health insurance

YOUR STUDENT HEALTH INSURANCE
2015-2016
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Welcome t
For over 40 years, Smeba, your Student Health Insurance Centre, has been successfully
managing your health!
Whether you are a university student or a recent
graduate, a new school year approaches!
In addition to registering at your higher education
institution, you will need to choose a Student
Health Insurance plan.
In your area Smeba, your local student health
mutual insurer, will manage your health coverage -
Speedy:
48 hours, that’s your
reimbursement delay
guaranteed by Smeba.
Advisory service:
a Smeba agent will be happy to
review your dossier and answer
any of your questions.
National third-party
payment system:
There is no need to pay cash
in advance.
Practical:
100 Smeba agent
+ 24 hours a day
“My Smeba space”.
Our mobile high
tech agency
a local Smeba advising
agent constantly visits all
major higher education
institutions.
02
SMEBA STUDENT HEALTH INSURANCE 2015-2016
not only anywhere in France, but also abroad if you
are planning to travel internationally.
Choosing a local student health mutual insurer
brings the reassurance that your daily concerns will
be met with targeted solutions.
It also means obtaining quality services and a quick
reimbursement of your medical expenses.
10
GREAT REASONS
FOR SIGNING UP
WITH SMEBA!
More than 2 million students
have placed their
trust
in us for over 40 years.
A close
relationship
& Nationwide
network:
More than 200 agencies
at your service in France.
International
Health Passport:
The Smeba third-party payment
system works worldwide.
Personalised
attention:
in each university town.
HEALTH INSURANCE
WHEN AND HOW TO REGISTER?
While you are in France, you will have to pay for any medical treatment you may receive. However, this is not a problem as
the social security system helps cover your costs.Health insurance is compulsory for anyone residing in France, whatever
their nationality your insurance ensures you enjoy the same rights and peace of mind as French nationals.The Smeba
provides you with your essential health insurance and gives you access to the French social security system.
EUROPEAN EXCHANGE STUDENTS
Before you leave your country, make sure you have a European Health Insurance Card.This will give you full access to the
French social security system without additional fees, and your reimbursements will come directly from the CPAM (Caisse
Primaire d’Assurance Maladie).This is the standard non-student social security centre. However, bear in mind that you will
be reimbursed at state social security rates, so you may prefer to subscribe to the Mutuelle for fuller cover.
FOR SHORT STAYS
If you are coming to France for less than 3 months, contact a Smeba advisor who will be able to explain the options open
to you, as you.
OVER THE AGE OF 28
If you are a mature student, you may not be eligible to subscribe directly to the student social security system.
In that case, you will need to make an application to the CMU.The CMU - Couverture Maladie Universelle (Universal Health
Cover) - was created to ensure that everyone has access to medical treatment. Once your application has been accepted,
the Smeba will handle your claims and reimbursement as for any other student.
1. Determine your situation
Your student public health insurance
(Sécurité sociale) fee must be paid to your
institution (€214 in 2014-2015).
Students on a scholarship are exempt from
paying the fee. If you have a special situation,
talk to a Smeba agent.
2. Subscribe to the Smeba health
insurance plan
Via your higher education institution’s website
by checking the Smeba check box in the student
health insurance (Sécurité sociale) section.
Via a hard copy form by indicating: Smeba.
3. Send your documents
to Smeba
Send us a RIB (your bank account details)
in your name together with your “déclaration
de médecin traitant” (physician declaration
statement) to complete your application
(downloadable form at www.smeba.fr).
If you were born abroad, send your birth
certificate and a copy of your passport and visa.
4. The carte Vitale (health insurance card):
How to use your card
If you already have a carte
Vitale, all you need to do is
to update it at a Smeba
agency.
If you don’t have a carte
Vitale, it will be issued as
soon as your institution
sends us your dossier.
Your certificate of
entitlement of benefits is
available online at any time,
in your personal space.
5. Your reimbursements
If you used your carte Vitale and you paid fees,
you will be reimbursed within 48 hours of your
file being processed.
If you used your carte Vitale and you did not pay
any fees, then the health professional will be
reimbursed directly by Smeba.
If you did not use your carte Vitale and you paid
fees, you will be reimbursed via a deposit within
48 hours.
To do so, send us your healthcare records
(feuilles de soins).
SMEBA STUDENT HEALTH INSURANCE 2015-2016
03
SUPPLEMENTAL HEALTH
INSURANCE
The public health insurance system covers approximately 70% of your medical expenses.
For a full reimbursement, it is essential that you sign up for a supplemental health coverage
plan. Smeba offers health plans and an extended supplemental health coverage plan.
SMEB’2
No increase
in 2015!
SMEB’1
€5
per month.
Protect yourself from
major healthcare
expenditure.
SMEB’ AUTONOMIE
(SMEB’ AUTONOMY)
€10
per month
(1)
the first year!
e mos t
The plan covers th
.
re
ca
standard
Theo, 22 years old, never
been ill, subscribed to
Smeb’1 on the advice of his
parents, to protect himself
from any large unforeseen
expenses.
st
ar of
Alexis, in his 1 ye
, is
Technical College
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medicatio
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om
Smeb’Auton
(Smeb’Autonomy).
.
insurance coverage
€20
per month.
This plan covers he
alth
expenditure at 10
0%
of the social socie
ty rate.
SMEB’3
€34
per month.
For coverage of more
specific needs.
Lea, 24 years old,
has undergone all
the
recommended m
edical
examinations. Sh
e needs a
pair of glasses fo
r working
with computer sc
reens.
With her Smeb’2
insurance
coverage, she can
take
advantage of a pa
ir
reimbursed up to
€70.
Anais, 20 years old, requires
a dental prosthesis. Thanks
to her Smeb’3 insurance
coverage and the €250
lumpsum, her prosthesis is
fully covered.
That
Smeba
plus
!
An assistance and
repatriation contract
included in SMEB’2 and
SMEB’3 insurance plans.
SAVE €100 ON THE PRICE OF YOUR SUPPLEMENTAL HEALTH
COVERAGE PLAN
Thanks to the Pays de la Loire Region, students residing in
this region are entitled to a €100 contribution towards the
Pack 15-30.
The SMEB’AUTONOMIE plan is free of charge and you are
entitled to a payment of €100 for the SMEB’2 and SMEB’3
plans.
Visit the site of the Conseil Régional Pays de la Loire
(Regional Council Pays de la Loire) to take advantage of this
coverage offer which is valid for one year.
04
SMEBA STUDENT HEALTH INSURANCE 2015-2016
SMEB’1 €5
per month
100%
Reimbursement of healthcare
(based on Social Security
reimbursement)
Hospitalisation
General practitioner (GP)
consultations/visits
SMEB’2 SMEB’3 20 €
34 €
per month
100%
of all care except
pharmacy at 15%
per month
100%
of all care except
pharmacy at 15%
SMEB’
autonomie(1)
(SMEB’ AUTONOMY)
10 €
per month
the first year
100%
of all care except
pharmacy at 15%
and thermal cures
pharmacy at 65%
Fixed prices
Annual fixed prices
€18 or €13.50
(PSY)/day, limited
to 30 days/year
€18 or €13.50
(PSY)/day, unlimited
€18 or €13.50
(PSY)/day, unlimited
€18 or €13.50
(PSY)/day, unlimited
Non-prescription pharmacy
€15
€20
€30
€15
Male condoms
€10
€10
€10
€10
Hospital
Female contraceptives
€50
€50
Vaccines not reimbursed
including antimalarial treatment
€80
€80
Fracture
€80
€80
Alternative medicine* including
osteopathy and hypnosis
€50
€70
€70
€200
Dental **
€250
Optical ***
Orthopedics
€50
Hearing aids
€150
Surgery if medical treatment is
exceeded
€100
Lumpsum for stressless
return – taxi
2 X €15
Coverage for initial PSC1
(first aid) or renewal
€30
Birth
€150
Care following an accident limited to 400%
Sports medicine appointment 100% based on a GP consultation
Annual preventive consultation: 100%
Advantages
Prévention Santé Mutualiste
(Mutual Health Prevention)
included
included
included
included
Mutual health aid fund
included
included
included
included
included
included
Assistance/repatriation
* List of health care treatment supported through alternative medicine: osteopathy/homeopathy/acupuncture/hypnosis/visit to a dietician/counselling.
** The lumpsum dental benefit corresponds exclusively to any type of dental prostheses (excluding dental treatment and care).
*** Optical lumpsum with a maximum of €150 for the frame, within the limits of a full set (2 lenses and a frame) per two-year period, except for minors and changes in vision.
Flat-rate amount can reach €200 in SMEB’2 for complex lenses only: simple single-vision lenses where the sphere is outside the -6.00 or +6.00 dioptre zone or where the cylinder
is greater than +4.00 dioptres and multi-focal lenses or progressive lenses.The detailed content of the insurance coverage can be found in the mutual health regulations available
at smeba.fr under the heading Join.
Drugs reimbursed at 15% by social security are not covered.
(1) valid for every new Smeba supplemental health coverage subscriber; then €12 per month.
The reimbursement levels (Social Security + Mutual) indicated apply to the rates, social security reimbursement rates and the conditions for reimbursement of social security
currently in force, subject to reimbursement by this scheme, within the limit of the costs incurred and within the conventional health care protocol, and excluding participating
interest payments made by the insured party and the excesses stipulated under Article L322-2 § 2 and 3 of the Social Security Code.
SMEBA STUDENT HEALTH INSURANCE 2015-2016
05
INSURANCE PLANS
UNIVERSITY INSURANCE
Your essential insurance plan throughout your studies: your private life, your student life,
your internships, your sport activities, your studies... It is mandatory for your internships.
You get civil liability coverage for
your daily student activities,
internships, jobs, activities in France
or abroad
ou are covered for all personal, material or
Y
immaterial accidents in the context of your various
activities. It is valid worldwide. It falls under the
realm of your school insurance and it is often
mandatory for your studies and internships.
Repatriation and assistance
insurance covered worldwide
When you travel in France or abroad, you are
covered in case of accident, illness or
hospitalisation. You also get emergency services
on marked ski slopes.
Legal information service
FEES AND ADVANTAGES
*€12/year
€24/year
For subscribers to a
Smeba supplemental
health coverage plan.
If you have not
subscribed
to a Smeba
supplemental
health coverage
plan.
€12
per year
or only
€1 per year
Free for
3 months
3
months
free
Starting this summer,
enjoy the benefits of free
university insurance, by
subscribing from July 2014.
You will be covered for 15
months for the price of 12!
Stipend related to family event
In case of a parent’s accidental death, Smeba pays
you €300/month until the end of the academic year.
Civil liability coverage for medical
and para-medical studies
In case of legal problems in the context of your
private life, contact our lawyers to obtain
information about your rights and obligations.
It covers internships and medical residencies until
the fourth or fifth year in medicine, pharmacy,
speech therapy, physiotherapy, dentistry, nursing,
midwifery, paediatric assistant, radiography,
occupational therapy and psychology studies.
Individual accident
Personal items: documents, keys,
phone, bicycle, musical instrument
If you are the victim of an accident, Smeba will
reimburse you up to €4,600 of the actual fees
remaining at your expense.
Foresight plan for your exams
Did exceptional events prevent you from taking
your exams? Smeba will pay up to €4,500 of your
school fees when you renew your school enrolment
and it will pay you an amount of €800 to help you
begin the school year.
Payment of the fees for replacing official documents
in case of loss, theft or damage due to fire.
Payment of the fees for replacing your keys in case of
theft, as well as the lock, if applicable. Reimbursement
of your mobile phone’s communication fees due to
fraudulent use in case your phone is stolen.
Reimbursement of damages to your musical
instrument due to an accident or to your bike and your
personal belongings after an accident on a public
thoroughfare.
Civil liability coverage of the individual and the family head: The insurance plan is covered by AXA France IARD – 26 rue Drouot – 75009 Paris – with a capital of €214,799,030 – Paris Trade and Companies Registry number:
722 057 460 – Company governed by the Insurance Code, according to Group Policy no. 1743420304. €91 excess.
Broker S2C – 432, Bd Michelet – 13009 Marseille. SARL (limited liability company) with a capital of €7,622.45 – Marseille Trade and Companies Registry number: B 395 214 646 00022 – APE Code 672 Z - ORIAS no. 07 030 727 –
www.orias.fr
Broker VITAL ASSUR – 4 bis rue de Londres – 67000 Strasbourg – Strasbourg Trade and Companies Registry number: B 389 426 065 00014 – APE Code 672Z – ORIAS no. 07 030 428 – www.orias.fr
RESSOURCES MUTUELLES ASSISTANCE, Union Technique d’Assistance subject to the provisions of Book II of the Code of Mutuality. SIREN no. 444 269 682 – Registered place of business: 46 rue du Moulin in VERTOU 44121.
JURIDICA – Underwritten by JURIDICA (S.A. with a capital of €8,377,134.03, Versailles Trade and Companies Registry number: 572 079 150) – Head office: 1, Place Victorien Sardou, 78160 Marly-le-Roi. RC/IA – Underwritten
by S2C432, Bd Michelet, 13009 Marseille – SARL (limited liability company) with a capital of €7,622.45 – Marseille Trade and Companies Registry number: B 395 214 646 00022 – APE Code 672 Z – ORIAS no.: 07 030 727.
06
SMEBA STUDENT HEALTH INSURANCE 2015-2016
HOUSING INSURANCE
IT IS MANDATORY IF YOU RENT ACCOMMODATION.
FEES
Fees per year
subscriber
Fees per year non
subscriber
With Smeba, no general excess*
Your incident claims are fully reimbursed.
The excess is the amount that remains at your
expense after the payment of damages by the
insurer.
Shared housing
Student housemates named in the contract are also
insured without any additional fees.
They enjoy the full contract coverage in the same
manner as the lead subscriber.
Basic
guarantee
Basic plan
+ theft
Basic
guarantee
Basic plan
+ theft
University
housing
€25
€39
€37
€51
Immediate insurance certificate
Room in a
private home
€30
€44
€42
€56
Studio and oneroom flat
€55
€70
€67
€82
You are insured starting at 0:00 a.m. of the day
following your subscription.
Your certificate is issued immediately, so you can
move in right away.
Two-room flat
€79
€96
€91
€108
Three- and fourroom flat
€102
€120
€114
€132
*
Except for: water damage (0.15 times the FFB index) and natural disasters for the
amount indicated in the Vital Assur General Provisions No. EQVA/0600B, Private Life
Civil Liability of the non-subscriber fee: €91.
To subscribe, contact your Smeba agency
or visit www.smeba.fr/assur
CAR INSURANCE
• An insurance policy dedicated to young drivers.
• Unique insurance guarantees adjusted to suit young drivers.
• Competitive prices, up to -30% in savings on average.
• Online coaching provided by the road safety training
organisation Codes Rousseau (with no obligation to achieve
a particular result).
• A 100% online interactive service: QUOTES, SUBSCRIPTION,
COACHING.
• Build up your insurance BONUS from your very first years
of driving.
• Payment monthly by direct debit.
For all students holding a driver’s license with or without
any insurance incident history, get your quote directly online:
www.smeba.fr/assurances/assurance-auto-et-moto.html
JEUNE CONDUCTEUR ASSUR, a brand of GTA SEMEUSE, a subsidiary of the Finaxy Group – 5 rue du Général Foy – 75008 PARIS – SAS with a capital of €681,870 – Paris Trade and Companies Registry number 384 946 109 –
ORIAS no. 07 001 754 (www.orias.fr) and subject to control by the ACPR (Prudential Control and Resolution Authority): 61 rueTaitbout – 75436 Paris Cedex 9. Insurance coverage, excluding assistance, is provided by MGARD – SA
with a capital of €13,600,000 – Paris Trade and Companies Registry number 752 934 083 – Head Office: 36 rue Lafayette – 75009 PARIS. The Assistance coverage was placed with Axa Assistance France Assurances – SA with
a capital of €31,275,660 Nanterre Trade and Companies Registry – SIRET 451 392 724 – Intracommunity VAT number FR 81 45 13 92 724 - Head Office: 6 rue André Gide – 92320 CHATILLON.
SMEB’ASSUR: Union d’Economie Sociale de Courtage en Assurance – 46, Bd du Roi René – 49007 ANGERS CEDEX 01– RC 36177 – SA with a capital of €19,208.58 – SIRET 383 333 432 00193 – APE 6622 Z – ANGERS Trade
and Companies Registry number: 383 333 432 – Management no. 91 b 621 – ORIAS no. 07 000 099 – www.orias.fr. Financial Guarantee and Professional Civil Liability pursuant to Articles L.512-6 and L.512-7 of the Insurance
Code.
Furniture base: fire, water damage and glass breakage guaranteed to €3,000 for a room, €7,500 for a studio or F1 (one-room flat), €9,000 for an F2 (two-room flat), and €12,000 for an F3 or F4 (three- or four-room flat,
respectively). Furniture base: theft guaranteed up to €2,300 for a room, €3,750 for a studio or F1 (one-room flat), €4,500 for an F2 (two-room flat) and €6,000 for an F3 or F4 (three- or four-room flat, respectively). Excess
applied to the insurance guarantees: theft and vandalism: 0.11 times the FFB index, natural disasters (amount indicated in the general provisions of Vital ASSUR no. EQVA/0600C – July 2015). FFB index on 01/01/2015:
930.80. The insurance guarantees are underwritten by L’Équité: SA with a capital of €22,469,320 – Company governed by the Insurance Code – Paris Trade and Companies Registry: B 572 084 697 – Head Office: 7 boulevard
Haussmann – 75442 Paris Cedex 09. Company belonging to the Generali Group registered in the Italian register of insurance groups under number 026. Broker VITAL ASSUR (an intermediary insurance company in the
MGEL group) – Head Office: 4 bis rue de Londres – 67000 Strasbourg – Trade and Companies Registry number: 389 426 065 00014 – APE 672Z – ORIAS no. 07 030 428 www.orias.fr
PRIVATE LIFE CIVIL LIABILITY of the non-subscriber MRH fee (comprehensive home insurance): Civil liability of the individual and the family head: the insurance guarantee is covered by AXA France IARD – 26 rue Drouot –
75009 Paris – SA with a capital of €214,799,030 – 722 057 460 – Paris Trade and Companies Registry – Company governed by the Insurance Code, according to Group Policy no. 1743420304. Excess of €91. Broker S2C –
432, Bd Michelet – 13009 Marseille. SARL with a capital of €7,622.45 – Marseille Trade and Companies Registry number: B 395 214 646 00022 – APE Code 672 Z - ORIAS no. 07 030 727 – www.orias.fr. Broker VITAL ASSUR –
4 bis rue de Londres – 67000 Strasbourg – Strasbourg Trade and Companies Registry number: B 389 426 065 00014 – APE Code 672Z – ORIAS no. 07 030 428 – www.orias.fr
SMEB’ASSUR, an insurance brokerage firm and its partners described above, operate under the Prudential Control and Resolution Authority – 61 rue Taitbout, 75436 Paris Cedex 09.
SMEBA STUDENT HEALTH INSURANCE 2015-2016
07
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Smeba
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■ Smeba is the only student mutual health insurer with
an agency in this city.
BREST
63, rue Professeur-Langevin 29200 Brest
Tel.: +33 (0) 2 98 47 87 87
[email protected]
CHOLET
Mobile high tech agency in
the Cholet Campus, at the main
hall of the college (every
Wednesday).
[email protected]
LA ROCHE-SUR-YON ■
2, place du Marché 85000 La Roche-sur-Yon
Tel.: +33 (0) 2 40 35 93 59*
[email protected]
LAVAL ■
2, rue du Lieutenant 53000 Laval
Tel.: +33 (0) 2 41 20 82 98*
[email protected]
LE MANS
• 34, av. François-Mitterrand 72000 Le Mans
Tel.: +33 (0) 2 41 20 82 93*
• Agence Campus Espaces
de services universitaires
av. Laënnec Tel.: +33 (0) 2 41 20 82 96*
[email protected]
NANTES
7, allée Duguay-Trouin 44000 Nantes
Tel.: +33 (0) 2 40 35 90 90
[email protected]
QUIMPER ■
4, place de Locronan 29000 Quimper
Tel.: +33 (0) 2 98 47 87 80
[email protected]
RENNES
• 31, 33 quai Chateaubriand
(angle place Pasteur) 35000 Rennes
Tel.: +33 (0) 2 99 78 33 66
• Agence Campus Rennes 2 Maison des étudiants Erève
Tel. : +33 (0) 2 99 78 80 00
[email protected]
To expedite the processing of your dossier
and to request a reimbursement, please send
your letters to:
Smeba – BP 50705 – 49007 ANGERS Cedex 01
To benefit from the strength of a national network,
select the emeVia network.
More than 200 reception posts nearby.
SAINT-BRIEUC ■
2, bd Waldeck-Rousseau 22000 Saint-Brieuc
Tel.: +33 (0) 2 99 78 80 05*
[email protected]
SAINT-NAZAIRE
Mobile high tech agency
in the university cafeteria
(every Monday).
Tel.: +33 (0) 2 40 35 90 90
[email protected]
SMENO
MGEL
SMEREP
SMEBA
SMECO
VANNES ■
24, rue du Lieutenant
Colonel Maury 56000 Vannes
Tel.: +33 (0) 2 98 47 87 73*
[email protected]
SMEREB
SMERRA
VITTAVI
* local phone number with standard rates
LORIENT
40, rue de Lanveur 56100 Lorient
Tel.: +33 (0) 2 98 47 87 77*
[email protected]
www.smeba.fr
With our mobile high tech agency, a local Smeba
advising agent constantly visits all major higher
education institutions.
Immediate update of your health dossier, French public
health system records, Carte Vitale, reimbursements.
Consult our office hours at various institutions at
www.smeba.fr
MEP
SMERAG
MEP
VITTAVI
www.emevia.com
THE STUDENT SOCIAL SECURITY OPTION
The national network of local student mutual health insurers
MEP ı MGEL ı SEM ı SMEBA ı SMENO ı SMECO ı SMEREB ı SMERRA ı SMEREP ı SMERAG ı VITTAVI
Smeba carries out insurance operations under Book II of the Mutuality Code. SIREN 305.007.171. It is a member of emeVia, the national network of local student mutual health insurers, of the Fédération Nationale de la Mutualité
Française (National Federation of the French Mutual) and of the Union Agrume Groupe Harmonie. Ministerial approval dated 27 May 2003.
Photos: Shutterstock – Design and realization:
ANGERS
• 42, boulevard du Roi René 49000 Angers
Tel.: +33 (0) 2 41 20 82 82
• Agence Saint-Serge :
6, allée François-Mitterrand 49000 Angers
Tel.: +33 (0) 2 41 20 82 90
[email protected]
!