The Government approves the new Muface concert with an increase in the premium

The Council of Ministers today approved the tender for the Muface contract for the next two years with an increase in the premium of 17.12%, a percentage three points higher than that initially offered to insurers that provide services to civil servants -Adeslas, Asisa and DKV-, which rejected the first proposal as insufficient. After this increase, the average premium per mutual member will go from 1,032.12 euros to 1,208.81 euros in 2026, which represents an increase per insured of 176.69 euros.

As reported by the Ministry for Digital Transformation and Public Function, the total amount of the concert amounts to 1,337 million in 2025 and 1,344 million in 2026. This represents a biannual increase of almost 304 million compared to the concert that expires this year . In total, the premium increase will be distributed by 16.5% for next year and an additional 0.62% for the following year. On average, the annual increase in the premium over the last 25 years has been 4.4%.

For the calculation, two concepts have been taken into account: on the one hand, the coverage of the new health services included in the portfolio of the National Health System (related to oral health, increased spending on hospital pharmacies, innovative medicines and advanced therapies, new vaccines in the calendar and the increase in cost in chronicity), and on the other, the increase in medical fees. In addition, For the first time, the rate deficit is taken into account – the difference between premiums paid and health costs incurred by the entities -, including them in the calculation for the purpose of determining a premium increase that makes it possible to compensate for losses and address new ones. health system expenses.

Current contract

Insurers estimate that they collectively lose 200 million a year

The Government, insurers and officials were confident of finding a way out after the companies rejected that the financial allocation they receive was 14% higher than the current one, as initially proposed by the Executive. The three companies providing the service – SergurCaixa Adeslas, Asisa and DKV – had been warning for months that the current contract is highly deficient. In fact, according to a study commissioned by the sector, the joint loss amounted to 200 million per year between 2022-2024.

The current agreement ends at the end of this year and in January 2025 mutual members have to decide again whether to bet on public health or on one of the insurers that has won the next contest with Muface.