1st euro insurance
One names “1st euro insurance”, an insurance when it is 100% private. There is indeed no intervention of a social security, or any other entity, with a 1st euro insurance. Therefore, the Insurer of a 1st euro insurance reimburses medical expenses from the 1st euro spent. That’s why it is called 1st euro insurance.
Conditions and reimbursements are processed based on subscribed conditions. I.e. based on a table of benefits, general conditions, etc.
1st euro insurance vs social security
On the opposite, expatriates can indeed subscribe – when eligible – to basic intervention such as:
- ONSS outre mer for Belgian expatriates. It was previously OSSOM and ORPSS,
- Caisse des Français de l’Etranger (CFE) for French expatriates,
The above entities respect social security procedures. Which is completely different compared 1st euro insurance. Respecting social security rules means that members benefit some advantages in certain cases. For example, in case of cancer, social security can cover up to 100%.
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.
CFE can manage a coordination between risks, such as social security does. For example, a coordination between long term disability and retirement (pension).
La Caisse des Français de l’Etranger
CFE proposes the following modules:
Medical – Maternity insurance. I.e. MondExpat, JeunExpat, RetraitExpat, or FrancExpat plan.
- Option : Short and Long Term Disability, Lump sum in case of Death (available for employees only)
- Option : Assistance repatriation for JeunExpat / Solo subscription
Professional Risks: this module provides the expatriate with benefits in case of Work Accident or Professional Illness.
Pension: this benefit corresponds to the basic state pension.
Advantages of la Caisse des Français de l’Etranger
La Caisse des Français de l’Etranger offers 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.
Pay attention to the local regulation with 1st euro insurance
Please note that subscribing to a 1st euro 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.