Hello, I’ve never made eyeglasses in France before, but am thinking of making a new one just in case the current one breaks. I was consulting my mutuelle from MGEN where I’m on the plan “MGEN Référence Actif”, and I noticed:
Verre unifocal de faible et moyenne correction
Réseau: régime obligatoire=60%, 60 € (verre simple adulte)
Verre unifocal de forte correction
Réseau: régime obligatoire=60% 140 €(verre simple adulte)
What does “regime obligatoire” mean in this case in connection with reimbursements?
I heard that in the eyeglass stores in Paris, you can get your eye examined as well, is this true? Or, do I’ve to consult a “formal” opthalmologist (meaning, outside the store, say from mondocteur) to get any reimbursement from sécu and/or mutuelle?
Given the above detail about my mutuelle, does it mean that, for a simple glass and with no big correction, they’ll reimburse upto 60€/glass, i.e. 120€ for the eyeglass/lunette?
If your answer to 1) is yes, and I get examined in a optical store and get eyeglasses from them, will sécu(CPAM) still reimburse me, specially considering the fact that I’m not in any kind of emergency and also that I’m not consulting an opthalmologist? Will they reimburse me 70% of the eyeglass’s cost-i.e. if the eyeglass costs me 200€, will sécu reimburse 140€
Why not go into a local Optician and ask them. Show them your Carte Vitale and your Mutuelle Insurance document… and they can give you an idea of what would be covered by the State and by Insurance…
Just one thing… the State will only pay something towards the cost …every 2 years (unless your eyes have changed dramatically)…and generally Mutuelles only pay something if the State does too…so you may get nothing if you insist on new glasses without just cause.
Okay I should write and update here. I went to the office my mutuelle(MGEN) today and asked them what’d happen if I walk into even a decently priced eyeglass store (like lunette pour tous), get a free eye exam and the subsequent eyeglasses. The answer was: in this case, the sécu wouldn’t possibly pay anything and hence the mutuelle wouldn’t either. Note that I’ve lost my old prescription so I needed a new prescription anyway.
However, if I go to an opthalmo/opticien even in my non-emergency situation, get a prescription, and the subsequent eyeglasses, my mutuelle would refund me upto 60€ x 2(glasses)+80€(frame)=200€. As far what the sécu would refund me in this case, this still remains unclear.
Hi @Hello_World actually the refund from the mutuel is a bit different for the glasses as it’s not based on the Sécurité Sociale but is rather a fixed amount as the refund from the SS is so low that it wouldn’t be relevant. So if you have some you can claim to the mutuelle they’ll pay whatever the refund from the social security.
Therefore the only question you should ask your optician is “how much will the mutuelle refund me”? or actually “Combien serais-je remboursé par ma mutuelle” as I don’t think your local optician is fluent in english is he/she?
I was surprised to learn from my French doctor that it could take 2-3 months to get an appointment for an eye test in France. I replied that in UK your eyes can be tested within a day or so. My French doctor suggested that if I am visiting UK soon, then have an eye test there, bring back the prescription, which the French doctor can sign and take it to the optician in France for the glasses to be made. That sounds easy, so I have an appointment for an eye test at Specsavers in Bristol on Monday, arranged two days ago. The test is free I am retired (over 65) with an S1, so if this doesn’t work I will have lost nothing. Has anyone else done this?
Actually the glasses will be refunded not matter what BUT the exams won’t be if the social security don’t refund them. If the exam was performed by a doctor it will be refunded (perhaps not in full but it has to) otherwise it probably won’t be
So Fabien, on your point-say I go to a “lunettes pour tous” and get my eye checkup for free and get a new pair of glasses thereafter, would that mean the SS and/or mutuelle are going to refund it? As much as I’d have hoped the answer to be in the affirmative, I got the negative impression after talking to a personnel in my current mutuelle (MGEN), who told me that “He doesn’t think I’d get full reimbursement even for my glasses” if I get my eyes examined outside a registered doctor’s office (e.g. at a shop like “lunettes pour tous”).
six days ago, I suggested you visit an Optician with your paperwork… have you done that yet?
Also, if you look at the website of Lunettes pour Tous, it clearly states that the eyetest is free and “Nos lunettes sont remboursées par la sécurité sociale et les mutuelles.” Obviously that would depend on individual circumstances… (the Social only pay once every 2 years, for example)… so the best thing is to go and have a word with them.
No I haven’t but scheduled an appointment with one, in January-the earliest I got.
Okay thanks for sharing the information from lunettes pour tous-I’ll have a word with them for sure, however I’ve come across in other situations in France conflicting information from relevant authorities, as in the present case; for example, one of my friends was told recently by préfecture de police that he could work with a récépissé only, while his permis de travail is getting prepared, but his company didn’t allow him to do that.
On the other hand, my mutuelle told me that my chance of getting reimbursement is low(“I don’t think you’ll get reimbursed”, to quote) if I go get my eyes examined in a shop as opposed to a doctor. Yes I’m aware that the eyetest is free. But there could be a reason lunetttes pour tous may state that all glasses are reimbursed by SS and mutuelle-to increase their business; after all, the patients’ getting reimbursed aren’t their concern, neither of the opticians. So the real proof of reimbursements could come from anecdotal experiences from the patients.