When you enroll in French social security for the first time as a student, you’ll pay a fee of about €213 to get basic coverage, and you’ll have the choice between SMEREP (or one of its regional affiliates with a slightly different name) or LMDE, which is a national organization.
In theory, the two companies are identical, because basic health coverage is the same for everyone and determined at the national level. Therefore, the main difference should be the mutuelles, or optional complementary health plans. These plans allow you to get better coverage, such as being reimbursed 100% of all of your medicine, doctors appointments, and hospital stays, as opposed to paying a small portion of the fee yourself when you get health services.
While LMDE has the advantage of being national instead of regional (making it easier to keep your insurance if you plan on moving to a new region of France), there are several reasons why you should select SMEREP rather than LMDE.
1) Through 2015, students affiliated with LMDE have complained about significant problems getting reimbursed, whereas SMEREP promises reimbursements within 48 hours of receipt of your feuille de soins and prescription. However, a restructuring of the organization in 2015 has led to promises of improvements in processing time. As of August 2015, LMDE promises to complete most reimbursements within 7 days, and has a dedicated phone line for students to call with questions. The average wait time, according to a May 2015 article in Le Monde, should not exceed 2:30 minutes.
2) LMDE has been placed under judicial review, and may have to file for bankruptcy. In addition to its significant problems reimbursing students, the company has €35 million in debt and has six months (until August 2015) to straighten itself out. If you are hesitating on which mutuelle to choose, try asking other students from your university about LMDE in your region.
3) LMDE has a paid customer service line which is outsourced to North Africa, making it difficult to get answers about documents you may have sent to your local office. SMEREP and its affiliates have free customer service lines answered in France, as well as local offices where you can go to ask questions.