Reimbursement French national health insurance and supplementary health insurance providers

Since January 1, 2020, the government has introduced the ' 100% Santé' scheme (full cover). This makes it possible to obtain certain treatments free of charge, including optical equipment. Indeed, until now, equipping yourself with frames and lenses was rapidly becoming expensive! Do you know how you will be reimbursed by French national health insurance and your supplementary health insurance providers in 2022? Do you know the rates and reimbursement bases that will enable you to benefit from the '100% Santé' scheme (full cover)? Are you informed about what happens when you break your glasses? At the start of the new year, MyMonture takes a look at the new reimbursements for your Eyeglasses.

Eyewear reimbursement: the '100% Santé' scheme (full cover)

From now on, you can choose between two options. The ' 100% Santé' scheme (full cover), known as class A, or a choice of free-rate spectacles, known as class B. With the A basket, the cost of frames and lenses is fully reimbursed. Class B allows you to combine a '100% Santé' scheme frame with free-rate lenses. Of course, you are completely free to choose the frame and type of lenses that suit you, at the prices quoted by your optician. The '100% Santé' scheme (full cover) includes 10 frames for children and 17 frames for adults. They are available in two colors only. The sale price of these frames is limited to €30. At Mymonture, we offer a choice of over 120 frames.

The lenses cover all visual corrections (myopia, presbyopia, astigmatism and hyperopia). What's more, these lenses must meet certain aesthetic requirements and incorporate a range of techniques, such as thinning, anti-reflective and anti-scratch coatings. All French citizens are eligible for the '100% Santé' scheme (full cover). All you need is CMUCC (couverture maladie universelle complémentaire) or complementary health insurance (CSS). CSS is a government subsidy enabling low-income households to obtain health coverage. The "complémentaire santé solidaire" is available to salaried employees in the private or voluntary sectors. Other categories of people can apply to the various supplementary health insurance providers. These account for 95% of supplementary health insurance providers. To make sure that the one you are insured with is one of them, check the guarantees in your contract.

Reimbursement of glasses by French national health insurance

French national health insurance reimburses the full cost of optical equipment only on presentation of a prescription from an ophthalmologist. You do not have to go through your GP to consult this specialist. The basis for reimbursement of the consultation is 70% of the set fee. The remaining 30% is reimbursed by your supplementary health insurance providers, or is paid by you if you do not have a supplementary health insurance provider. The basis of reimbursement for your glasses is set differently by the health insurance scheme for frames and lenses. Reimbursement is based on the patient's age: under 18 and over 18. It also varies according to the degree of correction and the type of lens.

The frame is reimbursed at 60% on the basis of €0.05. Lenses are reimbursed at a rate of 60%, based on the lowest rate of €0.05. If your child is under 6 years of age, one or more pairs of glasses per year may be reimbursed if the condition progresses, always with a doctor's prescription. If your child is aged between 6 and 18, only one pair of glasses per year will be reimbursed. The period of validity of a prescription issued by an ophthalmologist differs according to the patient's age. Under the age of 16, the prescription is only valid for one year. Between the ages of 16 and 42, the prescription is valid for 5 years, and over 42, for 3 years. However, the practitioner may reduce the period of validity or renew corrective lenses if he or she deems that a new correction is necessary.

French national health insurance reimbursement for contact lenses

Health insurance reimbursement for contact lenses concerns only a few optical defects. These include accommodative strabismus, myopia equal to or greater than 8 dioptres (the measurement required of a lens to correct a visual defect), irregular astigmatism and various other conditions that cannot be corrected by lenses. French national health insurance reimburses 60%, or €23.69 per eye. The annual fee is €39.48, with the remainder paid by supplementary health insurance providers or the patient. Of course, a prescription from an ophthalmologist is essential.

Reimbursement of glasses by your supplementary health insurance providers

Supplementary health insurance providers are reimbursed in addition to your national health insurance. It covers the cost of your optical equipment according to the level of cover you have purchased. Some supplementary health insurance providers reimburse according to the French national health insurance percentage, while others take into account the annual French national health insurance ceiling (known as PMSS) or reimburse a pre-determined amount. Since the reform, more than 90% of "responsible" complementary health insurance plans follow this concept.

Supplementary health insurance providers can reimburse up to €100 per frame. For lenses, six reimbursement levels have been created. These cover single-vision lenses, which correct a single sight problem, and complex lenses, which correct several sight problems, including progressive lenses. Here's an idea of the minimum and maximum reimbursements for your glasses provided by supplementary health insurance providers:

• from €50 to €470
• from €125 to €610
• from €125 to €660
• from €200 to €750
• from €200 to €800
• from €200 to €850

Supplementary health insurance providers only reimburse vision equipment every two years. If you break your lenses or frames, your supplementary health insurance providers will not reimburse you for two years. However, if your eyesight changes as a result of a medical prescription, the period is reduced to one year. With regard to changing lenses after a cataract operation, a 2020 decree obliges supplementary health insurance providers to reimburse a first lens after the first operation and a second lens after the second operation. So there's no need to wait for both operations to obtain suitable lenses.

Online third-party payment with MyMonture

MyMonture.com is the first optician on the web to offer online third-party payment. We are the only optician to offer the same services and the same quality of optical equipment as a traditional optician. Our strength also lies in providing our customers with frames from the top brands at half the price.

With MyMonture, you benefit from a range of services:
MyMonture offers online third-party payment to all supplementary health insurance providers (MMA, MGEN, AXA, HUMANIS...) and networks (Kalixia, Carte Blanche, Seveanes, TP+, Itelis...). We also have agreements with management centers such as CGRM and the HENNER group... Would you like to select optical equipment that exceeds the reimbursements provided by the French health insurance system and your supplementary health insurance provider? Or add a cord, cleaning products... We allow you to pay in 3 instalments, free of charge. We know how complicated it can be to choose an eyewear frame on a platform. That's why, at your request, we also offer a free home trial service of 3 frames from leading brands (Carte Blue imprint). You can test them for 10 days.

On our site, you'll also find over 60 major brands and 10,000 references - 10X more than a traditional optician. For people who wear progressive lenses, our team of state-qualified opticians is specialized in this type of lens fitting (Freeform). In addition to all these services, we are the only optician on the market to offer you a second pair of glasses for as little as €1. A 30-day money-back guarantee and a 6-month visual adaptation guarantee for your Progressive lenses.

Satisfaction and service are a priority at Mymonture, which is why we guarantee after-sales service on all our ESSILOR Group Guaranteed French-origin frames and lenses. For maintenance and cleaning of your equipment, don't hesitate to come to our store or contact us on the website. This service is entirely free of charge.

With MyMonture, you benefit from quality optical equipment:
The lenses fitted to the frames by our state-qualified opticians are of French origin from the ESSILOR Group, the world's leading lens manufacturer. Our business is certified by Bureau Véritas, which guarantees the conformity and quality of the products we sell. Should you break your glasses, MyMonture sérénité guarantees replacement for 2 years against manufacturing defects or with a 40% deductible (Mymonture covers the 60%).

When you choose MyMonture for your eyewear, you benefit from attractive prices on more than 60 major brands, as well as online third-party payment for your supplementary health insurance providers. What's more, you're guaranteed to have no or very low out-of-pocket expenses. In fact, we're the cheapest optician on the market. What's more, you'll appreciate the fact that you don't have to go anywhere, or pay many euros in advance.