The “100% health” reform has reshuffled the cards for the coverage of dental care and hearing aids for the French, but has not changed the situation for the purchase of glasses, underlines a study published Thursday by the Drees , the statistical department attached to the Ministry of Health.
Implemented gradually between 2019 and 2021, this reform, also referred to as the “zero charge rest” should allow French people with health insurance to have nothing to pay to equip themselves with dental, hearing or dental prostheses. glasses. Provided that the insured choose their equipment from among the products of the said “100% health basket”.
13% of frames sold affected
The assessment of the reform, recent and hit by the health crisis, is still difficult to draw up, underlined the Court of Auditors last summer. However, the “100% health” formula has met with some success with people with dental or hearing problems.
From 2021, some 57% of dental prostheses and 40% of hearing aids sold in France were thus part of this “basket” allowing full reimbursement, recalls the Drees. On the other hand, only 13% of the frames sold were part of the basket.
Gap
To understand this discrepancy, the DREES looked at the level of coverage enjoyed by the French before the reform. It notes that in the end “the penetration rates of 100% health seem at least partly linked to the levels of guarantee offered by the contracts of complementary health before the reform”.
In other words, before the introduction of the “zero charge remainder”, the level of cover offered by health insurance was globally less good than that allowed after the reform for the purchase of dental and hearing aids. In detail, seven out of ten French people with health insurance had “a reimbursement guarantee lower than that fixed by the reform” for these expenditure items.
Against the target
For the purchase of glasses, the situation before the reform was very different. In 2019, only 7% of beneficiaries had a less good optical guarantee than that provided for in the 100% health basket. Last summer, the Court of Auditors had already been critical of the interest of the reform for the reimbursement of purchases of glasses. It “even translates, contrary to its objective, into an increase in out-of-pocket payments”, wrote the financial magistrates.
At the end of January, the Minister of Health, François Braun, promised to launch in 2023 “stage 2 of 100% health”. The government’s project is to make the device better known and to update the baskets of care covered, “in particular to obtain a stronger mobilization on optics”, explained the former emergency doctor.