There complementary health insurance (C2S or CSS) replaces the complementary universal health cover (CMU-C) since 1er November 2019: it is a device which aims to help the most modest people to access medical care. The C2S also replaces the old assistance for the payment of complementary health (ACS) which gave the right to a reduction on the cost of mutual insurance.
In practice, the C2S allows people with a low income to be reimbursed for the additional part of health expenses. In other words, it reimburses what Health Insurance does not reimburse. It therefore works like a mutual, with the big difference that it is free or very inexpensive.
The condition of the resource ceiling in 2021
Two conditions are necessary to qualify for a C2S: benefit from health insurance coverage (thanks to a professional activity or universal health protection) and justify resources below a certain amount, which depends on the number of people in the household.
In 2021, C2S is free if the annual resource ceiling do not exceed :
- 9041€ for a single person,
- 13562 for a two-person household
- or €18,986 for a four-person household.
She is paying – less than 1€ per day and per person – if the annual ceiling is between €9041 and €12205 for a single person or between 13562 and 18308 for a two-person household. We then speak of complementary health insurance with financial participation.
Online approach or by mail: which forms?
To request to benefit from the C2S, the process can be done either online or by mail. Online, go to your Ameli account to complete an application form. By mail, complete the CERFA form n°12504 and send it to your health insurance organization.
Recipients of the active solidarity income (RSA) are entitled, themselves and the members of their household, to a C2S without financial participation. The request is then made via the form S3711.
Think about renewal
Once the application has been filed, the Health Insurance makes its decision within two months. Your C2S lasts one year from the date of acceptance of your file.
At the end of this year, if you wish renew C2Syou must make a new request before the end of your rights, ideally between two and four months before this deadline, to avoid a breach of your rights.
Glasses, third-party payment… what are the advantages?
In addition to financial assistance for healthcare reimbursement, the C2S offers other advantages:
– the absence of fee overruns on medical tariffs if you first go through your attending physician before consulting a specialist;
– reimbursement of the daily rate in the event of hospitalization;
– the absence of a medical deductible or flat-rate contribution for drugs and paramedical procedures;
– third-party payment, which eliminates the advance of medical expenses;
– a refund package for glassesdental prostheses, hearing aids but also canes, wheelchairs or bandages.
Sources:
- Who can benefit from Complementary Solidarity Health and how? Ameli.fr, September 14, 2021
- Complementary health insurance in brief. Ameli.fr, December 29, 2020
- Overview of assistive devices. Ministry of Solidarity and Health, October 3, 2019
- Complementary solidarity health (ex-CMU-C)Service-public.fr, 1er April 2021
Read also:
- Eyeglasses: how to benefit from a full refund?
- Social security budget 2022: 5 good news for our health
- Teleconsultation booths at the supermarket: what you need to know
