Understanding the true cost of health insurance and reimbursements

The true cost of health insurance extends beyond monthly premiums to include various out-of-pocket expenses. In 2025, the average monthly premium for all profiles was €86.03, with 2026 projections ranging between €86 and €122 per month.

Total healthcare expenditure must account for non-reimbursable costs such as medical deductibles and flat-rate contributions for medications, paramedical acts, and sanitary transport. The annual cumulative ceiling for these deductibles has been raised to €140.

Furthermore, reimbursement percentages (such as 200% or 300% of the Social Security reimbursement base) can be misleading. These percentages are calculated based on conventional rates rather than actual practitioner fees. If a specialist's fees exceed these calculated limits, particularly in dental, optical, or audiology services, the patient remains responsible for the difference. Choosing a plan requires aligning coverage levels with specific medical needs to avoid paying for high-tier guarantees that may not be utilized.