Help for hearing loss

Experiencing hearing loss 

Hearing loss is often linked to age but can be due to other factors including noise exposure damaging inner ear cells, high blood pressure, diabetes, mood and cognitive impairments, or underlying disease which can affect people of any age. If you think you might require a hearing aid, your first step should be to consult an ear-nose-throat (ENT) specialist, in French oto-rhino-laryngologue (ORL). 

An ENT doctor will be able to test your hearing and determine the cause of any loss and the best course of treatment. If this is required, the doctor will prescribe a hearing aid but he or she must rule out other potential illness. If a disease is suspected, you may also be referred to an otologist.

Otology is a medical sub-specialism of ENT medicine which focuses on ear abnormalities and hearing disorders. Otology seeks to correct sudden or progressive hearing disorders that may be due to mechanical damage, infection, or disease. 

If you experience a sudden decrease in hearing quality, or deafness, ear pain, body balance issues, vertigo or tinnitus, this may be a sign of ear disease that requires the attention of an otologist. If you are already wearing a hearing aid, it is recommended that you consult with an ENT doctor at least once a year to evaluate your condition. 

Note that you can test your own hearing using a phone app called Höra, developed by the Fondation pour l’audition.

Hearing aids 

The 100% Santé includes hearing aids and hearing aid accessories. Before the reform, which has been fully in place since 2021, the average person faced out-of-pocket costs of around €1,700 to equip both ears. Now patients can choose a 100% Santé model and have nothing to pay. 100% Santé has been hailed a particular success in this area.

From 2019 to 2021, numbers who bought them rose by 75% and four out of 10 buyers chose a product from the 100% Santé range. To benefit, you are required to subscribe to a mutuelle. A share of your reimbursement will be covered by social security and the remainder by the mutuelle. The specifics of how this cost is shared is worked out by Assurance Maladie; the net result is that, if you are in the French health system, you will not have to pay anything.

Audioprosthetists

To obtain reimbursement of a hearing aid, you must first request a quote from an audioprosthetist. Usually, this is part of what is called the standardised estimate model. You have to submit this to Assurance Maladie before making your purchase. It will verify that the quote follows government guidelines and, if it is reform-compliant, your reimbursement will be authorised. 

When requesting a quote for an electronic hearing device, make sure this includes detailed information about the equipment, such as its brand name, model, commercial reference and medical device class, warranty information, accessories, etc., as well as fitting services. The quote should also provide for an initial fitting and a follow-up fitting for any necessary adjustments. Fitting services are an integral part of the standardised estimate model and are assumed inseparable from any devices.

Your audioprosthetist should include detailed information and proposed costs for all of the following: taking an impression of the ear canal; testing, checking and adjusting; progressive adjustments personalised to your hearing needs; advice on product use, handling and maintenance; follow-up sessions at third, sixth and twelfth month after delivery.

An audioprosthetist is qualified to perform preliminary examinations and help you test equipment. If you book an appointment with an audioprosthetist, he or she will be able to examine your ear canals, perform various measurements of hearing ability, tolerance to loud sounds, ability to hear and understand speech, and to inform you about the various types of hearing aids available that might suit your needs.

Reimbursements

The 100% Santé reform provides access to people with a doctor’s prescription and responsible mutuelle to a range of fully reimbursable devices. As with eye care and dental care, the reform creates categories of products and services which are subject to varying degrees of state coverage.

There are two categories of hearing aids since the 100% Santé reform.

Class I hearing aids are part of the 100% Santé plan (fully paid for by a combination of state reimbursements and a responsible mutuelle); this includes entry-level products that qualify for full coverage. Their prices are capped at €950 per ear for patients aged 20 or more or €1,400 for people under 20. 

Assurance Maladie says they should be good quality, both in performance and appearance. If you shop around, you can find all the main kinds of hearing aid model, whether classic BTE, remote earpiece or in-ear. 

They all come with a 30-day trial and a four-year guarantee. If you do not have a responsible mutuelle one of these will cost you up to €710 per ear or €560 for under-20s after reimbursement from Assurance Maladie.

Class 2 hearing aids are not subject to price regulation; they are outside of the 100% Santé plan. Typically, they are higher-end products which may contain additional features and optional functionalities. Sellers are free to determine their prices for products in this category, although the health reform has had a moderating effect.

 Reimbursement for these from Assurance Maladie is for most people aged 20 or more based on 60% of up to €400 per ear, ie. €240. Responsible mutuelles may help towards costs of Class 2 aids, up to total per ear (Assurance Maladie + mutuelle) of a maximum of €1,700 per ear. 

In the case of blind people and people aged under 20, class 2 aids can benefit from state reimbursement of 60% of up to a maximum cost of €1,400 per ear, ie. €840. For people on the CSS scheme for those on low incomes, total (Assurance Maladie and CSS) reimbursement is possible for Class 2 aids up to €800 per ear (€1,400 for under-20s).