Cataract surgery reimbursement
Cataract surgery reimbursement by the French national health insurance (Assurance Maladie) covers 100% of the surgical procedure and anesthesia. A detailed written quote is provided to you at the pre-operative consultation.
Cataract surgery reimbursement by the French national health insurance
Cataract surgery reimbursement by the Assurance Maladie (the French national health insurance) is full on the items below, with no out-of-pocket advance from you.
The surgical procedure
Within cataract surgery reimbursement, the procedure itself — performed on an outpatient basis — is fully covered by the national health insurance (CCAM code BFGA427), with no advance payment from you.
Local anesthesia
Cataract surgery reimbursement includes the local anesthesia administered by a board-certified anesthesiologist, covered at 100% with no advance payment.
The standard monofocal implant
Cataract surgery reimbursement also includes the reference monofocal implant, which corrects either distance or near vision. So-called premium implants (EDOF, multifocal and/or toric) carry an additional cost detailed below.
Supplementary physician fees
Dr Gozlan is not an OPTAM signatory. Beyond the cataract surgery reimbursement by the national health insurance, supplementary fees (above the national rate) apply for the surgeon and the anesthesiologist; these are reimbursable in whole or in part by your top-up insurance.
Surgeon
A supplementary fee is added to the Assurance Maladie portion. The amount varies. It is reimbursable in whole or in part by your supplementary insurance, depending on your contract.
Anesthesiologist
The anesthesiologist also charges a supplementary fee, on top of the base cataract surgery reimbursement. This amount is reimbursable by your top-up insurance according to your coverage.
Premium implants: what extra cost?
If you opt for a so-called premium implant — EDOF, multifocal and/or toric — an extra cost is added to the cataract surgery reimbursement by the national health insurance. These implants can significantly reduce, or even eliminate, dependence on glasses.
Monofocal implant
Included in the cataract surgery reimbursement by the national health insurance. No extra cost for the implant itself. Vision is corrected for one distance only (far or near); glasses remain necessary for the other distance.
Premium implants (EDOF, multifocal and/or toric)
Their extra cost is generally between €100 and €250 per eye. This amount is paid by the patient and may be covered in whole or in part by your top-up insurance. It will be itemised on the quote provided at consultation.
Summary of cataract surgery reimbursement
Here is a synthesis of the various items in the cataract surgery reimbursement and how each is covered.
| Item | Assurance Maladie portion | Supplementary fee |
|---|---|---|
| Surgical procedure | 100% — no advance payment | Variable — reimbursable by top-up insurance |
| Anesthesia | 100% — no advance payment | €100–250 per eye — reimbursable by top-up insurance |
| Monofocal implant | Included | — |
| Premium implant (EDOF, multifocal and/or toric) | Not included | €100–250 per eye — reimbursable by top-up insurance |
The supplementary-fee amounts will be itemised precisely in the quote provided at the pre-operative consultation, in accordance with regulations.
Role of your supplementary insurance
Once the cataract surgery reimbursement by the national health insurance has been applied, the cataract surgery reimbursement of supplementary physician fees and the extra cost for premium implants depends entirely on your top-up insurance contract.
Check your surgical coverage
To optimise the cataract surgery reimbursement, contact your top-up insurer before the consultation and ask for the detail of your coverage for CCAM code BFGA427 (extraction of the lens). Specify that the surgeon is not an OPTAM signatory.
Send the quote to your insurer
Once you receive the quote at consultation, send it to your supplementary insurer for a coverage simulation before you commit. A reflection period applies before signing.
How to obtain a quote for cataract surgery reimbursement?
The quote procedure is a key step in preparing for the cataract surgery reimbursement; it is regulated by French law. Here are the steps.
1
Pre-operative consultation
The consultation assesses your cataract, the state of your eyes and your visual expectations. It specifies the terms of the cataract surgery reimbursement that will apply and includes a complete work-up (biometry, topography, fundus examination) with discussion of the implant choice with Dr Gozlan.
2
Issuance of the regulatory quote
A written, itemised quote covering the full cataract surgery reimbursement is provided to you, in accordance with regulations. It specifies all items: surgeon's fees, anesthesiologist's fees, the chosen implant and operating-theatre costs. A reflection period applies before you sign.
3
Coverage request to your top-up insurer
Send the quote to your supplementary insurer to obtain a precise estimate of your out-of-pocket cost after the cataract surgery reimbursement. Mention that the surgeon is not an OPTAM signatory.
To learn more about the implants included in the cataract surgery reimbursement, consult our complete guide to cataract implants. To book an appointment with Dr Julien Gozlan, use the contact form or the Doctolib link available on the site.
Frequently asked questions
Yes, fully covered. The surgical procedure and local anaesthesia are entirely reimbursed by the Assurance Maladie, with no upfront payment. Additional surgeon and anaesthetist fees apply and may be reimbursed in full or in part by your supplementary insurance, depending on your policy.
The standard monofocal implant is included in the Assurance Maladie reimbursement. Premium implants (EDOF, multifocal and/or toric) incur an additional cost borne by the patient, typically between 100 and 250 euros per eye, which may be covered by your supplementary insurance.
A supplementary fee is the difference between the surgeon fees and the Assurance Maladie base rate. It applies to both the surgeon and the anaesthetist. This amount may be reimbursed in full or in part by your supplementary insurance depending on your level of cover. Dr Gozlan does not participate in the OPTAM.
Coverage of premium implants and supplementary fees depends on your supplementary health insurance contract. Contact your insurer before your consultation, quoting the CCAM code BFGA427 (crystalline lens extraction).
References & medical sources
- Assurance Maladie (Ameli.fr). Cataract: coverage by the French national health insurance. ameli.fr; updated 2024.
- Haute Autorité de Santé (HAS). Common Classification of Medical Procedures (CCAM) — cataract surgery. Paris: HAS; 2024.
- Directorate of Research, Studies, Evaluation and Statistics (DREES). Health expenditure in 2022 — results from the national health accounts. Paris: DREES; 2023 edition.
- Busbee BG, Brown MM, Brown GC, Sharma S. Incremental cost-effectiveness of initial cataract surgery. Ophthalmology. 2002;109(3):606–612. doi:10.1016/S0161-6420(01)00971-X
- World Health Organization (WHO). World report on vision. Geneva: WHO; 2019.