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Health insurance: rights holders

Assigns of Health Insurance: What is it?

Under certain conditions, people who are dependents of an insured person (spouse, partner or children) may benefit if they are not insured social, benefits in kind of health insurance, including reimbursement care: they are called beneficiaries.

What are the economic and human consequences of the beneficiaries?

The Code of Social Security provides benefits in kind of health insurance (in particular the management of care) family size. The right of an insured person can be extended to his family in accordance with Article 1 of the Constitution of 1946 (mentioned in the preamble of the 1956): The Nation guarantees everyone "including the child, the mother and elderly workers' protection of health.

The evolution of the health insurance today seems in line with that of the company, since these rights are granted to domestic partners and "civil unions" partners. Even children over 16 years can be recognized as dependents "autonomous" and receive reimbursement for their care on their own.

Which may be entitled to an insured person?

The quality of entitlement covers a wide variety of situations, with two common criteria:

1) it does not take itself, raise a compulsory social security;

2) there must be a dependent of an insured person.

The quality of entitlement can be recognized:

- The spouse, partner or partner related to the insured person by a civil solidarity pact (PACS), provided that either the total, effective and permanent charge of the insured person;
- Children up to 16 years (18 years in case of apprenticeship, 20 years in case of studies) that are the responsibility of the insured, regardless of their status;
- To parents, children, allies and collateral (third degree), provided that they live under the roof of the insured and participate in housework and child rearing;
- The (x) cohabiting (ren) living under the roof of the insured person and his full, effective and permanent load for at least 12 months.

Demand for quality of successor should be made ​​to the illness depends the insured insurance agency.

The dependents are entitled to reimbursement of their care. They are also entitled to prevention in the same conditions as the insured (health exams, screening, prevention), but they are not entitled to daily allowances.

Which can be autonomous beneficiary?

The quality of autonomous beneficiary can receive refunds benefits of health insurance on their own bank or postal account. It is automatically recognized spouse, partner or partner related to the insured person by a civil union.

The quality of autonomous beneficiary is systematically offered to students 16 to 20 years, with a membership in the system of student social security, without consideration of assessment. If they are not students, this quality may finally be granted to children of the insured (or his spouse, partner, partner "PACS") from 16 years at their request.

At any time, interested parties may waive such.

What's happening in case of change of situation?

The quality of entitlement is linked to a specific situation. If this situation is changing (the insured's death, divorce, breach of PACS ...), this quality is lost. However, the right to reimbursement for care is generally maintained for a year.

Maintaining the Rights of benefits in kind of health insurance is maintained indefinitely to beneficiaries who have raised three children. 

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