people to have access to healthcare, the government has set up the “100% Health” system. It allows 100% coverage of dental, optical, audiology and relevant equipment for patients. How does this device work? Who can benefit ?
What is the “100% Health” reform?
The “100% Health” plan was implemented in January 2019. It aims to strengthen the coverage of Social Security and the reimbursement of hearing aids for policyholders benefiting from complementary health insurance and who have subscribed to a responsible contract according to the guarantee levels imposed by the reform. In fact, previously, Social Security covered 75% of health costs. Since the “100% Health” reform, formerly Remaining at Zero Charge, care and equipment are reimbursed in full . As the devices are quite expensive, some patients decide not to have them. In 2014, 67% of hearing impaired people were not equipped.
The “100% Health” plan is a contract between the State and health professionals. These will offer a basket of 100% Health care of which the remainder payable by the patient is 0 . It will be fully financed by Social Security and complementary health insurance . Obviously, although free, the care and equipment will be of high quality and up to standard. Since January 2021, anyone who has subscribed to a “responsible” complementary health contract will be able to benefit from the “100% Health” plan. However, a patient is free not to choose this basket. In this case, reimbursement will be made according to the guarantees provided in your complementary health contract. On the other hand, at each consultation, the doctor must offer a 100% Health basket quote . The out-of-basket quote may be presented in addition. In any case, the doctor must guide his patient as best as possible so that he can make the appropriate choice.
100% Health which hearing aids are affected?
The “100% Health” reform provides for full reimbursement of hearing care and equipment. However, support only concerns a selection of treatments and devices. There are two categories of hearing aids. The first is the one which benefits from the “100% Health” plan, the second is not part of the basket. However, it is possible to combine categories 1 and 2. In this case you will have to pay the difference yourself.
For category 2, the professional is free to set his price. The remaining cost will then depend on the mutual insurance’s calculation method. For category 1, prices will be capped at 950 euros per ear . A sum fully covered by Social Security and your mutual health insurance. In 2021, Social Security will reimburse from 400 euros on each device. The doctor must then direct his patient towards equipment that meets the criteria in the basket.
Class I includes 12 adjustment channels and 3 features to choose from. The patient will be able to test the 100% Health device at least 30 days before making the purchase. It will benefit from a 4-year warranty. Renewal is also covered every 4 years for anyone over 60 years old.
