Health · Healthcare & Policy · 2 hrs ago
Alsace-Moselle’s health system offers higher reimbursements at lower cost
Alsace-Moselle has a local health scheme that adds coverage on top of France’s national health insurance.
The system began under German rule in the late 19th century and continued after the region became part of France following the Second World War.
More than 2 million people are covered, including many workers, retirees, unemployed people and their families in Bas-Rhin, Haut-Rhin and Moselle.
For an example diabetes medicine costing €77.60, the local scheme can raise reimbursement from 30% to as much as 80%.
Members fund the extra coverage through a contribution of 1.3% of gross income; that is €24 a month for someone earning the minimum wage.
Private health insurance costs about 40% less on average in the region because the local scheme pays more, and it had a financial surplus in 2022.
A France 2 investigation examining whether the model could offer lessons for the wider health system is due to air on 5 November 2026.
Alsace-Moselle’s mandatory local health scheme reimburses some medical costs at higher rates than France’s standard system.
More than 2 million people in Bas-Rhin, Haut-Rhin and Moselle are covered.
Members pay an additional contribution of 1.3% of their gross income to fund the scheme.
Complementary health insurance costs are on average 40% lower in Alsace-Moselle than elsewhere in France.
The scheme had a surplus in 2022, when its former president lowered the employee contribution rate.
- Who
- More than 2 million people in Bas-Rhin, Haut-Rhin and Moselle, including private-sector employees, retirees, unemployed people and their families.
- What
- The Alsace-Moselle local health scheme provides additional reimbursements alongside France’s Social Security system.
- When
- Established in the late 19th century; the article was published on 4 November 2026.
- Where
- Bas-Rhin, Haut-Rhin and Moselle, in France.
- Why
- It was maintained as a local exception after Alsace-Moselle became part of France after the Second World War.
This story does not have two clearly opposing sides.
Otto von Bismarck established the local scheme when the region was German.
France retained the scheme after Alsace-Moselle became part of the country.
The scheme’s former president, Patrick Heidmann, lowered the employee contribution rate from 1.5% to 1.3% after it ran a surplus.
France 2 was scheduled to air the Cash Investigation programme featuring the report.
- Coverage
- More than 2 million people
- Eligible departments
- Bas-Rhin, Haut-Rhin and Moselle
- Member contribution
- 1.3% of gross income
- Complementary insurance costs
- On average 40% lower than in the rest of France
- Medicine example
- A €77.60 diabetes medicine is reimbursed up to €65.85 through the local scheme
What people are saying
The price charged is 77.60 euros, and what is covered by the Health Insurance in the local scheme is 65.85 euros.