How to Effectively Compare Health Insurance to Make the Best Choice

The supplementary health insurance is increasingly weighing on household budgets. Comparing health insurance is not just about aligning monthly rates: the structure of the contract, the pricing policy over several years, and the organization’s ability to absorb future cost transfers determine the actual quality of coverage.

Transfer of costs from Social Security to supplementary insurance: what the 2026 decree changes

A decree published in the Official Journal on August 22, 2026, raises the portion of expenses left to be covered by supplementary insurance for medical devices listed in the list of products and services (LPP). The range increases from 40-50% to 50-60% of the reimbursement base starting January 1, 2027. Social Security is now limited to 40-50%.

Based on 2024 expenses, this transfer represents up to an additional 110 million euros per year for supplementary insurance in optics, with over 100 million just for the 100% Health basket. We recommend checking, before any subscription, whether the organization has communicated its strategy for absorbing this additional cost.

A comparator that only displays the current monthly rate without modeling the impact of this transfer provides a distorted view. To quickly compare several offers and their levels of LPP guarantees, a tool like comparsante.fr allows filtering by reimbursement item rather than just price.

History of premium increases: the criterion that comparators hide

The premiums of individual contracts have followed a clear trajectory in recent years. According to the French Mutuality: +3.4% in 2022, +4.7% in 2023, +8.1% in 2024, +6% in 2025, and +4.3% in 2026. Five years of cumulative increases radically change the real cost of a contract.

Before subscribing, we find it relevant to ask the insurer for the history of its increases over three to five years. A contract displayed at an attractive rate in the first year but for which the organization applies systematically higher adjustments than the market average will cost more in three years than a contract that is initially more expensive but stable.

Online comparators rarely display this data. It must be sought in the general conditions or explicitly requested from the sales department. An organization that refuses to communicate its revaluation history sends a negative signal about its transparency.

Redistribution rate and management fees

The redistribution rate measures the portion of premiums actually returned in the form of benefits. A high rate (above the industry average) indicates an organization that allocates fewer resources to its structural costs. This ratio, published in the annual reports of mutuals, usefully complements the reading of a guarantee table.

Health guarantees: reading a reimbursement table without making mistakes

The mention “100% BR” (reimbursement base) does not mean “zero out-of-pocket.” It indicates that the supplementary insurance reimburses up to 100% of the rate agreed upon by Social Security, which is often lower than the rate actually charged by the healthcare professional. Only a guarantee expressed as a high percentage of the BR or as a flat fee covers excess fees.

Three items deserve particular attention during comparison:

• Optics outside the 100% Health basket: high-end frames and progressive lenses generate significant out-of-pocket costs if the annual flat fee is capped too low.
• Prosthetic dental care: crowns and bridges not covered by the 100% Health remain freely priced. The difference between an entry-level contract and an intermediate contract mainly plays out on this item.
• Excess fees from specialists: a contract that reimburses 200% BR covers better than a contract at 150% BR, but the actual difference depends on the practitioner’s area of practice (sector 2, Optam, Optam-CO).

We recommend simulating a real consumption scenario rather than comparing abstract tables. A couple wearing progressive glasses and consulting a cardiologist in sector 2 does not have the same needs as a young professional without chronic pathology.

Medical deductibles and flat-rate contributions: what the mutual does not cover

The medical deductibles (on medications, paramedical acts, and health transport) and the flat-rate contribution of 1 euro on consultations remain legally the responsibility of the insured. No supplementary insurance can reimburse them, as it is a regulatory prohibition.

This point is often a source of confusion. A contract that states “full coverage” does not cover these deductibles. Comparing them between organizations makes no sense for this specific item, but their annual amount must be included in the calculation of the overall out-of-pocket cost.

Teleconsultation and digital services

Most supplementary insurances now include access to teleconsultation in their contracts. The differentiating criterion is not the presence of the service (which has become standard) but its conditions: number of consultations included per year, access to specialists or only to general practitioners, availability time.

A contract that offers unlimited teleconsultation with access to specialists provides measurable value, especially for insured individuals living in areas underserved by healthcare professionals.

Method for comparing health mutuals: concrete steps

Effectively comparing requires following a precise order rather than navigating through dozens of offers without a reading grid.

• Establish your actual consumption profile over the past twelve months: number of consultations, specialized acts, optics and dental items consumed.
• Request the history of increases over three to five years from each pre-selected organization.
• Compare guarantees item by item on the three to four most consumed items, in percentage BR and in flat fee.
• Check the waiting period applied to heavy items (hospitalization, prosthetic dental care, optics): some contracts impose several months of waiting before reimbursement.
• Consult the redistribution rate in the organization’s annual report.

The monthly rate is only the last filter. A contract with a low premium but high annual revaluation and low redistribution rate will cost more over time than a contract that is initially more expensive but stable and transparent.

The cost transfer planned for 2027 makes this approach even more strategic. Contracts subscribed today will have to absorb a structural additional cost starting next year, and only financially solid organizations will be able to limit the impact on premiums.