most people who have a supplemental health care policy – a mutual – can get free glasses and some dentures starting this year.
This is due to the new 100% Santé plan, a campaign promise by President Macron that aims to remedy a situation where many people are put off buying glasses or dental work because of the high costs.
The changes do not benefit people who have very high insurance coverage for these areas of health, but this does not apply to the majority of less expensive policies.
Outside the 100% Santé system, for example, glasses in France are reimbursed for adults at 60% of the fixed government charge of €2.84 for the frame, plus €2.29-24.54 per lens, depending on strength.
A person with a mutual that he only returns up to 100% of the state invoice he could therefore be left obliged to pay hundreds of euros.
The government estimates that a person with an “average” mutual would have previously paid around €65 after compensation (compared to nil with 100 Santé) from a typical cost of €290 for a pair of glasses.
Similarly, the basic government tariffs used as a basis for reimbursement for dental prosthetics such as crowns and bridges are, outside the new system, often hundreds of euros less than the actual costs usually charged.
People can still choose glasses or prosthetics that are out of the scheme – and pay for them – if they want a particular brand, but the government says they don’t have to to get good quality hardware.
This provides them mutual it’s of a “responsible” kind and compatible with the system, but that’s true for 95% of them mutuelles in France.
The 100% Santé it will be extended to hearing aids from 2021, but hearing aid stores are already aiming to offer a range at a moderate, limited cost.
Glasses
All optical shops should now stock a range of 100% Santé Glasses.
They must offer a choice of at least 17 frames for adults and 10 for children, and two colors, at a fixed price that does not exceed €30.
Some go much further, such as Direct Optic – with brick-and-mortar stores as well as online sales – which claims to have a selection of 300 100% Santé frames.
A range of lenses for different prescriptions and of good quality should also be available, including thin, hardened lenses with anti-scratch and anti-reflective treatments.
For those who buy their glasses in models other than it 100% Santéhowever, the return may now be more limited than before.
“Responsible” mutuelles should not now compensate the frame in more than 100 euros, as opposed to the ceiling of 150 euros before the reform.
It will be possible to combine a 100% Santé frame and simple lenses, or vice versa.
If you select the 100% Santé range, depending on whether the store is accredited with your health network mutual owned, you may have nothing to pay up front – known as le tiers payant.
Otherwise, you will have to pay and then get compensation from you mutual. This also applies if you buy glasses from electronic optics.
The manager of an Optic 2000 optical store in Ile-de-France said RTL radio the new series is not like the old “Lunettes Sécu» wore as a child. Brits may remember ‘NHS glasses’, which were also known as functional but ugly.
“These look much nicer, they’re perfectly acceptable and very appropriate to wear,” he said.
Contact lenses are not included in the new design.
Dental prosthesis
The 100% Santé applies to crowns and bridges.
To cover up under this, components can include metal in less visible areas of the mouth and white ceramic in the front.
“Movable” prostheses, e.g. dentures, will be included from next year.
You should ask your dentist for a formal estimate of the work you want done – un devis – which should list in it a number of options, either under the 100% system or otherwise.
Prosthetic work can now be grouped into three sections: 100% Santé? at moderate prices within set ceilings; or at free market price if you want the most sophisticated models.
Before the reform, an adult who had a ceramic crown fitted paid an average of €550, €195 of which was non-refundable.
Now the cost in its context 100% Santé will be limited to €500 and will be fully refunded.
Dentists offer the same services as before, but with some standard procedures now offered as part of it 100% Santé.
This differs from eyeglass manufacturers, who have come up with a specialist 100% Santé rows.
Philippe Denoyelle, president of the Dental Union, said: “We will put exactly the same products, with the same quality, as before.”
