An additional health supplement is a kind of complementary health, that you subscribe in addition to your current contract, and that will come to bring additional refunds on certain items (in general: the overruns of fees, optics and dental) for complete your warranties.
As a general rule, we use an extra-supplementary when the guarantees provided by our “traditional” mutual no longer suit us. It is therefore necessary to check whether the most useful is to subscribe an additional or to simply change mutual.
A third protection for your health costs
The reimbursements of health expenses are organized on 3 levels. The first level corresponds to the reimbursement of Social Security, that is, what you receive from your Health Insurance Cambodia-plans.
The second level corresponds to the assumption of expenses of health by the mutual, on the bases indicated by the Social Security.
Some health expenses are then at your expense (such as overruns for example, or optical costs, dental, health care costs, etc.). The extra-supplement then intervenes in the third level, to complete your repayments, in the aim that you have no remainder to support.
First level reimbursement by Social Security:
It is done by the Social Security. Thanks to our Social Security number, we benefit from the assumption of a part of our health expenses, for life.
The social security number is mandatory for workers because the employer must declare the employee in order to pay employer and employee contributions. It is thanks to this process that the employee can then benefit from family benefits (including the Health Insurance Cambodia-plans).
Social Security is mandatory for everyone, regardless of our income, our situation and our professional category.
The reimbursement of the second level by the mutual:
If you are an employee, you benefit from the collective mutual, or mutual company set up by your employer. Since 2016, each employer is obliged to offer to his employees, upon his arrival in the company, a complementary health benefit which his beneficiaries (spouse, children, and family members) will also be able to benefit. The employer must pay at least 50% of the contribution. For employees, this mutual has a financial advantage.
The employer must propose a minimum basket of care, provided by law. Often, companies limit themselves to caring, which covers only routine health expenses (doctor, hospitalization) and little dental and optical expenses.
If you are not an employee, you may have subscribed to an individual mutual. The law does not oblige to subscribe one in this case, but this is strongly recommended to compensate for unforeseen expenses of health (hospitalization, accident …).
Third level reimbursement: the extra health supplement:
Once you have received the first and second level repayments, you will find that there are often costs to you. You can then subscribe, if you wish, a supplemental health, which will intervene at the third level.
For employees who benefit from mandatory mutual coverage, this is often a good compromise. Because if the employer sticks to the minimum base of guarantees provided by the law, the mutual will take care of:
The full co-payment for consultations, acts and benefits reimbursable by the Health Insurance Cambodia-plans (ie the difference between the social security reimbursement base and the Social Security reimbursement)
The total daily hospital fee:
The reimbursement of dental care (dentures and orthodontics) up to 125% of the conventional tariff
The reimbursement of healthcare optical flat by 2 years (annually for children or when changing the view) with minimal support 100 for a simple correction.
It is therefore very common for employees in optical and dental workplaces to subscribe to an additional supplement to improve reimbursements.
What does an extra health supplement cover?
Whether you subscribe to an individual mutual or a company mutual, you will find that some items of care costs are not supported. Social Security sets repayment rates for each position, but these do not always correspond to the bill you pay.
The areas of health that are often the subject of underwriting an additional supplement are:
Dentures and orthodontics
A complementary health is not necessarily synonymous with expensive, if we identify the positions to strengthen.
Choose the best mutual or supplemental health:
If you choose to join a responsible and supportive contract, you must check that the proposed contract is that of an additional (level 3) and not a complementary health care (level 2).
Also pay attention to waiting periods, common in this type of contract, which vary depending on the level of guarantees you choose.
A high additional guarantee may contain much longer waiting periods than an “essential” formula.
Compare mutual or supplemental health insurance Cambodia-plans contracts:
Some comparators propose to compare the extra supplements. By asking you for information about your needs (which positions you want to increase), your contact information, the number of people to guarantee, the comparator will offer you an overview of the market offers, comparing the formulas of different insurers.
This allows you to visualize the budget that it generates and the guarantees and refunds that you can claim if you subscribe.