Cataract Surgery Coverage and Reimbursement
The surgical procedure and anesthesia are covered at 100% by the French National Health Insurance. A detailed quote is provided at your pre-operative consultation.
What the National Health Insurance Covers
Cataract surgery is covered at 100% by the French National Health Insurance for the following items, with no upfront payment required on your part.
The Surgical Procedure
The procedure itself — performed as day surgery — is fully reimbursed by the French Social Security system based on the standard tariff (CCAM code BFGA427). No upfront payment is required for this portion.
Local Anesthesia
Anesthesia is administered by a specialist anesthesiologist. The National Health Insurance portion is also covered at 100%, with no upfront payment required.
Standard Monofocal Implant
The standard monofocal implant is included in the National Health Insurance coverage. It corrects either distance or near vision. So-called premium implants (EDOF, multifocal and/or toric) incur an additional cost, described below.
Excess Fees
The Dr Julien Gozlan is not a signatory to the OPTAM (Controlled Fee Practice Option). Excess fees apply for both the surgeon and the anesthesiologist. These amounts may be fully or partially reimbursed by your supplemental health insurance, depending on your level of coverage.
An excess fee is charged in addition to the National Health Insurance portion. The amount varies and may be fully or partially reimbursed by your supplemental insurance, depending on your policy.
The anesthesiologist also charges an excess fee. This amount may be reimbursed by your supplemental health insurance, depending on your level of coverage.
Premium Implants: What Are the Additional Costs?
If you opt for a premium implant — EDOF, multifocal and/or toric — an additional cost is charged on top of the National Health Insurance coverage. These implants can significantly reduce or even eliminate dependence on glasses after surgery.
Monofocal Implant
Included in the National Health Insurance coverage. No additional cost for the implant itself. Vision is corrected for a single distance (far or near); glasses remain necessary for the other distance.
Premium Implants (EDOF, Multifocal and/or Toric)
Their additional cost generally ranges from €100 to €250 per eye. This amount is the patient's responsibility and may be fully or partially reimbursed by your supplemental insurance. It will be detailed in the quote provided at your consultation.
Summary of Billing Items
Below is an overview of the different billing items and their coverage.
| Item | National Health Insurance Portion | Excess Fees |
|---|---|---|
| Surgical procedure | 100% — no upfront payment | Variable — reimbursable by supplemental insurance |
| Anesthesia | 100% — no upfront payment | €100–250 per eye — reimbursable by supplemental insurance |
| Monofocal implant | Included | — |
| Premium implant (EDOF, multifocal and/or toric) | Not included | €100–250 per eye — reimbursable by supplemental insurance |
The exact amounts of the excess fees will be detailed in the quote provided at your pre-operative consultation, in accordance with applicable regulations.
Role of Your Supplemental Health Insurance
Reimbursement of excess fees and the additional cost of premium implants depends entirely on your supplemental health insurance policy. Each insurer has its own levels of coverage.
Check Your Surgical Coverage
Before your consultation, contact your supplemental insurer and ask for details on your reimbursement for CCAM code BFGA427 (lens extraction). Specify that the practitioner is not a signatory to the OPTAM in order to obtain a reliable estimate.
Submit the Quote to Your Supplemental Insurer
Once you have received the quote at your consultation, submit it to your supplemental health insurer to obtain a coverage simulation before committing. You have a reflection period before signing.
How to Obtain a Quote?
The quoting process is governed by law. Here are the steps involved.
Pre-operative Consultation
The consultation assesses your cataract, the condition of your eyes, and your visual goals. It includes a comprehensive evaluation (biometry, topography, fundus examination) and allows you to discuss implant selection with Dr Julien Gozlan.
Provision of the Regulatory Quote
A written, itemized quote is provided to you in accordance with applicable regulations. It details all billing items: surgeon's fees, anesthesiologist's fees, the chosen implant, and operating room charges. You have a reflection period before signing.
Request for Coverage from Your Supplemental Insurer
Submit the quote to your supplemental health insurer to obtain a precise estimate of your out-of-pocket costs. Mention that the practitioner is not a signatory to the OPTAM.
To learn more about the available implants, see our comprehensive guide to intraocular implants. To schedule an appointment with Dr Julien Gozlan, use the contact form or the Doctolib link available on the website.
References & medical sources
- French National Health Insurance (Ameli.fr). Cataract: coverage by the French National Health Insurance. ameli.fr; updated 2024.
- French National Authority for Health (HAS). Common Classification of Medical Procedures (CCAM) — cataract surgery. Paris: HAS; 2024.
- Directorate for Research, Studies, Assessment and Statistics (DREES). Healthcare expenditure in 2022 — results of the 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.