remboursement semelles orthopédiques

Do you suffer from foot pain, lower back pain or back or joint problems? You may need to wear orthotic insoles. Orthopedic insoles allow you to take care of yourself on a daily basis and instantly relieve your pain. However, they may have a significant cost depending on where you order them. Currently in France, social security and mutual insurance companies offer support for orthopedic insoles for patients who need them. But what is the support rate? And how to get reimbursed for your orthopedic insoles? We tell you everything about the reimbursement of orthopedic insoles by social security and mutual insurance. 

How much do orthopedic insoles cost?

Custom-made orthopedic insoles can cost between 75€ to 400€ depending on the materials from which they are made. 💰 These soles are generally prescribed by a doctor and carried out by a podiatrist or in an orthopedic center. Price variations depend on your prescription and the type of orthopedic insole you will need.

  • Soles classics in cork cost between €75 and €150
  • Soles functional, made with various materials adapted to your pathology, such as silicone, plastic or cork, cost around €200
  • Soles high-end and technological, made to measure with a molding of your foot and requiring machining or expensive materials, can exceed €350.

You must add to the cost of the insoles the price of one or more consultations with the health professional who made the insoles for you (podiatrist or podorthist).

You can of course find orthopedic insoles online for a lower budget, between €20 and €50. These insoles are not tailor-made, but designed to meet a specific need and pathology: knee pain, back pain, sports practice, plantar fasciitis, flat foot, etc.

 reimbursement for orthopedic insoles

Are orthopedic insoles reimbursed?

THE Orthopedic sole are reimbursed uniquely if purchased through a prescription medical advice from your doctor or podiatrist. 🩺 However, they are not fully refunded. In fact, the Social Security reimburses 60% of the conventional rate, and it is possible to have another part reimbursed by your mutual health insurance if it is part of your package. The amount of coverage from your mutual insurance depends on the organization you belong to and your health coverage.  

Whatever your case, orthopedic insoles are never fully reimbursed. Even if Social Security and your mutual fund cover part of it, you will still have a balance to pay, but it will be less compared to the total cost of your insoles.

How to get reimbursed for orthopedic insoles?

As previously indicated, it is possible to be reimbursed only for orthopedic insoles that have been prescribed by a doctor.

Reimbursement of insoles by Social Security

Social Security covers 60% of the base price of your orthopedic insoles prescription.

The conventional price depends on the size:

  • Size less than 28: the reimbursement basis is €12.94 per insole, or €25.88 per pair
  • Size between 28 and 37: the reimbursement basis is €14.02 per insole, or €28.04 per pair,
  • Size above 37: €14.43 per sole, or €28.86 per pair.

The support will therefore not be the same for your child or if you are an adult. For example, for a pair of orthopedic insoles with a size larger than 37, the Social Security reimbursement is calculated as follows: 60% * €28.86 or €17.30.

Knowing that most orthopedic insoles prescribed by a podiatrist will cost you around a hundred euros, we see that the care is very weak. This is why he is essential to have mutual insurance to have additional reimbursement.

reimbursement for orthopedic insoles

Reimbursement of insoles by your mutual insurance company

The amount of reimbursement for your orthopedic insoles depends on the health insurance you have.

Reimbursement of orthopedic insoles by your mutual can take the form:

  • a percentage on the social security reimbursement base (BRSS)
  • of a package

If we take the example of a reimbursement rate of 200% from the BRSS, then your mutual will reimburse you 140% of the price of the insoles (because you must subtract the part reimbursed by Health Insurance).

For a pair of adult insoles that cost €150, here is how the reimbursement would be spread out:

  • €17.30 reimbursed by Social Security
  • €28.86 * 200% = €57.72 reimbursed by the mutual
  • That is 74.98€ remaining to be paid at your expense

You should know, however, that most mutual insurance companies set a price ceiling for orthopedic insoles, and can only be reimbursed up to a certain amount (€80 for example). It is therefore important to consult your mutual insurance company on this subject.

Frequently asked Questions :

How many times can you be reimbursed for insoles per year?

Social Security takes care of 1 pair of soles per year for adult And 2 pairs of soles per year for one child.

Which mutual fund reimburses the best?

In France, the top 3 mutual insurance companies that best reimburse orthopedic insoles are Cegema, April and Apicil.

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