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The year ends with difficulty for mutual health organizations. The accounts of the OCAM (complementary health insurance bodies) would show a loss of around 900 million euros for the first half of 2021. What are the reasons? Explanations.
According to a study by the FFA (French Federation of Insurance), the Ctip (Technical Center for Provident Institutions) and the FNMF (National Federation of French Mutuality), from which Argus de l’Assurance was able to obtain a copy, the supplementary health accounts show bad numbers for the first half of 2021, with a significant difference over the same period in 2019.
Yet the 2021 edition of the health accounts results revealed a meager increase for 2020, with the weakest pace on record. These results indicated an increase in “Only” 0.4% for the year 2021, an unprecedented figure. Indeed, the year 2020, marked by the start of the health crisis in France, had dissuaded a good number of insureds from going to their doctor, in particular for fear of becoming infected.
However, the French seem to have returned to the medical offices to carry out their medical care. Perhaps this is an effect of the wave of vaccination during which millions of citizens have completed their vaccination schedule. Nevertheless, the explanation seems to lie elsewhere, in particular in the zero-charge remainder from which many people seem to have benefited.
A sharp increase in expenses due to 100% Health
Indeed, since the start of 2021, the 100% health applies to hearing aids. Entry-level prostheses are now fully reimbursed by Social Security. Excellent news for thousands of French people who suffer from hearing problems.
With prices sometimes reaching 1500€ for a single device, for a total bill of 3000 €, many of them did not renew their equipment or simply did not obtain it.
As a result, the number of French people equipped has jumped 68% between the first half of 2019 and that of 2021, marking a record increase in sales. Hearing care expenses fell from around 80 million euros in 2019 over the first half of the year, to around 194 million euros for the same period in 2021 (figures from the Syndicat des audioprothésistes, SDA).
Same phenomenon on the dental care side. In a press release dated May 4, 2021, Health Insurance already noted an increase of 10,3% between the first quarter of 2020 and that of 2021. This is explained by the implementation of the remains at zero charge for some of the most expensive dental treatments, such as the installation of a ceramic crown, since January 2020.
If 100% Health only explains part of these losses for complementary health organizations, some of them should see their price increases in order to absorb this amount.
