Significant advancements have been made in wheelchair reimbursement in France, with a unanimous National Assembly vote for full coverage by health insurance. The government aims for 100% reimbursement of manual and electric wheelchairs by 2024. Despite challenges regarding pricing regulations, the proposed legislation advocates for complete coverage without price caps. Currently, many individuals face high out-of-pocket costs, as only about half of wheelchair purchases receive full reimbursement, highlighting ongoing issues in the system.
Significant Progress in Wheelchair Reimbursement
A groundbreaking step towards the complete reimbursement of wheelchairs has been achieved. During the night of December 3 to December 4, the National Assembly cast a unanimous vote favoring full coverage of wheelchairs by Health Insurance. This pivotal bill, introduced by Deputy Sébastien Peytavie (Génération.s), who notably is the first wheelchair-using parliamentarian of the Fifth Republic, declares that these essential mobility devices will be “fully covered by health insurance organizations,” potentially supplemented by complementary health insurance and the disability compensation benefit (PCH).
Commitment to 100% Coverage
The government has pledged to ensure 100% reimbursement for both manual and electric wheelchairs by the end of 2024, a promise reiterated by former Minister for Disabled Persons, Fadila Khattabi, in La Croix on April 11. This initiative was further endorsed by the President of the Republic in April 2023, who characterized it as “a measure of social justice.”
However, challenges persist regarding the execution of this plan. Current Minister for Disabled Persons, Charlotte Parmentier-Lecocq, highlighted that while there is a collective aim, differences in approach remain. Ongoing discussions between Social Security, manufacturers, and distributors aim to establish regulations for wheelchair pricing.
The government had initially earmarked 300 million euros to support full reimbursement, proposing a cap of 2,600 euros for manual wheelchairs and 18,000 euros for electric models. Wheelchairs priced below these thresholds would receive 100% coverage, leaving those with higher costs without full reimbursement. Given that manual wheelchairs can soar to 10,000 euros and electric options may reach 50,000 euros, the financial burden can be significant, especially when additional features tailored to individual needs drive up costs.
Deputy Peytavie’s proposal advocates for “complete coverage by Social Security for all wheelchairs, irrespective of the required functionalities.” He criticized the existing price cap as “unjust,” “ineffective,” and “insufficient” for the actual requirements of disabled individuals, many of whom resort to crowdfunding or loans to acquire necessary equipment. “Some devices are costly,” he stated, emphasizing that “the dignity of those who rely on them daily is priceless.”
This legislation, which has passed its first reading in the National Assembly, will soon be reviewed by the Senate. Deputy Peytavie expressed hope for a decree from the government, or future administrations, that would eliminate price limits entirely.
Current Reimbursement Landscape
In France, over one million individuals rely on wheelchairs, predominantly women over the age of 70, as reported by a study from Irdes (Institute for Research and Documentation in Health Economics) in October 2022. To qualify for reimbursement, an individual must obtain a prescription from a healthcare professional and select a wheelchair certified by the Center for Studies and Research on the Equipment of Disabled Persons (CERAH).
Reimbursement amounts vary significantly based on the chosen model and accompanying services. For instance, manual wheelchair reimbursements range from 394.60 to 962.20 euros, while electric wheelchairs see coverage from 2,702.88 euros to 3,938.01 euros. Manual wheelchairs with standing aids are reimbursed between 1,559.84 euros and 2,425.05 euros, and electric counterparts with similar features receive up to 5,187.48 euros.
In scenarios where the wheelchair price exceeds Social Security’s reimbursement limits, individuals may apply for the disability compensation benefit (PCH) or explore options through complementary health insurance, Agefiph, or the Departmental Compensation Fund (FDC).
Unfortunately, only about half of wheelchair purchases or rentals see full reimbursement from Social Security, according to Irdes estimates. “The average out-of-pocket expense has been 900 euros, with some individuals facing costs exceeding 5,000 euros. This situation is unacceptable,” lamented the Minister for Disabled Persons in La Croix last April.