It's essential to make an informed choice when it comes to health insurance when you're operating as a micro-entrepreneur. Opting for this status offers numerous administrative and tax advantages. However, as a self-employed worker, although your social security cover is now broadly comparable to that of salaried employees, it does not respond in the same way to needs relating to work stoppages, industrial accident risks and occupational illnesses.
In this situation, taking out a good mutual insurance policy is the best way to protect yourself against life's hazards. Let's find out together how you can find a quality mutual insurance company.
What is the health insurance fund for micro-entrepreneurs?
Some time ago, the Régime Social des Indépendants (RSI) gave way to the Caisse Primaire d'Assurance Maladie (CPAM) to manage the social protection of self-employed workers.
In the past, the RSI collected social security contributions for micro-entrepreneurs, but today most of them are affiliated to the CPAM, just like all salaried employees, with the exception of those in certain liberal professions, such as training or consultancy, who are covered by the Caisse Interprofessionnelle de Prévoyance et d'Assurance Vieillesse(CIPAV).
What healthcare costs are reimbursed by the general health insurance scheme?
As an insured person, you are entitled to reimbursement of your healthcare expenses in the event of illness or maternity.
Under certain conditions, daily benefits may also be paid in the event of work stoppage. To qualify, you must meet the following criteria:
- Have been a member of the health insurance fund for at least one year.
- Always be in business.
- Be up to date with dues payments.
- Average annual income of over €4,162 over the last three years.
The amount of compensation varies according to your sales. These indemnities represent 1/730th of average annual income after deductions, up to the Social Security ceiling of €43,992 in 2023.
If your average annual income is less than €4,162, you will not receive any compensation. If it exceeds this threshold but remains below €43,992, you will receive a daily amount equivalent to your income divided by 730. However, the maximum amount is €60.26, corresponding to 1/730th of €43,992.
Self-employed professionals affiliated to the Caisse Interprofessionnelle de Prévoyance et d'Assurance Vieillesse (CIPAV) benefit from a different calculation of their daily allowances. The amount varies from €24.10/day to €180.79/day, equivalent to 1/730th of three Social Security ceilings.
Why choose a mutual insurance company for a micro-entrepreneur?
Social security coverage of healthcare costs is gradually declining, whether for salaried workers, pensioners or the self-employed. It is therefore in everyone's interest to take out supplementary health insurance, both for themselves and for their dependants. If micro-business is a secondary activity for you, you should certainly already have a group health insurance plan. In fact, since 2016, all employers have been required to provide health insurance for their employees, and to cover at least 50% of the cost of contributions.
However, being properly reimbursed for your medical expenses is one thing, but it's not enough. In the event of incapacity for work due to serious illness or accident, it is essential to have contingency insurance. A supplementary provident insurance policy covers part of the financial loss, which can sometimes be considerable, resulting from the inability to continue your main activity. It offers protection in the event of disability, dependency or death, enabling the policyholder or his/her beneficiaries to cope with these difficult situations.
Which mutual should you choose?
The Madelin law, in force since 1994, offered self-employed workers the possibility of taking out supplementary provident insurance, with contributions deductible from taxable profits. This scheme has not been available since 2020, and in any case did not apply to auto-entrepreneurs, due to the application of flat-rate charges that do not clearly define taxable profit.
So, if you want to improve your health cover, you have no choice but to take out a standard mutual insurance plan. Some mutual insurers are specially designed for the self-employed, and offer attractive rates.
Occupationalinjury and disease insurance (AT/MP) covers accidents at work, commuting accidents and diseases recognized as work-related. To subscribe, you need to fill in a form and send it to your CPAM. Contributions are collected by Urssaf, at a rate determined by the regional office. Please note that a minimum income is required (€20,049.09 per year).
Before choosing your mutual insurance company, it's essential to compare the benefits offered and the rates. Some benefits may seem essential, while others may be less of a priority. Make your selection according to your needs and budget.