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HEALTHCARE

Carte vitale: How much will dental and eye care appointments cost me?

The basic health insurance you are entitled to with your carte vitale covers you for a certain amount of dental and eye care. Here's a look at what you need to know.

Carte vitale: How much will dental and eye care appointments cost me?
Photo: AFP
Working out what your carte vitale entitles you to within the French health service can be a complicated business. 
 
After taking a look at what you can claim back from the French state with your carte vitale if you have the basic cover afforded by the card, with no top-up insurance, in terms of general healthcare, this time we're focusing on what happens when it comes to dental and eye care. 
 
This is what you need to know. 
 
READ ALSO:

Carte vitale: What your French health insurance card entitles you toPhoto: AFP

Teeth
 
Dentist appointments
 
Helpfully dentist appointments are reimbursed in exactly the same way as appointments with GPs, which means you will receive 70 percent back from the French State on the cost of your consultation. 
 
Like doctors, dentists in France work under two sectors – sector one dentists mostly charge the standard €23 apart from in exceptional circumstances, while sector two dentists are entitled to charge more, and you will not get refunds for any amount over the €23 minimum. 
 
That means that in most cases you will receive €16.10 back from the French State for your appointment. 
 
You can check which sector a dentist works under on the official site of France's state health insurance ameli.fr and it will also be listed if you are booking an appointment through the Doctolib app
 
Unlike when you visit other specialists you do not need to a referral from your registered GP first to get the 70 percent reimbursement (for more on that read here) and you are free to consult a dentist at any time. 
 
Dental care 
 
The list of reimbursed dental care includes removal of tartar, treatment for decay, as well as tooth removal, among other services, and you will get 70 percent back, with prices for each service varying. 
 
For example if you visit a dentist for tartar removal it will cost  €28.92 and, with the basic reimbursement of 70 percent, you will receive €20.24 of that cost back. 
 
Meanwhile for root-canal work on a molar tooth, which is far more expensive at €81.94, you will receive €57.35 back from the French State. 
 
For the full price list of services visit the dental care section of the ameli.fr site. 
 
Photo: AFP
 
False teeth
 
The price of certain treatments on false teeth was capped as of April 1st 2019 to make treatment more accessible. 
 
That means that dentists are not allowed to charge more than the maximum price agreed with the French State for 11 types of care, including crown implants (€107.50) and a complete set of dentures (€182.75). 
 
It's important to remember that the government is set to bring in a round of further changes set to make dental care even more accessible over the next couple of years, with certain dental surgery set to be 100 percent covered by basic health insurance. 
 
This will include the cost of metal crowns for back teeth and ceramic crowns for more visible teeth at the front of the mouth as well as certain kinds of bridges and dentures. 
 
While costs will be capped on other kinds of dental surgery, such as the fitting of a ceramic crown at the back of the mouth.
 
Eyes
 
Appointments with eye doctors are not reimbursed by the French State, however basic health insurance will cover the some of the costs of your prescription glasses. 
 
The reimbursement system is particularly favourable to those aged under 18. 
 
If you are under 18, frames are reimbursed by 60 percent on the basis of a cost set at €30.49 and lenses are reimbursed at 60 percent of the cost, with prices varying according to the kind of prescription you need. 
 
For example the cost of single focus clear lenses you will be reimbursed 60 percent of €12.04 – even if they cost more, while for the most serious prescriptions you will be reimbursed 60 percent of €66.62, and again that's even if they end up costing you more. 
 
Photo: AFP
 
Meanwhile, if you are over 18, you'll also be refunded 60 percent of the price of your frames – but the catch is that this is based on a cost set at €2.84. 
 
Similarly the price you'll be refunded for on your lenses is also much lower. 
 
For the lowest prescriptions you will 60 percent of €2.29 back and for the most serious prescriptions, you will receive 60 percent of €24.54 back. 
 
For the full list of reimbursements on eye care, check the ameli.fr site here.
 
However there is some good news for anyone who can hold off on getting their specs for another year. 
 
From 2020, the price of glasses will be fully covered for “quality lenses” and for frames costing up to €30. 
 
Opticians will stock 17 adult frames and seven children's models, all available in multiple colors and wearers will be able to renew them every two years and once a year for under-15s. 
 
On the other hand, customers who want branded frames or a special treatment on the lenses may have to cover part of the cost themselves, depending on the benefits of their top-up health insurance known as a “mutuelle”.

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HEALTH

Mutuelles: Why is French health insurance getting more expensive?

France’s top-up health insurance 'mutuelles' have been getting steadily more expensive in 2020. Here’s a look at what’s changing, why and who is the worst affected.

Mutuelles: Why is French health insurance getting more expensive?
A dentist is checking the teeth of an elderly lady in a nursing home in Paris. Photo: AFP

“The prices have never been so high in France,” said Fabien Soccio, spokesperson for the company Meilleure Assurance (Best Insurance).

His company this week revealed the results of a new study of France's private health insurance fees, mutuelles, to French media.

After comparing 55 different mutuelles health insurances, Meilleur Assurance concluded that there had been a general spike in the average cost.

What is a mutuelle?

France has generous state health care that covers a lot of medical expenses, but not all costs are reimbursed.

In France you pay upfront for your doctor's appointment, prescription or procedure and then the government reimburses the costs to you. Depending on the procedure and your situation, usually about 80-90 percent of the cost is reimbursed.

If that cost is a €25 appointment with your GP that's not such a big deal, but with more expensive treatments the costs can mount up, which is where a mutuelle comes in.

The mutuelle is a 'top-up' insurance – not obligatory, but recommended – which covers extra costs that are not covered by the state. How much a mutuelle covers will depend on the kind of insurance, where you live and the expenses in question.

If you are an employee, your employer must pay for at least half the cost of your mutuelle

Who was affected by the price increase?

The 2020 price hike touched the country as a whole, however some regions and population groups were harder hit than others, Soccio told Le Parisien.

To compare the costs for different socio-demographic groups, Meilleur Assurance created three different types of profiles; a 25-year-old employee with a “classic” mutuelle; a couple with two children, also on a “classic” mutuelle and a 60-year-old couple with “strengthened” guarantees in their mutuelle.

Seniors hardest hit

Retirees tend to go for fuller versions of mutuelles because these cover additional costs (such as dental and optical treatments). 

Seniors on extensive types of mutuelles were those suffering the steepest price increases this year, Soccio said. 

“In 2020, fifteen départements exceeded a threshold of €3,000 in annual fees for a senior couple with extra guarantees,” Soccio said.

“That’s an average increase of more than €176 in one year,” he said.

For the couple with a child, the increase was slighter ( an extra 4 percent), whereas the young employee saw health insurance bills largely unchanged.

READ ALSO Brexit: Do I need a mutuelle to get residency in France?

 

.. along with Parisians

The study also revealed large price differences between different regions, with inhabitants in the Paris region Ile-de-France paying the highest bills for their mutuelles.

A retired couple would pay on average €528 more if they lived in Paris compared to if they lived in a more rural, cheaper département like Mayenne.

Similarly, employees would pay 30 percent more on average in Paris than in Pays-de-la-Loire.

Parisians also saw the steepest price increases since last year, by 14.6 percent on average for the retired couple with a mutuelle covering extra costs.

On a national level, the average price increase for the same couple was 12.1 percent. 

.. but everyone was a little worse off

However the country as a whole saw a price increase last year, with even those opting for the cheapest kinds of health insurance affected by the general price hike.

In one year, from 2019 to 2020, the cheapest type of health insurance had increased by 13.7 percent, according to the study. 

Why the increase?

Prices generally increase a little every year, but this year was unusual, Soccio said.

“Today, we are in an uncertain and troubled situation,” he told Europe 1, listing several factors that had contributed to the price increase: the Covid-19 pandemic, the government's new health reform known as “100 percent Santé”, and a new health tax known as the “Covid surtax”.

When the French government presented their new budget for 2021, centred on their dazzling €100 billion relaunch plan, they promised not to increase taxes for the French. Instead, to top up their savings a little, the government introduced a new tax, the “Covid surtax”, which will be paid through the mutuelles and other health insurance companies.

This tax will provide €1 billion in total to the state in 2021, and €500 million in 2022, according to French media.

What about the future?

Soccio said he worried the trend of prices increasing would continue in the next couple of years, leading to steep prices for even those opting for the cheaper mutuelles.

“It's safe to bet that the national average costs will pass €3,000 in the next two years,” he told Le Parisien.

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