Like any other top up, premium is simply based on age, level of cover and postal address. Yes, for some reason, it is more expensive if you live in Paris or Bordeaux compared to Angoulême!!
There is no health questionnaire. You get a Tiers payant card (piece of paper in fact) that prooves you are insured. You can check your reimbursment, send quotes and bills and reprint your card directly from your Allianz customer account.
I have on the spreadsheet below detailed 5 types of cover and premium for someone born in 1953 so 68 years old. This example includes a 10% discount as a customer (meaning this person already has another contrat with us, either car or house, etc).
HOSPITAL ONLY COVER
What does it cover: This cover is quite good in regards to hospitals as it is 400% cover and also up to 150 euro per day for an individual room. In France, you either share the room with someone else or you can choose to be on your own like an hotel room (with your own bathroom). Note that the cover does not guarantee you will be able to get the room, it simply covers the cost if you can get one. Usually, you can always get one in a private hospital (Clinique).
It also covers things outside the hospital such as ambulance, x-rays, scans and blood test.
What it does not cover: Well, mostly it does not cover things outside hospitalisation such as dentists, opticians, glasses, GPs, consultants, medicines, physios. However, do note that you are covered a certain percentage of the cost by CPAM (French health system) for those. For instance, the GP visit is covered 70% (GP visit cost 25 euro).
What does it cover: This cover is the basic cover at pretty much everything at 100% of the CPAM set price. It is the cheapest basic cover as it does not include the 100% santé reform.
What it does not cover: Well, it does not cover surcharges, medicines that are only reimbursed 15 and 30% by CPAM and other perks such as individual room, alternative medicine, etc. Also, it might not be enough cover to reimburse fully your glasses and teeth treatment if these are complicated. It also does not include the new reform of 100% santé so if you want hearing aid, glasses or crowns covered by the new reform, do not choose this cover.
What does it cover: This cover is the basic cover at pretty much everything at 100% of the CPAM set price and also include the 100% santé reform so covers hearing aid, crowns and glasses.
What it does not cover: Well, it does not cover surcharges. Also, it might not be enough cover to reimburse fully your glasses and teeth treatment if these are complicated and above the new level of cover set by the French government via the 100% santé reform. It does include the 100% santé reform.
SERENITE HOSPITAL COVER
What does it cover: This cover is the best cover for hospital and also up to 125 euro per day for an individual room and 100% for the rest plus some perks.
What it does not cover: Surcharges made by consultants and specialist (for consultations). Also, it might not be enough cover to reimburse fully your glasses and teeth treatment is those are complicated and above the new level of cover set by the French government via the 100% santé reform.
What does it cover: This cover is the best cover for hospital and everything else.
What it does not cover: Not much really!! Although you still might have to pay surcharges on tooth implants.
When does the cover start: Straight away.
What about pre-existing conditions: There is no health questionnaire, so they are covered.
Can I upgrade or downgrade the level: Not the first year but any time after that yes.
Does the top up cover me abroad: Only if CPAM does. It is a top up not a private health insurance.
How do I cancel it: On the anniversary date each year or if you leave France, we need proof of address abroad. Or now with new law at any time once the first year has passed.
If you already have a top up but not with us, we will do the cancellation for you, so you have nothing to do.
How does it work:
When you have your carte vitale: When you visit your GP or other medical professionals, you first give them your carte vitale and then you pay. The reimbursement is then automatically done by CPAM and Allianz is linked with CPAM by the “télétransmission” so the top up from Allianz follows within 10 days of CPAM reimbursement.
Tiers payant card: That is your top up card. This card does not show your level of cover. It simply proves that you have a top up and gives information to the medical profession in case of a “prise en charge”- this is when the top up pays instead of you.
You can download it from your Allianz customer account.
Contact us !
In order to discuss and meet your need as best as possible, feel free to contact us with a mail, phone call... We can also schedule a meeting in one of our four agencies... Or directly to your home !