1st euro insurance or private medical insurance
One names “1st euro insurance”, insurance when it is 100% private. I.e. with no intervention of a social security or any other entity. Therefore, the Insurer reimburses medical expenses from the 1st euro spent. Conditions and reimbursements are processed based on subscribed conditions i.e. table of benefits, general conditions, claims administration procedures…
On the opposite, expatriates can indeed subscribe – when eligible – to basic intervention such as:
- ONSS outre mer for Belgian expatriates (ex OSSOM, ex ORPSS),
- Caisse des Français de l’Etranger (CFE) for French expatriates.
The above entities respect social security procedures. This means that they can provide members with a better coverage in certain cases such as cancer. This also means that they can manage a coordination with other risks supported by the social security. For example, a coordination between long term disability and retirement (pension).
Medical insurance on Top-Up to CFE
When an expatriate decides to subscribe to CFE, the organisation is:
- a basic reimbursement / coverage by la Caisse des Français de l’Etranger (C.F.E.) – this coverage is subscribed on a voluntary basis
- a complementary and private insurance on Top-Up to CFE.
Due to specific agreements with la la Caisse des Français de l’Etranger (C.F.E.), the Top-Up plan proposes “guichet unique” service. This means that the member can send all his/her request for reimbursement to the Top-Up plan’s claims administrator. Coordination between the Top-Up plan’s claims administrator and CFE eases the administration for the member.
La Caisse des Français de l’Etranger proposes the following modules:
MODULE 1 : Medical – Maternity insurance (MondExpat, JeunExpat, RetraitExpat, FrancExpat)
Option : Short and Long Term Disability, Lump sum in case of Death (available for employees only)
Option : Assistance repatriation for JeunExpat / Solo subscription
MODULE 2 : Professional Risks
In case of Work Accident or Professional Illness
MODULE 3 : Pension
La Caisse des Français de l’Etranger offers several advantages to its members, such as:
- similar benefits as the French Social Security during the expatriation,
- specific benefits in certain cases (example: Affection Longue Durée),
- waiting period waiver when returning to France, for the enrolment to the French Social Security,
- coordination between riks, such as long term disability and pension when both are subscribed.
⇒ “Equivalences” shows main differences between CFE + Top-Up and 1st euro insurance
Please pay attention to the local regulation
Please note that subscribing to an international health insurance does not free you from the local regulations. If you are eligible to contribute to the local healthcare system in certain countries and do not have local cover in place, you may be subject to paying a tax levy