Glasses, dentistry, hearing aids: Major changes to reimbursement rules proposed
‘We have to change healthcare spending to make our system sustainable,’ says mutuelle top-up boss
France’s healthcare spending was 11.5% of GDP in 2024
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The level at which glasses and hearing aids are reimbursed by top-up mutuelles in France looks set for significant cuts after the head of the national federation overseeing the system stressed the need to make it financially sustainable.
France’s healthcare spending was 11.5% of GDP in 2024, having risen by 20% between 2019 - 2023.
The spiralling costs are exacerbated by top-up mutuelles encouraging overconsumption on certain items, says the president of La Mutualité Française Eric Chenut.
"We live in a society where people expect things to be quasi-free and they no longer realise how much things cost," Mr Chenut told newspaper Les Echos on April 11.
"We are continuing to open opticians‘ shops in our country, even though we have more than twice the European average.
“We have to change healthcare spending to make our system sustainable,” he said.
In particular, Mr Chenut proposed that mutuelles should offer a new pair of glasses every three years - down from once every two - and a new hearing aid every five years - down from once every four.
Alternatively, he suggested cutting the reimbursement for glasses from €100 to €30 for top-up mutuelles with the contrat responsable et solidaire label, and likewise for hearing aids and dental prostheses.
Most mutuelle contracts are labelled contrat responsable et solidaire, which means they satisfy certain reimbursement standards set by the state - including reimbursement up to 100% (after state reimbursement) for most common illness.
The savings for mutuelles would result in a price drop for their policy holders, who would pay an estimated 20% to 25% less for their top-up mutuelle.
The proposed changes for glasses would affect the more expensive 'Classe B' frames, which, despite being outside of France's 100% Santé scheme, are eligible for €100 reimbursement every two years.
The cheaper 'Classe A' frames already have a price cap at €30, however due to the mutuelles paying €100 for more expensive frames, many people see it within their rights to claim this payment - something that Mr Chenut says must change.
"The role of social security and mutual insurance companies is not to to just pay out," he said. "It is to guarantee effective access to care.
Mr Chenut previously spoke of the need to rein in healthcare spending in January 2025, which he observed was “growing faster than national wealth”.
“With our aging population and scientific advances, and without a structural overhaul, these costs will continue to rise until we can no longer cope.”
The proposals of La Mutualité Française will be presented to the government this week.
Cost of mutuelles rises
Top-up health insurance is not obligatory in France, but more than 90% of people have some form of it to cover the healthcare costs that remain after reimbursement by the social security system.
The price of this cover increased on average by 4.7% in 2023, 8.1% in 2024 and a further 6% in 2025, according to data from, consumer magazine 60 Millions de Consommateurs.
However, for retired people both the costs - and the increases - are higher.
The average price of cover for over-75s in 2025 is €171 a month, and €136 a month on average for retirees, after an increase of 9.1% between 2023 and 2024 alone.
This compares to a cost of €35 for those aged 16-25, according to data from mutuelle price comparison website Mutuelle.fr.
