The increase in the ceiling for medical deductibles scheduled for October 2026 and the reductions in reimbursements for medical devices and health transport change the calculation of the actual out-of-pocket expenses. Comparing health mutuals without integrating these recent parameters amounts to evaluating contracts on outdated bases.
Medical deductibles and out-of-pocket expenses: the parameter that comparison tools underestimate
Law No. 2025-1403 of December 30, 2025, regarding the financing of Social Security for 2026 has confirmed an increase in medical deductibles. The annual ceiling will rise to 140 euros in October 2026, according to JeChange. This amount remains non-reimbursable by responsible contracts.
We observe that most online comparison grids display guarantee levels without ever factoring in this unavoidable out-of-pocket expense. A contract that generously reimburses optical or dental care does not compensate for this deductible if your consumption of medications and paramedical services is regular.
Before comparing quotes, it is essential to estimate your personal exposure to these deductibles. A chronic insured person under daily treatment will reach the annual ceiling in just a few months. For this profile, the difference in contributions between two contracts matters less than the coverage of non-deductible items. To check the coverage conditions and after-sales service of organizations, a useful resource is: https://www.sav-mutuelle-sante.fr/, which allows you to cross-reference feedback on actual reimbursement times.
Individual mutual or collective contract: the arbitration modified by public service reform
Since January 1, 2025, mandatory company mutuals are gradually extending to the State public service. A decree dated November 26, 2025, cited by Juritravail, specifies the implementation modalities starting December 1, 2025, and then January 1, 2026.
This change disrupts the arbitration for public agents who previously held an individual contract. The collective contract imposes a base of guarantees but limits customization. An agent who benefited from an additional dental or optical coverage tailored to their needs may find themselves with a standardized coverage that is less effective for these items.
Check portability and additional coverage options
The reflex is to compare the care package of the collective contract with that of the old individual contract, item by item. The discrepancies generally focus on three lines:
- Excess fees for specialists in sector 2, often capped lower in collective contracts than in high-end individual contracts
- Dental prostheses outside the 100% Health package, where reimbursement bases vary from simple to double depending on the contracts
- Complementary medicines (osteopathy, psychology), rarely included in mandatory collective bases
If the collective contract leaves gaps, an individual additional coverage can fill these items. We recommend comparing the total cost (collective contribution + additional coverage) with that of the old individual contract before making a decision.
Reductions in Social Security reimbursements 2026: which items to monitor in guarantees
Several reductions in reimbursements by Health Insurance have come into effect or are announced for 2026. According to ADP Assurances, medical devices and health transport are the most affected items.
A contract that displays “100% BR” on these lines reimburses less than before in absolute value, since the reimbursement base itself is decreasing. Insured individuals who rely on the displayed percentage without checking the actual amount in euros risk a nasty surprise at the time of the statement.
Reading a guarantee table without making mistakes
The mention “100% BR” (reimbursement base) means that the mutual covers the co-payment, no more. For items where Social Security has reduced its coverage, look for contracts expressing their guarantees in “percentage of the actual expense” or in euro allowances.
In practice, for health transport or certain medical devices, an annual allowance in euros offers better protection than a percentage of the reimbursement base. This technical distinction almost never appears in public comparison tools that rank offers by level (1, 2, 3 stars) without delving into the calculation method.
Cancelling and changing health mutual: the calendar to follow
Since the law of July 14, 2019, any insured person can cancel their health supplement after one year of membership, without fees or justification. The cancellation takes effect one month after the request is received by the organization.
A common trap concerns mandatory collective contracts. An employee cannot unilaterally cancel the contract taken out by their employer. However, they can cancel their individual additional coverage or the coverage for their dependents if they are not covered by the obligation.
Transition strategy without coverage interruption
We recommend subscribing to the new contract before canceling the old one, setting the effective date of the new one to the day after the effective cancellation. Most organizations accept a deferred effective date. Any day without additional coverage exposes you to full out-of-pocket expenses for unforeseen care.
Choosing a mutual in 2026 is not just about comparing fixed guarantee tables. The increased deductibles, the reductions in Social Security reimbursements, and the extension of mandatory collective coverage to the public service change the calculation parameters. Checking the expression method of guarantees (percentage BR, percentage of actual expense, euro allowance) and estimating your actual out-of-pocket expenses after deductibles remains the most reliable method to avoid paying a high contribution without effective coverage.
