The new reform 100 % Santé gives you access to glasses free of charge paid by Cpam and your top up, so you no longer need to go back to the UK to buy them!
It exists 2 types of glasses:
-Class A which are fully covered under the 100% santé as long as you have a top up contract that includes it (contrat Responsable).
These are glasses:
-with a frame fully conformed to European standard with a premium below or equal to 30 euro
-Each opticians have to be able to present to you at least 17 different models (10 for children) in 2 different colours. They have to show you their range available.
-The lenses are anti reflection, anti-scratch and very thin
-Their prices are capped
-The reimbursement from Cpam and top up has been increased to ensure the quality of the proposed glasses
-They can be both unifocal and progressive lenses.
-Class B: not covered by the 100% santé. Basically, anything goes so you can have Versace glasses but you have to pay for it!! Also note that you can get some money back from your top up on class B glasses, but the amount depends on your contract.
You can choose to have Class A frame and class B lenses or vis versa. So, if you don’t like the selection of frames in class A for instance, you can choose Class B frame, pay for it but have the lenses (class A) fully reimbursed under the 100% santé.
General things to know about eyes treatment and glasses in France:
Do not wait to become blind to have an appointment with an ophthalmologist (eye doctor). Most of them have a waiting list of 6 Months or more. And you must first get a prescription from your GP to go and see one.
Then you get a prescription for your glasses from the ophthalmologist to purchase your glasses. Don’t just turn up at the glasses shop to get a test!! It won’t work. And you won’t get reimbursed without the prescription.
With an old prescription from your ophthalmologist, the optician can renew your glasses and redo an eye test, but the prescription must be less than 3 years old for adults above 42 years old, less than 5 years old for people aged between 16 and 42 years old and 1 year for children below 16 years old.
You can only renew your glasses every 2 years if you are above 16 years old and once a year for children below 16. There are exceptions if your sight has deteriorated very badly or in case of some disease like glaucoma, etc.
Note that if you have your cataract done, it is under hospital treatment so nothing to do with your level of cover for glasses.
Since 1st of January 2020, all the opticians must include systematically in their quote the 100% santé glasses.
Do insist for the 100% santé. Especially if you are on a budget!! And yes, of course, the professionals selling you the glasses get more money selling Classe B than Classe A, so beware, the optician may not mention it.
See an example of a quote below. The first offer includes the 100% santé. In this instance my customer doesn’t believe it was mentioned (the optician spoke English) and left 0 in the section indicating how much is reimbursed by the top up insurance.
In the second offer (autre offre), the one NOT 100% santé, you can see the optician put the amount reimbursed by both CPAM and the top up insurance. Leaving 614.15 euro to pay for the customer.
Note that Opticians (unlike dentist) have a system that allows them to check what cover for glasses you have with your top up.
Conclusion: The new law is fantastic and means you can get treatment covered fully by your top up as long as you have the proper contract (Contrat Responsable). But you need to know the law before you visit your local optician!! Now you do!!
Please feel free to contact me for a quote for a top up insurance. Note that the law has changed now, and we can cancel your existing top up contract at anytime as long as you have had the contract for at least one year so please do not hesitate and contact me for a quote. You probably have a contract with extra level of cover for teeth where now it is not necessary as 100% is enough so you could have a cheaper contract! Plus, with Allianz, you can choose better cover for hospital while staying on low level for teeth or glasses, etc. Most companies have level 1, 2, 3 etc. so if you want best cover for hospital, you have no choice but have best cover for all the rest as well.
And remember to check out our web site www.bh-assurances.fr/en for all my previous articles and register to receive our monthly Newsletter. You can also follow us on Facebook: “Allianz Jacques Boulesteix et Romain Lesterps”
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