Question 13694 — maternity health insurance

Summary

Mr. Jean-Paul Dufrègne draws the attention of the Minister of Solidarity and Health to the importance of completing the “100% health” to avoid any subsistence of the remainder incurred. Mr. Bruno Cimetière, optician-eyewear maker in Moulins in his constituency, wanted to share his questions, shared by many of his colleagues, on optical “100% health” in relation to the two-tier reimbursement system for glasses, as it is known in France for around ten years. Indeed, on the one hand, a system of care networks, managed by complementary health insurance, which impose a fixed reimbursement for glasses. On the other, a network of opticians who target, among others, French people who do not have mutual insurance and who see the unreimbursed portion (out-of-pocket costs) increasing while the costs of glasses are falling. “Ensure the French are 100% reimbursed on their glasses is an essential first step, but which could prove incomplete if, for example, they have to advance the costs of their reimbursement (240 euros on average), choose corrective equipment in ignorance of the additional care to which they are entitled or suffer an out-of-pocket charge due to a greatly reduced reimbursement due to the practices of the healthcare networks (certain networks provide differentiated reimbursements of more than 400%!). However, in a context where the “100% health” reform is primarily aimed at the most vulnerable French people, maintaining such provisions could alter its effective scope, in that they create a break in equality, with each euro contributed not giving the same rights according to their healthcare professional and blurring the social message of “100% health”.” In view of the testimony from this optician, he asks him to clarify the Government's position regarding the abolition of differentiated reimbursement, as well as the actions it plans to combat all forms of out-of-pocket costs incurred.

Machine translation from French. The official text remains authoritative.

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