To combat the renunciation of care in audiology, the government introduced reforms which made it possible to increase the reimbursement of hearing aids. The changes introduced have led to the establishment of two distinct classes of hearing aids, reimbursed by Social Security and mutual insurance companies. In this article, we explain the implications of each category.
Get fully reimbursed with Category 1 hearing aids
Since January 1, 2021, patients with hearing problems can get hearing aids free of charge if certain conditions are met. In fact, the reimbursement of hearing aids in 2021 is guaranteed for hearing aids classified in category 1 thanks to the “100% health” government plan. The objective is to facilitate access to care for patients seeking better hearing health. Social Security and complementary health insurance have increased the coverage of this class of device, which makes it possible to offer equipment without any remaining costs.
Class 1 includes hearing aids whose maximum selling price is capped depending on the patient’s age and disability. If you are under 20, the selling price limit is 1400 euros. The same rate is applied for people with blindness and hearing impairment. For a patient over 20 years old, this package is limited to 950 euros. In concrete terms, Health Insurance and your mutual fund cover 100% of the costs of equipment if you meet the set conditions.
The devices offered must necessarily have several characteristics that guarantee their quality. They must have at least three options that solve the patient’s hearing difficulty, 12 adjustment channels and several years of warranty (4 years). Patients can test the effectiveness of the device over a period of 30 days before adopting them definitively.
What is the support for category 2 hearing aids?
Class 2 hearing aids are equipped with more efficient technology and meet specific needs. They provide relief for patients with complex audio problems. If you need to equip yourself with a device that is in this category, reimbursement rules change. You no longer benefit from the guarantee of a remainder at zero charge. While the Social Security reimbursement basis is the same for class 1 and 2 hearing aids, there is a significant change with regard to complementary health insurance.
As noted, Category 1 hearing aids have price caps. On the other hand, class 2 equipment is offered at a free price, set by the audioprosthetist. If you have taken out a responsible complementary health policy, you benefit from coverage up to a limit of 1,700 euros per hearing aid. This threshold includes reimbursement by Health Insurance and your mutual.
If you buy equipment at a price that exceeds the fixed ceiling, you are responsible for paying the excess. Reimbursement of class 2 hearing aids by your health insurance fund is free. Your insurance may cover all or part of the rest. This varies depending on the contract that binds you. This is why it is important to choose your insurer carefully. Taking your needs into account, prefer insurance that offers better reimbursement.
In addition to assistance for the purchase of hearing aids, it should be noted that expenses related to their maintenance are reimbursed. You will not have to pay to verify the efficiency of your device for a period of one year. You benefit two follow-up appointments fully reimbursed. In addition, accessories such as batteries, accumulators, spare parts, etc. can be covered provided that you present proof of expenses.
What are the conditions for benefiting from the reimbursement of hearing aids?
The coverage of hearing aids by the Health Insurance is subject to requirements that you must comply with if you wish to receive reimbursement. The hearing aid you aspire to must necessarily be the subject ofa medical prescription. The equipment must be prescribed by a doctor. If you do not have a doctor’s prescription, you will not be able to benefit from reimbursement of costs by your mutual health insurance or by the Health Insurance.
Also, to qualify for a refund, choose a device that is on the list of products and services issued by Social Security. With your medical benefit, go to an audioprosthetist. It carries out analyzes and offers you a range of devices that meets your needs. At least one of the recommended equipment must belong to category 1 in order for you to benefit from a rest at zero charge. You will be given a quote that provides all the details of the hearing aid (including its price and that of the adaptation services).
* The information and services available on pressesante.com in no way replace the consultation of competent health professionals. [HighProtein-Foods.com]