regulatory changes that may alter the situation.
Transfer of expenses to complementary insurance: what changes in 2026-2027
Several decrees published in the Official Journal on August 22, 2026, provide for a reduction in the share of Health Insurance for dental care, medical devices, health transportation, and certain medications. The transfer will apply from October 1, 2026, for transportation, and from January 1, 2027, for the other items.
The French Mutuality estimates that this transfer represents between 1.5 and 1.7 billion euros of expenses shifting to complementary health insurance. The co-payment increases for these items, and responsible contracts must reimburse it. Expected result: an increase in contributions starting from the 2027 renewals.
Before subscribing to or renewing a contract, check if the dental and medical device (optical, hearing aids) guarantees cover this expanded co-payment. A contract that seemed sufficient in 2025 may leave a heavier out-of-pocket expense starting next year. To compare available offers, platforms like easymutuelle.fr allow you to filter contracts based on these specific items.
Responsible contract and levels of coverage: decoding reimbursements
Almost all mutuals marketed today are responsible contracts. This label, defined by law, imposes a minimum base of guarantees (coverage of the co-payment, daily hospital fee) and sets ceilings on certain items such as excess fees.
Organizations then offer several levels of coverage, often presented under marketing names specific to each insurer. Comparing becomes complicated.
What the reimbursement percentages really mean
A reimbursement displayed at “100%” means that the mutual covers the co-payment, the portion not reimbursed by Social Security. You are reimbursed up to the base rate, nothing more. A reimbursement at “200%” or “300%” covers excess fees, up to two or three times the conventional rate.
A level of 100% does not cover any excess fees. If you consult specialists in sector 2 (free fees), this level may leave a sometimes significant out-of-pocket expense. Check the “excess fees” line in the guarantee table rather than the overall figure displayed on the surface.
The 100% health, a baseline to know
The 100% health system guarantees zero out-of-pocket expenses on a basket of care in optics, dentistry, and audiology, provided you choose equipment from the regulated basket. Any responsible mutual covers this basket. The difference lies in the equipment outside the basket, where the levels of reimbursement vary significantly from one contract to another.
Care items to consider based on your profile
Classic guides recommend assessing your needs. The advice remains vague if it does not specify which items actually create a gap in out-of-pocket expenses.
- Hospitalization generates the heaviest bills. A private room fee and good coverage of surgical excess fees can prevent hundreds of euros in out-of-pocket expenses for a single procedure.
- Optical and dental care outside the 100% health basket are the areas where contracts differ the most. High-end progressive lenses or a ceramic-metal crown not covered by nomenclature can leave several hundred euros to your charge with a basic contract.
- Alternative medicine (osteopathy, psychology) is not covered by Health Insurance. If you use these services regularly, a dedicated annual allowance in the contract makes a concrete difference.
Rather than seeking maximum coverage on all items, focus your budget on the two or three lines of guarantee that correspond to your actual expenses. Overcovering an item you do not use means paying a premium for nothing.
Annual cancellation: change mutuals without waiting for the due date
Since the law of July 14, 2019, any insured person who has subscribed to a complementary health contract for more than a year can cancel it at any time, without fees or penalties. This is annual cancellation. The new mutual takes care of the procedures with the former organization.
This right changes the choice logic. You are no longer stuck in an unsuitable contract for twelve months. With the expense transfers planned for 2027, checking now if your current contract absorbs the increase in the co-payment for dental care and medical devices becomes a useful precaution.
Before canceling, check two points: the possible waiting period of the new contract (some items are only covered after a few months) and the portability of your rights if you leave a collective company contract. Overlapping a few days between the old and new contracts avoids any period without coverage.
Mutual contributions have experienced significant inflation in recent years, and the expense transfers planned by the decrees of August 2026 suggest a new increase. Regularly compare, cancel when the contract no longer corresponds to your situation, and read the guarantee table line by line rather than the commercial name of the level: that’s where the difference between a mutual that protects and a mutual that costs lies.
