Family and birth
- Care for 0-18 years of age : 100% reimbursed
> All consultations* reimbursed (GP, specialist, orthodontist, physio, nurse) for your children aged 0 to 18.
> To benefit from care reimbursed 100% up to the age of 18, open a free General Medical Record (GMR).
* consultations based on official rates, excluding surcharges.
- Home-care for sick children : 10 days free
> Childcare and home-care professionals will take care of your sick child aged between 0 and 12 at home.
> After the first 10 days of free care, a fixed charge of € 12 per day will apply for an unlimited number of days.
- Birth : minimum € 350
> Premium of € 350 per birth or per adoption
> 9 sessions of ante-natal physio reimbursed.
> Contribution of € 250 per cycle of IVF.
> Contribution of € 150 for delivery at a birthing centre or at home.
> The newborn baby is covered in the event of hospital admission by Hospi Solidaire insurance from birth to the age of 18, with no excess to pay.
> Low rates for the hire or purchase of aid and care equipment (nappies, breast pump, baby scales, etc.) from Qualias Proximité Santé.
> The “Bien Naître” birth advice service.
Contribution up to € 25 per year, with no age limit for anti-infective vaccinations and desensitizing treatments.
- Optical : glasses or lenses
Contribution of € 50 in renewing or buying spectacles, glasses or lenses prescribed by an ophthalmologist and purchased from an accredited optician.
Laser surgery: € 100 per eye.
Contribution of € 40 per year (condom, pills, patches, injections and vaginal ring) or € 120 every three years (IUD, contraceptive implant).
25% contribution towards the cost of homeopathic medication prescribed by a doctor (up to € 175 per recipient per year).
- Well-being benefit
Contribution of € 10 per session of osteopathy, chiropractic and acupuncture (maximum € 70 per year), all disciplines combined.
Contribution of € 10 per session (maximum € 50 per year).
- Speech therapy
> Contribution of € 10 per session (75 sessions, renewable once / pathology, no age limit).
> Contribution of € 20 for an IQ test.
Dental care and orthodontics
- Dento Solidaire: this dental cover is automatically included in your premium. There is no surcharge and it covers the whole family:
> No medical questionnaire, no age limit, no excess to pay and no waiting period.
> Preventative and curative dental care reimbursed 100% up to the age of 18 (based on official rates).
> Orthodontics up to the age of 22*: up to € 750 + appointments reimbursed 100% (based on official rates and if the patient has a General Medical Record).
* If the treatment is approved by Inami
> Contribution of € 175 for dental prosthetics not reimbursed by Inami (dentures, crown, bridge, etc.) and implants.
- Dento+: insurance that provides even greater cover for your dental expenses.
> No medical questionnaire, no age limit and no excess to pay
> Preventative and curative dental care reimbursed 100% for all ages (based on official rates)
> Contribution towards orthodontist fees, with no age limit
> Significant contributions towards the cost of periodontics, prosthetics and dental implants
> Annual ceiling: up to € 1000
> Specific ceiling in the event of an accident: up to € 2000
> Free up to the age of 7
Hospitalisation: before, during and after
- Hospitalisation insurance
> Hospi Solidaire: hospital admission cover already included in your premium and no waiting period. Maximum of € 275 to be paid by the patient.
> Hospi +, Hospi +100 or Hospi +200: hospital admission cover from € 2.84 per month.
- No medical questionnaire and no excess to pay for under-18s.
- Serious or costly illnesses: additional contribution of € 150 to € 2150.
- Medical transport
> Maximum € 60 to be paid by you for your mileage costs by ambulance.
> Contribution towards the cost of transport associated with chemotherapy, dialysis, etc.
- Convalescence stays
> Contribution of € 25.10 to € 35.20 per day (higher contribution for BIM status).
> Additional contribution for stays resulting from hospitalisation.
Well-being at home
- Homecare and assistance
Homecare and assistance services provided by experienced professionals (care for sick children, nursing, family or domestic assistance, etc.).
- Adaptations to the home
Free advice for home alterations from Solival.
- Bandaging, orthopaedics, mobility aids
Low rates for the hire and purchase of assistance and care equipment (crutches, bed, etc.) from Qualias Proximité Santé.
- 24-hour tele-assistance
Contribution of € 6 per month towards the subscription costs of a Vitatel tele-assistance device.
- Home assistance premium
Annual allowance for high-dependency patients.
Holidays and leisure
- Insurance and assistance abroad
> Health insurance for stays in 72 countries (Europe, Mediterranean countries…).
> Mutas will reimburse your medical expenses if they exceed € 200 (maximum excess of € 60).
> 24-hour assistance service in the event of an emergency on 0032 2 272 09 00.
- Stays, courses and playgroups
Contribution up to € 20 for taking part in camps, playgroups, stays and holiday activities provided by youth organisations, public administrations and bodies providing entertainment for young handicapped individuals.
- Sport and open-air classes
Annual contribution of € 35 for regular activity in a sports club, open-air classes, sea, snow or sports courses of a minimum 3 days.
Premiums at 1st January 2019
For your convenience, you can choose the method of payment for your membership premium.
By quarterly direct debit (€ 34.65) or by annual transfer (€ 138.60)