Complementary Solidarity Health: all you need to know!

HEYME student health insurance

Since 1er November 2019 Assistance with the payment of Complementary Health (ACS) and Universal Health Coverage (CMU) have been replaced by Complementary Health Solidarity (CSS).

What is the Complementary Health Solidarity?

If your resources are modest, the Complementary Health Solidarity is an aid to pay your health expenses. It entitles you to the payment of the additional part and to exemption from advance payment for medical treatment. The costs are paid directly by the Health Insurance and the organization you have chosen to manage your Complementary Health Solidarity. You don’t have to pay anything.

Your health expenses are covered at 100% of the rates set by Social Security.

HEYME student health insurance

What benefits are covered by Complementary Health Solidarity?

If you are eligible for Complementary Health Solidarity, you will not pay:

  • The doctor, the dentist, the hospital or the nursing care;
  • The hospital package in its entirety and without time limit
  • Drugs in pharmacies;
  • Medical devices such as dressings, crutches, splints or wheelchairs;
  • Most glasses, dentures and hearing aids;
  • Medical tests, X-rays…

With Complémentaire Santé Solidaire, you can consult any healthcare professional (in a practice, clinic or hospital) and you will not be charged any excess fees unless your request is not justified.

Who can apply for Complementary Health Solidarity?

To request the Complementary Health Solidarity you must:

The resources taken into account are those of the last twelve months. The ceiling varies according to the place of residence and the composition of the household.

If you benefit from housing assistance or if you are accommodated for free, a lump sum will be added to your resources in the interests of fairness with other applicants. Know the ceilings

In order to study your eligibility rights for the Solidarity Complementary Health, a simulator is online on the Health Insurance website: https://www.ameli.fr/simulateur-droits

Complementary Health Solidarity does not apply to Mayotte, Wallis-and-Futuna, French Polynesia, New Caledonia and Saint-Pierre-et-Miquelon. Insured persons of the Mayotte scheme with low incomes can, however, request 100% coverage.

The Complementary Health Solidarity benefits the entire household and can only be requested once per household. Your household is made up of yourself, your spouse or your partner or your partner in the context of a PACS (civil solidarity pact), as well as all your dependents under 25 years old.

However, it is possible to make an individual request under certain conditions:

  • Children under the age of 16 who are covered by the Childhood Social Assistance (ASE) or the Judicial Protection of Youth (PJJ);
  • Children under the age of 16 who have broken their family ties;
  • People aged 18 to 25 no longer living under the same roof as their parents, having completed a separate tax return (or undertaking on their honor and in writing to do so the following year) and not receiving a pension food giving rise to a tax deduction;
  • Adults aged 18 to 25, living under the same roof as their parents, if they are themselves parents or if they will become one;
  • Isolated students, benefiting from annual emergency aid paid by the Regional Centers for University and School Works (CROUS) to the National Emergency Aid Fund (FNAU);
  • Separated spouses.

How much does Solidarity Complementary Health cost?

Depending on your resources, the financial contribution varies:

Below above a certain ceiling, you won’t have to pay anything.

Above above a certain ceiling, the monthly amount varies according to age. If your resources exceed the annual ceiling, you will have to pay each month an amount of less than 1 euro per day. For example, for insured persons aged 29 and under, this is €8/month, i.e. €96 per year (€2.80 per month and €33.60 per year if you are covered by the local Alsace- Moselle).

How long is the Complementary Health Solidarity valid?

Complementary Health Solidarity is granted for one year and requires you to redo a file each year (which allows you to reassess your resources).

How to apply for Complementary Health Solidarity?

You can make your request:

  • On the internet from your ameli.fr account
  • By sending or dropping off the form and supporting documents at your health insurance fund. You can download the form here

It takes a period of 2 months for the study of your file.

How to choose your Complementary Health Solidarity organization?

When compiling your file, you will have to choose the organization that will manage your Complementary Health.

  • If you are already covered by a complementary organization and that it is part of the list of complementary organizations managing the Complémentaire Santé Solidaire (see the list), you can then keep it and indicate it on the application form. On the other hand, if your current organization does not allow Complementary Health Solidarity, you will have to choose another one from the list above.
  • If you don’t have a complementary organization you will have to choose one from the list of complementary organizations managing the Complémentaire Santé Solidaire (see the list).

Whichever organization you choose, the coverage is the same everywhere, for everyone.

Our partner, The Family Mutual, is on the list of organizations managing the Complémentaire Santé Solidaire. For 80 years, it has provided its members with equitable and sustainable health coverage, to guarantee real quality of care without discrimination. It is a united, democratic and responsible player in the fields of health, welfare and prevention.

Not eligible for Complementary Solidarity Health: what to do?

In addition to the aid for Complementary Health Solidarity, there are national financial aid schemes but also scholarships and aid, offered by the regions.

These systems are specific to each region and are referenced for Metropolitan France and Overseas on the site https://www.etudiant.gouv.fr/pid37652/aides-des-regions-et-des-outre-mer.html.

A large number of local aid systems are also deployed. To find out more, get information from your CROUS (Regional Center for University and School Works), your local authority or directly from your town hall.

And at HEYME, what does mutual insurance give?

At HEYME from €9.90/month we cover your essential needs: hospitalization, routine care, pharmacy. And if you need extended coverage, we offer 4 levels of guarantees to meet your expectations.

Regardless of the level chosen, you have unlimited access to medical teleconsultation 24 hours a day with ABI. You can consult a doctor from your smartphone and directly from your sofa!

We also provide you with an app to view your reimbursements, download your third-party payment card, send us your documents and find a doctor near you!

And the icing on the cake… an app with good deals and discounts on your favorite brands: shopping, cinema, restaurant…

👉 HEYME student mutual

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