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Glasses and lenses: what is their reimbursement?
Currently, 7 out of 10 French people wear glasses and / or contact lenses. These devices are expensive and must be changed as soon as vision changes. They are partly covered by Health Insurance, and by complementary health insurance according to each person’s contracts.
Glasses and lenses: the different vision disorders
There are different vision disorders. Nearsightedness, for example, is characterized by sharp vision up close and blurry in the distance. Hyperopia results in a globally blurred vision, both far and near. Astigmatism is a disorder that blurs the vision of lines and features and finally presbyopia occurs with age, it causes blurred vision of everything that is close. All of these visual disturbances require correction. This is ensured either by wearing glasses or by wearing contact lenses.
Support for glasses and lenses
Eyeglasses and contact lenses are covered by Health Insurance. Reimbursements can be supplemented by complementary health insurance. The amount of coverage depends on the age of the patient, the visual impairment and the degree of correction. The reimbursement of prescription glasses and contact lenses requires a valid medical prescription. This is issued by an ophthalmologist. Since October 17, 2016, the validity period of a prescription is 1 year for those under 16, 5 years for 16-42 years and 3 years for over 42 years. The period of validity of the medical prescription can be modified by ophthalmologists. This is often the case in risky situations such as cataracts, AMD or glaucoma.
Reimbursement of prescription glasses
Health Insurance reimburses frames up to 60% of the fixed price. This is € 2,84 for over 18s and € 30,49 for under 18s. The cost of glasses is also 60% of the fixed price. The latter depends entirely on the correction (white single focus lens, white multifocal lens, progressive lens, etc.).
Since January 1, 2020, opticians have been offering a “100% Health” range, made up of a selection of prescription glasses (frames and lenses), fully covered by Health Insurance and complementary health insurance.
Patients can count on their complementary health insurance to obtain more complete reimbursement. This can be partial or total depending on the guarantees included in the contract taken out by the insured. Tinted glasses are only supported if their wearing is essential. This is the case in eye conditions, high myopia or photophobia. This support is then identical to that of conventional glasses.
People who wish to take advantage of tinted glasses promotional offers offered by opticians.
Good to know: under 6 years, several pairs of glasses per year can be reimbursed on condition that the vision changes. Between 6 and 18 years old, only one pair per year is supported. Once an adult, several pairs can be reimbursed per year if the eyesight changes.
The renewal of prescription glasses
It is not uncommon for people to lose or break their glasses. In this case, it is possible to renew its frame and / or its lenses. The optician can sometimes offer guarantees, however it is essential to have a valid prescription. Otherwise, a medical prescription is required.
Reimbursement of contact lenses
There are different types of contact lenses: hard, soft, reusable, disposable, weekly, monthly, etc. The reimbursement of these contact lenses by the Health Insurance is only possible under certain conditions. This is up to 60% of the annual flat rate fixed at € 39,48 in the event of irregular astigmatism, myopia equal to or greater than 8 diopters, accommodative strabismus, aphakia, anisometropia at 3 diopters or keratoconus. In other cases, no reimbursement is provided for by the Health Insurance. Once again, patients can count on their complementary health care for optimized care. In a large majority of cases, an annual package is offered. Its amount depends of course on the guarantees subscribed by the patient.
When you have vision problems, Health Insurance provides partial coverage for frames and corrective lenses, and in some cases contact lenses. The reimbursement is supplemented by mutual and health insurance according to the contract of each patient. It is therefore preferable to know the amount of the support well so as not to have any surprises at the time of purchase.