Repayments in France are changing
What is happening in the country of the Tour Eiffel? Ludovic Mathieu, Chairman of GIFO - Groupement des Fabricants et Industriels de l'Optique explains this to us in an exclusive interview.
Could you please explain how eyeglass purchase refunds currently operate in France?For most French people, the funding of eyeglasses is split in three parts: public social security (5%), private health insurance - OCAM (72%) and “out of pocket” (23%) paid by the wearers.This is only an average and of course it depends on the selected spectacles and the insurance contract subscribed to. There are many contracts offered by more than 500 companies. More than 90% of French people are covered by these contracts, most of which are provided by employers, and people with a low income can benefit from specific public care systems.On top of that, some healthcare expense management platforms appeared 15 years ago on the initiative of insurance companies in an attempt to reduce the relevant risks. They encourage the insured party to go to the optical retailers previously selected (based on quality criteria and discounts ).In a decree of November 2014, the French Ministry of Health created the OCAM observatory. What is its role? What will change for repayments?The decree plans to set up an Optical prices and reimbursements Observatory. Its aim is to monitor the evolution of prices, refunds and out-of-pocket expenses based on the evolution of quality. GIFO is a member of this observatory along with public administrations, end-users’ associations and opticians’ unions and we have started to define the indicators that will be followed over time.The idea is to measure the concrete impact of the new regulations enacted in 2014, which are designed to define a precise reimbursement method and, as a consequence, reduce the injection of financial resources into the optical sector. Public authorities maintain that repayment by insurance companies leads to an inflationary effect on the prices of optical glasses but they also want to be sure that the new regulations will not cause a decline in the quality of products.To go further into detail: the new specifications state that the maximum reimbursement is €150 for a frame and, with the exception of more serious vision defects, €160 for an optical lens and €300 for a progressive lens. Moreover, insurance companies have to relinquish the possibility of making annual reimbursements (except in the case of children and significant changes in vision) if they want to benefit from important tax advantages. From now on, the general rule will be at least 2 years between 2 repayments.Has it already implemented restrictive policies towards repayments?The law came into effect on April 1st 2015 but health insurance companies have until December 31st 2017 to fully comply with these new regulations. It's too soon to evaluate the overall effect but we fear that the maximum amount for reimbursement will become the maximum selling price and that many people will extend their renewal term.What do you think the consequences for the French domestic market and the European market will be? Should producers start to worry?GIFO members are concerned about the consequences. If we agree with the objective of improving access to eyecare for everyone, we think it shouldn’t be done to the detriment of quality and innovation and it shouldn’t hamper competition and freedom of choice for consumers and, therefore, freedom of differentiation for manufacturers.In a broader sense, we all know the social and economic impact of poor vision, whether in terms of productivity, academic failure or driving risks, and we fear that, contrary to the initial objective, these measures could result in a decline in eyesight tests.
Could you please explain how eyeglass purchase refunds currently operate in France?For most French people, the funding of eyeglasses is split in three parts: public social security (5%), private health insurance - OCAM (72%) and “out of pocket” (23%) paid by the wearers.This is only an average and of course it depends on the selected spectacles and the insurance contract subscribed to. There are many contracts offered by more than 500 companies. More than 90% of French people are covered by these contracts, most of which are provided by employers, and people with a low income can benefit from specific public care systems.On top of that, some healthcare expense management platforms appeared 15 years ago on the initiative of insurance companies in an attempt to reduce the relevant risks. They encourage the insured party to go to the optical retailers previously selected (based on quality criteria and discounts ).In a decree of November 2014, the French Ministry of Health created the OCAM observatory. What is its role? What will change for repayments?The decree plans to set up an Optical prices and reimbursements Observatory. Its aim is to monitor the evolution of prices, refunds and out-of-pocket expenses based on the evolution of quality. GIFO is a member of this observatory along with public administrations, end-users’ associations and opticians’ unions and we have started to define the indicators that will be followed over time.The idea is to measure the concrete impact of the new regulations enacted in 2014, which are designed to define a precise reimbursement method and, as a consequence, reduce the injection of financial resources into the optical sector. Public authorities maintain that repayment by insurance companies leads to an inflationary effect on the prices of optical glasses but they also want to be sure that the new regulations will not cause a decline in the quality of products.To go further into detail: the new specifications state that the maximum reimbursement is €150 for a frame and, with the exception of more serious vision defects, €160 for an optical lens and €300 for a progressive lens. Moreover, insurance companies have to relinquish the possibility of making annual reimbursements (except in the case of children and significant changes in vision) if they want to benefit from important tax advantages. From now on, the general rule will be at least 2 years between 2 repayments.Has it already implemented restrictive policies towards repayments?The law came into effect on April 1st 2015 but health insurance companies have until December 31st 2017 to fully comply with these new regulations. It's too soon to evaluate the overall effect but we fear that the maximum amount for reimbursement will become the maximum selling price and that many people will extend their renewal term.What do you think the consequences for the French domestic market and the European market will be? Should producers start to worry?GIFO members are concerned about the consequences. If we agree with the objective of improving access to eyecare for everyone, we think it shouldn’t be done to the detriment of quality and innovation and it shouldn’t hamper competition and freedom of choice for consumers and, therefore, freedom of differentiation for manufacturers.In a broader sense, we all know the social and economic impact of poor vision, whether in terms of productivity, academic failure or driving risks, and we fear that, contrary to the initial objective, these measures could result in a decline in eyesight tests.
