Health Insurance protects the health of every insured individual in their personal and professional life by ensuring access to healthcare. It covers all or part of the reimbursement for health expenses in case of illness, maternity, or accidents. What are the different missions of Health Insurance? What is the difference between Social Security and Health Insurance? Why is it necessary to enhance your health coverage with a supplementary insurance plan? Our comprehensive guide provides an overview of Health Insurance, its missions, and its functioning.
What is Health Insurance?
Health Insurance is a branch of Social Security that guarantees health protection for all insured individuals. To facilitate its proper functioning, each insured person contributes and, in return, receives coverage according to a defined scale. The scope of Health Insurance includes:
- Illness, Maternity, and Disability: It covers all or part of your health expenses, provides daily allowances in case of work stoppage, and a pension in case of disability.
- Occupational Diseases, Work Accidents, and Death: It covers treatment costs, pays daily allowances in case of work stoppage, and provides a pension to beneficiaries in case of death.
Note: The terms Health Insurance and Social Security are often used interchangeably. However, there is a difference between them. Social Security covers all social risks for the French (health expenses, family benefits, pensions, etc.). Health Insurance refers specifically to the “health” branch of Social Security, covering only the systems in place for the reimbursement of medical expenses.
How Does Health Insurance Reimburse Health Expenses?
The reimbursement process for care under Health Insurance is computerized. The Vitale card or insured’s card contains all the information about the insured individual’s profile. During a consultation with a healthcare professional, when picking up prescribed medications at a pharmacy, or during hospitalization, the patient presents this card to obtain partial or total coverage of medical care and equipment.
Health Insurance then relies on a specific reimbursement base and reimbursement rate to cover your health expenses. In some cases, you may benefit from third-party payment, a system that allows you to have no costs to advance. At Nema, we have the health insurance that you need.
