Supplementary optical insurances

Accepts all supplementary health insurance providers

Optician networks and supplementary health insurance providers—
—partners of your Mymonture optician

Mymonture is approved by all supplementary health insurance providers (more than 500 in France) and by the following closed supplementary health insurance networks: TP+, Sévéane, Kalixia, Itelis, and CARTE BLANCHE.

To receive reimbursement for your prescription eyeglasses or contact lenses through health insurance, several conditions must be met. First, you must present your optician with a medical prescription from your ophthalmologist or orthoptist. Only certain conditions are covered: nearsightedness, astigmatism, farsightedness, presbyopia, and amblyopia. The same applies to contact lenses: they are covered only if you have myopia of at least 8 diopters (the measure required for a lens to correct a visual impairment), irregular astigmatism, accommodative strabismus, aphakia, keratoconus, and anisometropia of 3 diopters that cannot be corrected with eyeglasses. As for coverage under your supplemental health insurance plan, it reimburses an amount specified in the policy you voluntarily enrolled in. Below, you’ll find extensive information about supplemental health insurance providers and Mymonture’s network of partner opticians.

What is a supplementary health insurance provider?

Supplementary health insurance providers are designed to cover all or part of the healthcare expenses not covered by the national health insurance program. Unlike national health insurance, which is mandatory, supplementary health insurance providers are optional. They involve a premium that you pay yourself. The premium depends on the coverage you choose.

The main types of coverage include doctor visits and medical care, prescription drugs purchased at a pharmacy, hospitalization costs, vision care and eyewear, dental care and prosthetics, as well as hearing aids. Depending on the insurer and your preferences, other benefits can be added: alternative medicine (homeopathy, nutritionists, osteopaths, acupuncturists, in-home care, health retreats, etc.). Of course, the more coverage you add, the higher your premium will be.

How does supplementary health insurance work?

The national health insurance program covers only a certain percentage of costs, depending on the medical procedures. To better understand how supplementary health insurance providers work, you need to know these three terms:

The agreed-upon rate

This corresponds to the rate set by the national health insurance program. Each procedure is coded and corresponds to a reimbursement percentage. For example, a visit to a primary care physician costing €25 is coded with the letter C. You are reimbursed 70% of the amount you paid the provider, which comes to €17.50.

The copayment

This is the portion not covered by health insurance. In our previous example, it amounts to about 30%, or €7.50.

The fee surcharge

This refers to an amount that some doctors charge in addition to the rates set by French national health insurance.

Three Levels of Coverage

Supplementary health insurance providers generally offer three levels of coverage with different premium rates. The first level reimburses only the copayment. The second level provides intermediate coverage, offering better coverage during hospitalization (such as a private room) and for certain alternative medical services. The third level covers many expenses related to the specialized care mentioned above (nutritionists, osteopaths, acupuncturists, home care, fees exceeding the Social Security rate, etc.). This final tier may even cover certain medication costs not covered by French national health insurance but for which a doctor’s prescription has been issued.

Reimbursement for Healthcare Providers

For your reimbursements, several healthcare professionals are paid directly by your health insurance and supplementary health insurance providers. These include pharmacists and opticians. To ensure that healthcare professionals receive reimbursements from your insurance providers, an electronic data transmission system has been established between French national health insurance funds and supplementary health insurance providers. This system allows eligible professionals to receive reimbursement within a few days.

What are the different types of supplementary health insurance providers?

There are three types of supplementary health insurance providers: management centers, closed networks formed through competitive bidding, and partner or approved plans. Here’s a brief overview of how they differ.

Management Centers

To provide their members with better benefits at affordable prices, many supplementary optical insurances use healthcare platforms. Examples include Henner and CGRM... All are independent and work in partnership with several supplemental health insurance providers or health insurers. The goal is to establish partnerships with opticians to negotiate favorable rates and secure discounts on eyeglass lenses, eyeglass frames, and contact lenses. This allows them to secure discounts of up to 40% on eyeglass lenses and 20% on contact lenses and frames. In return, patients can see the cost of their eyewear reduced by up to €100 for single-vision lenses, or even €200 for progressive lenses. The main advantage of this type of supplementary health insurance provider is that it offers a less expensive policy with better coverage.

Closed supplementary health insurance providers formed through competitive bidding

There are two types of healthcare platforms for supplementary optical insurance: closed networks and open networks. Closed networks consist of approved opticians who offer strict pricing terms but highly competitive prices. These networks accept all opticians who commit to selling their products without exceeding a certain price cap. Thus, any optician who adheres to these agreements can join these networks. As for policyholders, to enjoy these benefits, they must visit one of the approved opticians listed for them.

Open networks welcome opticians who agree not to exceed a certain price cap. They also commit to various best practices (customer service, precision, aesthetics, etc.). To join these networks, opticians must apply through platforms such as Sévéane, Kalixia, Itelis, Santé Clair, Carte Blanche, and others.

Approved or Partner Supplementary Health Insurance Providers (all other supplementary health insurance providers)

In the case of partner or approved supplementary health insurance providers, the health platforms select their opticians. These opticians are selected provided they meet certain rigorous criteria. They are required to commit to the quality of their services and, above all, to keep their prices in check. At these partner opticians—such as MGEN, Allianz, AXA, and MMA—you’ll find frames at low prices, under €50, as well as preferential rates on contact lenses. You’ll also find a variety of other services, such as free eyeglass maintenance or repairs, trials of contact lenses or progressive lenses, and replacement of a broken eyeglass frame…

Mymonture’s partner supplementary health insurance providers and optician networks

Approved by all supplementary health insurance providers thanks to Finess number 622608339

This is a reference number assigned to certain healthcare professionals, including opticians. We are approved by all supplementary health insurance providers (over 500 in France) and are the only platform approved by closed supplementary health insurance networks: TP+, Sévéane, Kalixia, Itelis, and CARTE BLANCHE.

What’s more, we’re the first online optician to offer third-party payment. With Mymonture, you don’t have to do a thing: our team takes care of requesting reimbursement for your eyewear costs directly from your insurance provider.

Learn more about online third-party payment