Two decrees published in the official Journal on June 23, spell out the rules of the new supplementary universal health coverage. Implementation on November 1, 2019.

It is a little known, but for health care, nearly 7 million people are now benefiting from universal health coverage complementary (CMU-C) or using the acquisition of complementary health (ACS). These two devices will be gathered in a single from the 1st November next. This is to improve access to care for people up eligible for ACS. Two decrees published on the 23rd of June in the official Journal specifying the new rules (1)

Two ceilings of resources

today, a person who resides in the metropolis can obtain access to the CMU-C if its resources, taxed or not, are less than 746 € net per month (1119 € per month for a couple and 1343 € for a couple with a child).

In case of a revenue to be slightly higher (1007 € net per month for a single person, 1510 € per month for a couple and 1813 € for a couple with a child), it is of the ACS, a financial aid awarded to pay the fees of a health insurance pre-selected (2).

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starting November 1, 2019, the CMU-C, renowned CMU-C “to pay”, will be extended to people today eligible to the ACS. It will be free for people whose resources are, as at present, below the various ceilings of the current CMU-C. financial participation is provided for when the resources exceed 35 % a maximum of the current ceilings of the CMU-C.

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A financial participation modest

For the current beneficiaries of the CMU-C, nothing changes. The new supplementary universal health coverage will continue to be free according to the same limits as today.

On the other hand, affecting people today, the ACS will have to make a choice before the October 31, 2019. They will be able to continue their contract ongoing health until its term, in the limit of October 31, 2020, or terminate this agreement, without charge, to switch to the new CMU-C. They will have to pay a financial contribution will be flat-rate and varies according to age accurate to the order of June 21, 2019 : 8, – €/month for less than 29 years, 14€/month, between 30 and 49 years, 21€/month between 50 and 59 years of age, 25€/month between 60 and 69 years of age, and finally 30€/month for the 70 years and older (3).

many Of the services supported

Overall, for the beneficiaries of the current CMU-C, the perimeter of the supported does not change. On the other hand, it will be larger for persons eligible for the ACS. As today, the supplementary part of the care, or copayments, will be repaid in full on the basis of the rates set by the health insurance (which excluded any excessive fee). This rule is in the care of the city, the hospital care and medical prescriptions : analyses, laboratory tests, drugs, care provided by physician assistants…

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The beneficiaries of the CMU-C to pay will also have access to some expensive care, within the limits of specific rates, and without any remains dependent on a number of optical equipment, dental, audio, in the framework of the reform of the 100% health, which will enter into force at the beginning of 2020.

Absence of lump-sum contribution of€ 1 and for deductible medical

All of the beneficiaries of the future of the CMU-C, either with or without financial participation, will continue to be exempt from the participation fee of 1€ is applied on the consultations in the city. Same thing for the franchise applied medical the medicines, the acts of the allied health and medical transports. As to the daily fee for hospital (20€/day), it will be fully supported, without restriction of duration.

A third party to pay in full and a simplified application

Like today for the people who benefit from CMU-C, the rule of the third paid in full will be required : it is the health insurance and the supplementary body which will pay directly to the practitioner consulted.

to access the new CMU-C, it will suffice to make the request online on his account ameli.fr.

(1) Decree n° 2019-621 June 21, 2019, and decree n° 2019-623 June 21, 2019.

(2) For individuals residing in the overseas departments, these ceilings are higher.

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(3) For insured persons covered by the regime of Alsace-Moselle, contributions less are planned.