Social Insurance Branches: Health, Maternity, Disability, Old-Age and Survivors
This domain tests each branch separately: who is eligible, what triggers the benefit, how long it lasts and how it is paid. Confusing two branches is the most common error.
Health and maternity
- Health cover is delivered through the carte Chifa; the insured is reimbursed after paying the practitioner, with a ticket modérateur left at his charge.
- Long-term conditions (affections de longue durée) and costly care are reimbursed at 100%; ordinary care at the standard rate. Third-party payment (tiers payant) applies in contracted facilities.
- Maternity: 14 weeks of leave around the expected date of delivery, with a daily allowance and full cover of care; the woman is protected against dismissal during the leave.
Invalidity, old age, survivors
- Invalidity: the medical commission assesses loss of earning capacity; the threshold is two-thirds. The pension is revised if the condition changes, and is increased where third-person assistance is needed.
- Old age: legal age 60; rate of 2.5% per year of insurance, full rate 80% at 32 years; reference wage is the average of the last five years subject to contributions, within the ceiling.
- Survivors: derived from the deceased's pension - 50% to the spouse, 10% per child, total capped at 100%.
Accidents at work and occupational diseases
- Presumption of work-relatedness; the employer alone bears the AT/MP contribution; care is free and an IPP rate gives a capital below 10% or a rente from 10%.
Worked example
An insured dies leaving a pension of 60,000 DZD, a widow and three children. Widow: 50% = 30,000. Children: 3 × 10% = 30% = 18,000. Total 48,000 DZD, within the 100% cap (60,000). With five children the shares would reach 100% and stop there.
Traps that cost marks
Mixing invalidity (any cause, medical commission, two-thirds threshold) with AT/MP (work-related, presumed); believing the 80% rate is automatic at 60 without 32 years; forgetting the 100% survivors' cap; assuming the spouse's share continues unchanged after remarriage.
Key points
- Health: Chifa card, ticket modérateur, 100% for long-term conditions.
- Maternity: 14 weeks, daily allowance, protection from dismissal.
- Invalidity: two-thirds capacity loss, set and revised by the medical commission.
- Old age: 60 years, 2.5% per year, 80% at 32 years.
- Survivors: 50% spouse, 10% per child, capped at 100%.
- AT/MP: employer-funded, capital below 10% IPP, rente from 10%.