An ophthalmologist is an eye and vision specialist. The price of a consultation varies according to the sector in which it is contracted (sector 1 or 2), but not only. What are the rates charged? Can we get reimbursed? Qare’s medical team explains everything to you.
Good to know : in the context of a coordinated care pathway, that is to say that you consult on referral from your attending physician , the price will be higher (€50).
Consultation with a sector specialist
An ophthalmologist contracted in sector 2 has the right to determine its own consultation rates . In other words, to practice fee overruns. Prices therefore vary significantly depending on the specialist. Among the professionals:
Sector 2 ophthalmologists who are members of OPTAM (excess fees are limited );
Sector 2 ophthalmologists who are not members of OPTAM (they are authorized to charge fees without limitation, “with tact and moderation” ).
A price variation according to the ophthalmological treatment
In addition to a difference in the agreed sector, the price of a consultation with an ophthalmologist can also vary depending on the treatment performed.
Indeed, if the specialist must carry out an in-depth examination with fundus, for example, the price of the consultation can go up to 70 €.
Your sight is failing?
Do not wait to consult your doctor , who can refer you to a specialist.
Ophthalmology reimbursement: payment for the consultation
What criteria must be met to be reimbursed?
You should know that even if consulting an ophthalmologist can be done by direct access , you must still declare a attending physician .
Without this declaration, you will not be included in the coordinated care pathway applicable to this specialty. You will therefore only be able to obtain a partial reimbursement of the consultation (30%).
The same applies to consultations with a gynecologist, psychiatrist, neuropsychiatrist or stomatologist.
How much can I be reimbursed for an ophthalmological consultation?
If you follow the coordinated care pathway, reimbursement by Social Security is up to 70% of the basic rate . Then, the amount will depend on the specialist you consult.
For an approved sector 1 ophthalmologist (or sector 2 member of OPTAM):
Do you need a prescription to go to the ophthalmologist?
An ophthalmologist is a doctor who can be consulted freely , without being referred by a general practitioner. So you do n’t need a prescription to get there.
As a reminder, what is commonly called the “coordinated care pathway” consists of going first to your attending physician to be prescribed a consultation with a specialist.
Ophthalmology consultations are not included . This is also the case for gynecologists or dentists , in particular.
On Qare, doctors are available 7 days a week, from 6 a.m. to 1 a.m. Make an appointment online now.
It is advisable to have your eyesight checked regularly by a vision specialist. Before the age of 45 , a consultation every 5 years is reasonable. This period is reduced to 2 years after 45 years.
An annual consultation is planned for children, as well as for people with a visual pathology, such as AMD, glaucoma, cataracts, etc.