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Has state reimbursement of hearing aids improved?
I understand that the reimbursement of hearing aids is due to improve this year – has it happened yet? L.B.
Yes, it has improved and there are two factors to bear in mind with this:
The usual system for reimbursement for hearing aids (prothèses auditives) is by the state at 60% of a set tariff per ear.
This set tariff rose on January 1 from €199.71 per ear to €300. It means the standard amount that can now be reimbursed by the state per hearing aid (for adults aged over 20) is €180, up from €120 in 2018.
In addition, if you have a mutuelle insurance, it will top up all or part of the rest of the cost at a certain percentage of the standard tariff, depending on the contract you have chosen.
For example, a mutuelle with 300% cover for hearing aids will top you up to a maximum €900 per ear (300% means three times the set tariff of €300).
Rules are set to come in by 2021 fixing certain minimum and maximum reimbursements by mutuelles that meet criteria so as to be labelled “responsible”. This will cover most policies.
However, the government wants to go further in making hearing aids accessible and has promised that people who are medically diagnosed as needing one will be able to have one of a range of models (excepting more expensive, top-of-the-range aids) completely free of charge by a combination of state and “responsible” mutuelle cover by 2021.
As of this year, this “100% santé” scheme is being launched in phases so the amount left to pay by the patient gradually reduces. It works by limiting the cost of a range of aids.
To receive “100% santé” you need a prescription from an ENT doctor, or a GP who has completed extra training, who has carried out hearing tests, plus a detailed devis (quote) from a hearing aid provider (audioprothésiste) for an eligible aid.
The average price of a hearing aid is €1,500 per ear, or €3,000 for the two ears, and until recently the average out-of-pocket price per patient was €1,700 to equip the two ears.
Under “100% santé” the out-of-pocket cost (after reimbursements, assuming a “responsible” mutuelle) is capped this year at €1,300 to equip the two ears.
