What is the difference between CMU and complementary solidarity health insurance?

There confusion between CMU and complementary solidarity health persists among many policyholders. These systems, resulting from reforms, play a fundamental role in access to care. The *update of aid has disrupted the conditions of eligibility and support*.
There complementary solidarity health, which was implemented in 2019, replaces the CMU-C and the ACS. *This unique contract aims to simplify access to care for French people with modest incomes*. This new approach offers tailored solutions to meet healthcare costs.

Universal health coverage (CMU)

Universal health coverage, or CMU, was established in France to ensure access to medical care for everyone residing in the territory. This system is mainly aimed at people with modest resources, guaranteeing them basic health protection. The CMU is available in two components: the basic CMU, which allows access to reimbursed care, and the CMU-C, which was free complementary health insurance to cover health costs not reimbursed by Health Insurance.

Evolution towards complementary solidarity health (CSS)

Since November 2019, the complementary solidarity health, designated by the acronym CSS, replaced CMU-C as well as Supplementary Health Assistance (ACS). This reform aims to simplify access to health coverage and offer a single contract for low-income policyholders. CSS reduces the cost of care by reimbursing the portion not covered by Health Insurance.

Main differences between CMU and CSS

There complementary solidarity health differs in several key aspects compared to CMU-C. First of all, CSS does not require excess fees or advance costs for all approved doctors. In addition, CSS beneficiaries benefit from expanded access to care by integrating benefits such as reimbursement for glasses and dental care, which were less favored by the CMU-C. The amount of the contribution may vary, but CSS offers free options for those with particularly limited resources.

Beneficiaries of complementary solidarity health insurance

CSS is aimed at people whose resources are below a certain threshold, adjusted each year. THE precarious workers, the unemployed or even those receiving minimum social benefits are often eligible. All social protection schemes can lead to rights to CSS, making this system accessible to a wide public in situations of economic vulnerability.

Advantages of complementary solidarity health insurance

One of the major advantages of complementary solidarity health lies in the significant reduction in healthcare costs. Socially insured people also benefit from medical monitoring without advance payment, which facilitates access to care. In the event of consultation with health professionals, the remaining cost is often zero or very small; thus, beneficiaries can focus on their health and well-being without the financial constraint of medical costs.

The complementary health insurance options also extend to prevention and health education. CSS includes screening and awareness programs, allowing policyholders to understand the importance of regular medical monitoring and disease prevention. This integrated approach not only strengthens individual health, but also contributes to overall public health.

Frequently asked questions about CMU and complementary solidarity health insurance

What is CMU?
Universal Health Coverage (CMU) is a system that allows people with low resources to access health coverage, including CMU-C, which is a free supplement.
What is complementary solidarity health insurance?
Supplementary solidarity health insurance (CSS) has replaced CMU-C since November 2019. It helps people on low incomes to cover health costs, and can be free or at low cost.
What is the main difference between CMU and complementary solidarity health insurance?
The CMU was divided into two parts: the basic CMU and the CMU-C. Supplementary solidarity health insurance unifies these systems into one to facilitate access to care and provide policyholders with better protection.
Are the eligibility conditions the same for CMU and complementary solidarity health insurance?
No, although both systems target people with modest resources, complementary solidarity health insurance can also include certain policyholders with income slightly higher than the CMU criteria.
Are there any costs to pay with complementary health insurance?
With complementary solidarity health insurance, there is generally no advance payment from health professionals, unlike certain previous systems.
Does complementary health insurance cover the same care as CMU?
Yes, complementary solidarity health insurance covers the same care as that covered by CMU-C, as well as other essential health benefits.
What types of care are excluded from complementary health insurance coverage?
Supplementary solidarity health insurance does not cover certain specific procedures, such as cosmetic dental care or alternative medicine, but it covers the majority of current health expenses.
How to apply for complementary solidarity health insurance?
To make a request, you must complete a file, generally available on the Health Insurance website, and provide the necessary supporting documents concerning your resources.
Can complementary health insurance be used in all health establishments?
Yes, it can be used in all approved establishments, and provides access to a wide range of care without upfront costs.
What are the reimbursement terms with complementary solidarity health insurance?
Reimbursements are made on the basis of Health Insurance rates. CSS generally covers unreimbursed costs as well as user fees.