Monday 11 January 2021
Hearing aids in France are now fully reimbursable to patients, within limits.
Since 2019 a gradual reform of the health system has been taking place, to grant 100% reimbursement for dental, optical and auditive care.
The policy was launched with the slogan '100 % Santé', but is also called 'Le reste à charge zéro'.
In practice, not all treatment is covered by the policy and there is only 100% reimbursement if you hold a complementary ('top-up') health policy, often referred to as a mutuelle. The policy also has to be 'responsable', but that is the case with the overwhelmening majority of insurers.
For those who obtain assistance with their health cover, the aids are also fully covered by the Complémentaire Santé Solidaire (CSS).
The change is a significant step towards reducing patient charges, and the gains for those need a hearing aid are particularly significant.
Prior to 2019, charges for hearing aids were poorly reimbursed by the social security system (€180 per ear), and only those who a premium complementary ‘top-up’ policy would find their costs fully covered. The costs of an aid can be around €1,500 per ear.
Since January 2019, the price of hearing aids has been capped, and the amount reimbursed by the social security system and mutuelles has increased, so that from this year, provided you select from an authorised list of hearing aids, you will no longer be liable for any charges. You may need to pay in advance and obtain later reimbursement, but up to 2022, the 'tiers payant' system is being introduced, when all charges are taken care of directly with the social security authority and health insurer.
Hearing aids are now classified as either Class 1 or Class 2; only those in the first class are fully reimbursed.
Nevertheless, the majority of hearing aids are classified as Class 1. The government have stipulated a minimum standard for such devices, which must have a minimum of 12 control channels, guaranteed for 4 years and include in-ear devices. In tests carried out by the consumer body Que Choisir earlier this year, Class 1 devices had "une efficacité équivalente à celle des modèles plus chers en fonctionnement automatique."
The charge for such devices has been capped at €950, of which €240 is reimbursed by the social security system and the remainder (€710) by your complementary top-up insurer. So, in practice, the bulk of the addditional cost of this initiative is being funded by the health insurers and, no doubt, the manufacturers.
As a result, there is already evidence that some insurers are not fully complying with the law, and only offering a lower level of reimbursement.
Class 2 devices include those which are rechargeable, are not price capped, so that if you choose such a device, you will be liable for the extra cost. The cost of such aids can reach €4,000+ per ear, for which the maximum level of reimbursement from the social security system is €1,700. Complementary insurers have greater discretion on their cover for these devices, with some only providing cover at the minimum floor level of €400.
In all cases, you will need a prescription provided by an authorised professional auditive specialist (audioprothésiste).