Why are mutuelle and French health insurance not sharing information?
Automatic sharing of information between insurers is common
It is possible to request a history of your healthcare payments
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Reader Question: Both Assurance Maladie and my mutuelle ask me to share information from each other. Is there a way for them to share documents between themselves?
If you are affiliated to French social security, in most cases your medical documents should be automatically shared between Assurance Maladie and your insurer.
Most major mutuelles accept télétransmission, which allows health documents to be sent automatically and electronically from social security to your insurer.
Check with your mutuelle that they accept this – if they do, you can ask them to set it up, provided they have your attestation de droits from Assurance Maladie.
You can find this in the Mes démarches en 2 clics section of your Ameli account.
The mutuelle should then be linked to your account within seven days, and you can check this in Mes informations to see if this has been done.
Manual method is possible
If your mutuelle does not accept télétransmission, after a doctor’s visit or other healthcare, you should obtain a décompte from Assurance Maladie, which states the reimbursements you have received for this.
You can find this under Mes Paiments.
Send this to your mutuelle to inform them of what remains to be topped up after the Assurance Maladie reimbursement.
In most cases, you can access a décompte from Assurance Maladie within 24 hours of your receiving a reimbursement for healthcare and then for up to two years afterwards.
If you did not use a carte Vitale
If you did not use your carte Vitale when paying for a procedure/visit you need to send Assurance Maladie paper feuilles de soins or factures acquitteées (medical bills / hospital invoices) showing the cost of the procedures, after which, assuming the care is eligible for a refund, you will receive décomptes as described above.
Thus, for the vast majority of care this is the system (if information sharing is not automatic): obtain the Assurance Maladie reimbursement, then send proof to the mutuelle, whose role is to ‘top up’.
The exception is where your mutuelle provides cover for a treatment that is not covered by Assurance Maladie.
This may include some alternative therapies or some kinds of non-reimbursed mental health care.
In this case you would send the facture for the service paid for directly to the mutuelle.
