What you need to know about the 100% Santé reform

According to statistics, the French refuse expensive treatment due to high prices:

• 2.1 million people do not use hearing aids
• 4.7 million do not have access to dental treatment,
• 6.7 million do not use glasses.

Social security, health care providers and insurance companies have teamed up to cover 100% of such treatment for anyone with supplementary health insurance.

Information in this article was updated on April 14, 2022.

What is the 100% Santé reform about?

The goal of the reform is to provide 100% compensation for expensive medical equipment and materials for all French people:

• Glasses.
• Dentures.
• Hearing Aids.

The reform is being implemented in several stages from 2019 to 2023.

All physicians must offer materials and equipment from Panier 100% Santé to patients. Users have the right to choose materials at their discretion from:

• Panier 100% Sante,
• Panier metrisé
• Panier libre.

In some cases, Panier can be mixed, we’ll talk about this later.

Panier 100% Santé vs Panier libre

Panier 100% Santé is an agreed list of materials and equipment at a specific price. If you choose this basket, the cost of treatment will be fully covered by social security and your health insurance.

If you choose a free set, then the prices for materials are not consistent. In this case, the insurance will pay the cost depending on the guarantees provided by your medical policy, and you will have to pay the rest out of your own pocket.

Conditions for using Panier 100% Santé with examples

Hearing Aids

The 100% Santé basket includes hearing aids with the following options for your comfort:

• background noise reducer,
• anti-Larsen,
• anti-acouphene,
• wind noise reducer,
• wireless connection.

Your doctor should offer you the Panier 100% Santé and your insurance will fully cover the cost of such equipment. You have this opportunity once every 4 years.

If you choose a free priced kit, reimbursement for such materials and equipment will be in accordance with your health insurance coverage.

Example

Hearing aid from the 100% Santé set at a price of 950 €. Social protection will compensate 400 € and your insurance company the remaining 550 €. Thus, the equipment will be fully compensated and you do not have to pay anything.

Dentures

Panier 100% Santé fully reimburses the cost of metal, zirconium and metal-ceramic dentures, depending on the position of the teeth. Thus, metal-ceramics are compensated for when prosthetizing incisors, that is, 8 upper and 8 lower front ones. The price of the prosthesis should not exceed 500 euros.

Panier 100% Santé provides complete compensation for the cost zirconium dentures for 4 premolar teeth that is 2 upper and 2 lower teeth. The cost of the prosthesis should be no more than 440 €.

Likewise, Panier 100 % Santé completely covers price metal implants for 12 distant teeth, molars. The maximum price of which should not exceed 290€ (see picture).

Example

A metal-ceramic crown for incisors costing 500 € will be reimbursed by social security in the amount of 84 €, and the remaining 416 € will be covered by your health insurance, you do not have to pay extra.

Optics

Panier 100 Santé includes:

• 17 adult frames and 10 children's frames for 30 €,
• 65 types of lenses.

Every 2 years you can change the glasses from this set. Children under 16 years of age are entitled to annual replacement glasses.

If you choose a free kit, you pay for materials at free rates according to the level of guarantees of your health insurance.

In addition, in optics you can be offered a mixed set, which includes materials from Panier 100% Santé and Panier Libre.

Example Panier 100% Santé (optics)

You choose glasses from the 100% Santé set at a price of 95 €, in which case social protection will compensate 17 €, the remaining 78 € will be paid by your insurance company. You don't have to pay anything extra yourself.

Itelis Network

Thanks to the partnership between AXA and the Itelis network, you can save even when choosing equipment from Panier Libre.

AXA has some of the best health insurance in France. Sign up for a consultation with me, I will help you choose a suitable tariff at competitive prices.

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