Healthcare costs: Which mutual insurance for the self-employed?

As aself-employed person or company director, it's essential to have good protection in the event of health problems.

Anytime's ambition has always been to simplify the life of the entrepreneur, to take him away from day-to-day paperwork and let him concentrate on what's essential: his core business!

That's why today, with the support of Stello, we're taking a look at the essential steps you need to take to ensure your health and that of your family when you're self-employed.


What type of mutual insurance company should I choose? 🤔

The first question to ask when choosing a mutual insurance company is the type of contract.

There are 2 types of mutual health insurance contracts:

  • Mutuelles for the general public, designed for individuals who do not have access to a company mutual, such as students or pensioners.
  • Company mutuals, reserved for professionals, are divided into 2 groups:

    - group mutuals covering all employees of a company,

    - and individual mutuals that cover a specific person and his or her family.


In the case of a TNS, a manager or a self-employed worker, it is more advantageous to subscribe to an individual professional mutual. These are specifically designed to meet the needs of this type of population.


How do you define your health needs? 🏨

To find a mutuelle that matches your profile, it's important to start by defining your needs. You can also include your family in the coverage. In this case, consider the needs of the entire household.

To make things easier, we've listed the major expense items found in all supplementary health insurance contracts.

The expenditure items to be taken into account are :

  • General consultations: These are the most common charges, and include consultations with general practitioners. These consultations generally range from €25 to over €50 in the most expensive areas.

  • Alternative medicine: this expense item generally includes all practices not reimbursed by social security. These include osteopathy, acupuncture, psychology, dietetics and sophrology.

  • Specialists: costs vary according to specialty (pediatrician, cardiologist, psychiatrist or gynecologist, for example) and whether they charge extra. If you're used to consulting a particular specialist, take this cost as a reference.
  • Hospital costs: hospital costs are generally a little more complicated to estimate, since they are exceptional. A good indicator of the level of costs is the price of a private room. This will cost around €50 in a hospital and €100 or more in a private clinic.
  • Teeth: dental costs include routine procedures such as scaling, but also implants, prostheses and crowns, as well as orthodontic treatment. You'll need a good level of reimbursement if you want ceramic crowns for your molars, or if you have children aged between 8 and 16 (the usual age range for braces).
  • Optical and hearing care: In this category, it's the material expenses that are important to note: lenses, contact lenses and hearing aids. Frames are not included, as social security has capped their reimbursement by mutual insurance companies at €100.



How do you find the offer best suited to your needs? ✅

The most important thing when comparing mutual insurance offers is to study the table of benefits in each offer. It is this element that determines the level of reimbursement for each of the expense items mentioned above.

The figures in this table are not fixed amounts in euros, but represent a percentage of the BRSS. BRSS stands for Base de Remboursement de la Sécurité Sociale. A summary can be consulted online for each type of healthcare expense.

Then, to obtain an accurate rate, you need to make the following calculation:

  1. Take into account the amount reimbursed by social security as indicated in the table (column"Amount reimbursed").

  2. Determine the total amount reimbursed(social security + mutuelle) by multiplying the percentage shown in the table of benefits by the social security BRSS.

To make life easier for you, Stello simulates the most important healthcare costs directly for you.

👉Modulatemy self-employed mutual offer


What are the other criteria for a good independent mutual? 🔎

To be attractive, a mutual insurance plan for the self-employed must include a number of prerequisites:

  • Minimal waiting period: the waiting period is the time between taking out a policy and coverage taking effect. A good mutual will have a zero waiting period, meaning that coverage takes effect immediately.
  • Teletransmission
  • An easy-to-use interface: when transmitting quotes or invoices, it's important that the process is quick and simple.
  • A "Loi Madelin" contract allows you to deduct the cost of your TNS health insurance from your taxable income.




How to deduct contributions to a self-employed mutual insurance company 💰

The Madelin law allows self-employed workers to deduct their health insurance premiums from their taxable income.

It is aimed at all self-employed individuals who declare their income tax as BIC or BNC, and also at majority managers covered by Article 62 of the French General Tax Code (CGI). This includes self-employed professionals, farmers and shopkeepers, non-salaried managers of EURLs, SARLs or SELARLs, etc.

It is advisable to ask the insurer whether the contract is eligible under the Madelin law.

Auto-entrepreneurs are not covered by the Madelin law, as they benefit from a simplified tax system (flat-rate, not actual expenses), but there's nothing to stop them from subscribing to an eligible mutual.

For"assimilated employees" (directors of SAS and SASU), who take out an "individual" policy, it's best to consult your accountant to find out the exact tax treatment of contributions.


How do I change my professional mutual insurance company? 📆

A professional mutual insurance policy can be terminated after 1 year's service, subject to 1 month's notice.

To do this, you must send a registered letter with acknowledgement of receipt to your insurer or contact your new insurer to find out if they can take care of it for you, as is the case with Stello!


➡️ Discover Stello complementary health insurance

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