Rebate optical: what changes in 2020

Good news for all those who wear glasses : you will now be able to benefit of frames and lenses, totally free. Mode of employment.

The optical equipment are expensive : not only the intervention of the health Insurance is anecdotal, but the reimbursement of complementary health are variable geometry. Where one is responsible for important for patients.

to remedy this situation, since the beginning of 2019, the government has committed itself to a reform - referred to as the "100% health", with health insurers and the trade unions representing health professionals. Its goal : to facilitate access to care or equipment is the most expensive. Are, among others, involved since the beginning of the year, the glasses.

A new offer strictly defined in

Two types of offers should now be available in all opticians, as these are independent or affiliated to a national trade mark. The first, and this is the novelty, is that of the basket 100% health (or "class A"). It has been defined to that you have no cost, regardless of the level of your health insurance (more commonly called mutual).

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This offer includes a minimum of 17 frames different, available in two colours (ten frames for children in two colours minimum also) with a sale price capped at € 30 for adults or children (€50 for the mounts intended for children under the age of six years).

This cart 100% health also includes glasses uni focal or multifocal (progressive) suitable for all the corrections, thinned and anti-reflecting coating and anti-scratch. The price of sale of each of these glasses is strictly regulated by the public authorities : it ranges from 32,50 € to 170 €.

Frame and lenses fully reimbursed

let's Imagine you need a fixed light and that your additional health or basic, with the only support of the ticket moderator, that is to say, the share of the tariff convention, which are not reimbursed by health Insurance, without any overruns.

For simple equipment, with a mount to € 30 and two glasses, worth 49 € each, you were so far repaid to the extent of 4.45 € by medicare, and from 2.97€ by your health insurer, or 7,42 € in total. The remaining burden was so important : 120,58 € to pay out of your pocket.

Since the beginning of the year, as soon as the equipment meets the requirements of the cart 100% health, you will receive 17,10 € health Insurance and 110,90 € to your health insurer, which leads to a full refund of your expense of optical.

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A basket in the price-free remains, but...

In parallel to this basket, 100% health, you can continue to choose without any constraint (if it is that of the price), another mount, and/or other glasses. Their sale price is free and the refund you can get depends on the level of guarantees of your contract, health (individual or group if you are employed). Has one exception : within the framework of the 100% health, a "mutual" responsible, very generous, will not be able to refund you more than 100 € your scope mount, including if you pay 300 € for example, compared to 150 €, as it was the case until now. Attention ! This new provision does not change the frequency of repayments of the equipment lens that remains fixed, for adults and children over 16 years to once every two years (unless a substantial change of the view).

For children under six years of age, the support is still possible every year, or every six months depending on the corrections to be carried out.

A mix is possible between the two offers

Another change introduced by the reform of the 100 % health : it is possible to mix a equipment class A equipment class B : for example a mount of a trade mark (class B) the lenses with 100% health (class A), or vice versa. In this case, to minimize your cost, don't forget to study in advance the guarantees of your contract.

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Supplemental health essential

the reform of The 100% health is aimed at all those who are covered by a complementary health, including the persons who may, under conditions of resources, to take advantage of the new Complementary health and solidarity that replaces since the beginning of November 2019, the CMU-C and contracts ACS (aid to the payment of a complementary health). On the other hand, it does not apply to people who choose to wear contact lenses of view.