Friday 10 January 2020
Since 1st January free prescription glasses have been available from opticians in France.
As in the UK and in many other countries of Europe, in France the cost of eyeglasses is poorly covered by the statutory health system.
Although some reimbursement is available, it is only for a nominal sum, with regulated rates that have not been uprated for decades. Only around 5% of the cost of a pair of prescription spectacles is reimbursable by the health system.
As a result, it is estimated that around 1 in 10 individuals in France forgo the spectacles they need.
In a survey carried out several years ago by the consumer magazine Que Choisir prescription glasses in France were found to be the most expensive in Europe, mainly because there were too many opticians; due to low turnover the opticians were required to take a large gross margin to cover their fixed costs.
Some households take out a specialist complementary health insurance policy that offers a higher level of reimbursement than standard polices.
Nevertheless, these policies are expensive and a lucrative source of revenue for the opticians, who are able to use them to prescribe glasses and frames to customers that may well exceed their needs.
One common practice has been for opticians to place a higher cost on the lenses (which have a higher level of reimbursement from the insurers) thereby enabling the customer to purchase a more expensive pair of frames (which have a lower level of reimbursement).
Since the beginning of the month that has now all changed, with the fulfilment of an election promise of President Macron of 'reste à charge zero'/'100% santé’ for most dental, auditive and optical care, a development we covered in relation to dental care in our article Dental Charges in France.
The cost to the French taxpayer of the measure will run into hundreds of millions of euros, but in a sleight of hand by the government, around one-third of the bill will be covered by the complementary (top-up) health insurers, some of which is bound to be passed on to consumers through increased insurance premiums.
So in order to benefit in full you will need to hold a complementary 'top-up' health insurance policy (assurance complémentaire santé), although without a policy you can meet the unfunded portion of the charge from your own pocket.
Alternatively, you will also be entitled if you obtain free health cover in France via the Complémentaire Santé Solidaire (CSS).
Under the new arrangements two categories of glasses will be available.
Class A - These spectacles will be available free of charge, with the cost shared between the public purse and the complementary insurers, who are obliged to offer this cover.
The price charged by the optician for the frame for such glasses has been set at a maximum of €30 (€50 for children under 6 years of age).
The government have stipulated that 17 adult frames in at least two different colours (so a choice of 35 frames) must be available, as well as 10 (20) child frames.
Insofar as the lenses are concerned, the maximum price that can be charged depends on the level of correction.
The regulated prices vary from €32.50 to €117.50 per single vision lens, and from €75 to €170 per progressive lens, including treatments (thinning, anti-reflective, anti-scratch).
Both the frames and lenses must meet minimum standards that have been laid down by the government.
Class B - The second category of frames and lenses has no price ceiling.
However, statutory reimbursement will only be at the regulated rate and the maximum that your complementary insurer is entitled to cover for the frames is €100. This is down from previous ceiling of €150, due to the cover they now provide for lenses. The terms of your 'top-up' policy will determine your total level of reimbursement for both the frames and the lenses.
There is the possibility to mix and match between the two categories.
For example, if you want a trendier Class B frame, or a frame with a brand name, you can combine it with Class A lenses, an option many are likely to use. The frame will be reimbursed according to the fixed price stipulated in your complementary contract, up to a limit of €100 euros. As for the lenses, they will be 100% reimbursable.
When you visit your optician they are obliged by the new law to at least make you an offer of Class A frames and lenses; you cannot be obliged to purchase the more expensive glasses.
Contact lenses are not covered by this measure, so the optician can freely determine their own prices.
Similarly, although the overwhelming majority of complementary insurers are participating, not all of them have chosen to do so, so you need to read your policy with care if you have not heard from them.
To obtain a prescription for glasses you will need to make a consultation with an ophthalmologist. You do not need to go through your doctor.
The charge for a consultation with an ophthalmologist remain unchanged, as does the level of reimbursement by the health system. Their charges are generally in excess of regulated rates so the level of statutory reimbursement is low. There are also substantial delays to see a specialist, but it is possible to obtain a renewal prescription from you GP, by presenting the old prescription.
Under the new measure you are entitled to a free renewal every two years, but you will need to periodically obtain a new prescription, depending on your age. For those aged 42+ years, the period of validity of a prescription is three years, between 16 and 42 years it is 5 years, during which period opticians are entitled to adapt the level of correction.
If the level of correction is the same in both eyes, even without a prescription the opticians normally offer cheaper unbranded spectacles in the store, although they do not go out of their way to advertise them. Whilst they may not be ones you would want to be seen wearing at a beachside restaurant in Cannes, they should be all you need for a book at bedtime! And, of course, non-prescription glasses are also available on-line.
You can discuss your health insurance requirements with our English language speaking health insurance partner, who is able to offer competitive policies for both private health and 'top-up' cover.