France Confirms Eyewear Reimbursement Loss and Proposes Extended Health Insurance Contribution

The draft Social Security Financing Law for 2027 (PLFSS) proposes a new 3.6% contribution on companies operating reimbursed medical devices, which may include optical equipment such as corrective lenses and frames. The tax applies to entities classified as 'operators' under the Social Security Code, excluding opticians who only sell or dispense products unless they also hold operator status. The calculation base is set at 70% of amounts reimbursed by Health Insurance after VAT and rebate adjustments. For example, €1 million in reimbursements would result in a €25,200 contribution. Based on annual optical spending of €8.33 billion with 4.4% covered by insurance, the sector's theoretical annual cost could reach €9.2 million before adjustments. Payments are due to the National Health Insurance Fund by November 1 of the following year. The government aims to better control rising medical device expenditures, which reached €12.1 billion in 2025.

Article 12 of France's draft Social Security Financing Bill (PLFSS) for 2027 proposes extending the exceptional 2.05% contribution imposed on complementary health insurance organizations (OCAM) into 2027, a measure initially established for 2026. The text does not directly mandate higher premiums or reduced optical reimbursements but aims to generate €1.1 billion for Social Security to help limit healthcare deficits and fund solidarity coverage. Actuaries anticipate continued premium increases due to rising costs, noting complementary insurance contributions grew by 8.2% in 2024. While no direct injunction targets the optical sector, sustained financial pressure on OCAMs risks indirectly affecting consumer budgets and purchasing decisions.

The French Council of State rejected appeals against Article 76 of the 2026 Social Security Financing Law on October 1, confirming that prescriptions issued by non-contracted doctors will no longer be reimbursed by the National Health Insurance (Assurance maladie) starting January 1, 2027. This measure specifically affects optical equipment and contact lenses prescribed by ophthalmologists practicing outside the conventional system. While such prescriptions remain valid for dispensing glasses or lenses, they will not qualify for standard insurance coverage. The government aims to deter liberal doctors from leaving the conventional system, noting approximately 1,000 doctors were non-contracted as of spring, accounting for nearly €200 million in annual reimbursed prescriptions. Currently, only four to five ophthalmologists practice in sector 3 in France. Opticians must now address the practical implications for reimbursement and patient information.