Hearing aid reimbursement (France)

Coverage for preset AZUR and ORISON hearing aids

The following information is related to the reimbursement of the AZUR and ORISON preset hearing aids in France and deals with their coverage :

  • By the social security,
  • By the mutual insurance companies.

For all other countries, we recommend you to contact directly the health institutions of your country (non-exhaustive list provided below) as well as your mutual insurance company :

Coverage of hearing aids by Social Security (general informations)

Apart from hearing aids eligible for the RAC0 (France), the social security covers hearing aids up to 199.71€ per ear.
This coverage is conditioned by :

  • The care pathway,
  • The hearing aid itself,
  • The follow-up services sold with the hearing aid.

• The care pathway

Hearing aids covered by Social Security must be prescribed by a doctor and must therefore require a consultation with an ENT doctor, who will perform an audiometric assessment. Since the 13th of January 2020, this prescription can also be issued by a general practitioner. However, the law prohibits hearing aid acousticians from "draining the clientele (...) by substituting themselves for doctors through the illegal practice of clinical audiometry, in accordance with the decree of May the 2nd, 1973 (J.O of the 18th of May 1973)." Without this list being exhaustive, the following procedures are strictly forbidden : "hearing assessment proposals (...), the audioprosthesist can in fact only intervene in execution of a medical prescription and a hearing assessment can only be performed by a doctor. By performing a hearing test, the hearing aid acoustician replaces the medical practitioner and can be prosecuted for illegal practice of medicine (...)" This prohibition aims to protect the consumer from potential abuses : no one can be a judge (quantifying a hearing loss) and a party (selling the hearing aid that would be suitable for this hearing loss), at the risk of increasing the hearing loss in order to direct the subject to a hearing solution at an excessive price.

• The hearing aid

The hearing aid reimbursed by the social security must be registered on the LPPR list (List of Reimbursable Products and Services).

• Additional follow-up services

To be covered by social security, the hearing aid must be sold with a follow-up service over time, which must be performed by the audioprosthesist who sold the hearing aid. According to a 2015 study by UFC Que Choisir (available here, in french), these services - which represent 40% of the total cost of hearing aids - are rarely used by people who have been fitted with hearing aids, because they have no use for them, they do not wear their hearing aids or because the hearing aid specialist has closed store. In 2017, a american double-blind, placebo-controlled clinical trial (available here) concluded that these expensive services do not generate more satisfaction in the handling, wearing and use of the hearing aid compared to a hearing aid sold without additional services (preset hearing aids such as AZUR and ORISON). These services generate, on the other hand, a consequent refusal from the people concerned, because of their expensive cost. In France, only 1 out of 4 presbyacusic people are fitted with a hearing aid. And, among those who are fitted, it is considered - a taboo figure - that 15% of them do not wear their hearing equipment. In march 2020, with the COVID-19 crisis, the execution of these services became more complex, in particular with the closing of many shops and the application of barrier gestures.

Coverage of AZUR and ORISON by Social Security

For all these reasons, AZUR and ORISON hearing aids are not covered by social security. Indeed :

• AZUR and ORISON are available over the counter (without prescription)

Available without a medical prescription, AZUR and ORISON hearing aids simplify the care process. And for a good reason : AZUR and ORISON are not intended for people with a severe hearing disability, but for those who experience a simple, age-related discomfort called presbycusis (see our Frequently Asked Questions to better understand the difference between severe hearing impairment and presbycusis). Preset by ENT doctors and available without a prescription, AZUR and ORISON hearing aids are an immediate response to the millions of people who give up on making an appointment with a doctor, as the waiting time for a consultation can be up to 6 months in some regions.

• AZUR and ORISON are not registered on the LPPR list

• AZUR and ORISON are sold without additional follow-up services

Preset, the AZUR (rechargeable digital mini-BTE) and ORISON (digital CIC) hearing aids are "ready to hear" : no follow-up service is required or billed, the user is perfectly autonomous.

Coverage of AZUR and ORISON by mutual insurance companies

As complementary health insurance companies, mutual insurance companies cover health expenses not covered by Social Security. They can also, according to their own policy, cover expenses for alternative care or for devices such as AZUR and ORISON hearing aids. More than a third of our clients have benefited from full or partial coverage by their health insurance company : we encourage our users to provide their health insurance company with the invoice for their hearing aids (AZUR / ORISON).

What recourse do I have if the mutual insurance company refuses?

If your mutual insurance company refuses to cover AZUR or ORISON, read again  your contract to find the justification for the refusal. If your contract is not clear, contact your advisor : in an amicable request, your advisor can release the reimbursement, even if your contract does not provide for it. Finally, if your requests are unsuccessful, you can turn to the social protection mediator. Contact the Médiateur de la Protection Sociale (CTIP, France).