Solidarity supplementary health cover (France)

In France, compulsory health insurance reimburses only part of health spending, and a supplementary policy covers the rest, co-payments, fixed charges, excess fees. For low-income households, two schemes coexisted until 2019: universal complementary health cover, free for the poorest, and the supplementary health aid, a voucher to buy a policy on the market, little used. Since 1 November 2019, solidarity supplementary health cover has merged them. It is free below a first income ceiling and costs a contribution of a few euros a month, depending on age, below a second ceiling. It covers a broad basket of care with no out-of-pocket cost, including glasses, dental and hearing aids, and bars health professionals from charging excess fees to its beneficiaries. It may be managed by the national health insurance or by a supplementary insurer on an approved list, at the beneficiary's choice. It is funded notably by the additional solidarity tax levied on all supplementary health contracts. For insurers, it is at once a compulsory contribution, a regulated segment and a revealing indicator: its high non-take-up shows the limits of protection that depends on an application.