Family Encyclopedia >> Work

100% health:are you concerned?

When your optician handed you the bill for your new glasses, you thought it was a joke. Even after the refund of the Social Security and your health insurance, the bill is still hard to pass. Fortunately, a reform provides for a refund integral expenses for equipment dental, optical and auditory. The objective:to allow the French to access care which they tend to give up for financial reasons.

What is zero charge remainder?

By definition, the remainder to be paid is the amount you must pay once Social Security and mutual insurance have made their reimbursements. In short:payable =your expenses – reimbursements social welfare agencies .

Good news ! These sums, which remain at your expense, will therefore be eliminated on certain quality equipment meeting precise specifications thanks to the capping of the prices charged by health professionals and the increase in the bases for reimbursement by Social Security.

This flagship measure of the "100% health" regulations has the main objective of fighting against the renunciation of care in France . Indeed, nearly one in three French people has already given up medical care for financial reasons. The rest at zero charge provides for the total reimbursement by Social Security and complementary health insurance of certain optical, hearing and dental expenses.

What does the zero-charge remainder reform provide?

An implementing decree was published on January 12, 2019 and specifies the floors and ceilings for coverage under the contracts responsible for optical, dental and audiology equipment. From the 1 st January 2020, the majority of mutual insurance contracts will include the remainder at zero charge for optical and dental care. The following year, hearing care will also be affected. Within two years, as an insured person, you will no longer be able to put your hand in your wallet to get glasses or a hearing aid.

  • The equipment optics :from 2020, professionals will have to offer you at least 17 frames (10 for children) in several colors, and with a value less than or equal to €30. The correction of the glasses will be taken care of, and these must be anti-reflective, anti-UV, hardened and thinned.
  • The prostheses dental :from the 1 st January 2020, some crowns and bridges will be fully reimbursed. This is particularly the case for monolithic and ceramic-metallic crowns on visible teeth. The following year, full reimbursement will concern all prosthetic procedures. The management will depend on the location of the tooth and the characteristics of the prosthesis.
  • The equipment hearing aids :it will be necessary to wait until 2021 for the latter to be affected by the remainder at zero charge. Cover provides for full reimbursement of all hearing aids including, in particular, 12 adjustment channels and a sound amplification system of at least 30 decibels. Several comfort options (anti-tinnitus, wireless connectivity, wind noise reduction, etc.) will be offered. All of these devices will be guaranteed for a period of 4 years. Of course, the cost will be doubled to provide equivalent care for both ears.

Who is affected by the remainder at zero charge?

All French people insured by a responsible complementary health contract will have access to the rest offer at zero charge. Healthcare professionals will be required to automatically offer equipment that meets the characteristics of 100% healthy baskets.

What is a responsible health contract?

A complementary health contract is said to be "responsible" if it respects specifications including floors and ceilings of guarantees which relate in particular to dental, optical and hearing care. Be aware that the majority of contracts are responsible. This type of contract aims to rationalize health costs.

To benefit from the remainder at zero charge, you just need to be covered by a responsible contract. From 2020, all healthcare professionals will be required to comply with the sale limit prices fixed regulations . Do you need a pair of eyeglasses, a hearing aid, or a dental crown? You will have no more excuses!