France has introduced full reimbursement for all wheelchairs, ending what disability advocates long described as an “obstacle course” of partial funding and heavy out-of-pocket costs. The reform is expected to benefit more than a million users but has raised concerns about possible delays and bottlenecks.
From 1 December, France's national health insurance will cover 100 percent of the cost of wheelchairs for people with disabilities or older adults experiences loss of autonomy.
It delivers on a pledge by President Emmanuel Macron at the National Disability Conference in 2023.
“You called on me to tell me the sometimes exorbitant cost you have to pay. It was a huge injustice,” the president said in a video posted on Instagram on Sunday.
According to the presidency the reform is a first in Europe. It covers all wheelchairs adapted to disability-related needs (from birth, acquired or accident-related) or to loss of autonomy associated with ageing.
“It’s a really revolution for people's autonomy, you no longer have to advance a single euro," Pascale Ribes, head of APF France handicap, told RFI.
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Disability often 'rhymes with poverty'
Ribes has been campaigning for more than 20 years on the cost of wheelchairs.
Until now, reimbursement for the most advanced wheelchairs was extremely low. Active, lightweight models costing up to €10,000 were reimbursed at around €600, while complex electric chairs priced at €40,000 to €50,000 were capped at €5,200.
Users often had to seek top-ups from complementary insurers, departmental disability services, local authorities, associations, relatives or online fundraising campaigns.
Ribes notes that “disability too often rhymes with poverty”, forcing many people to scramble for funding or risk having to abandon essential equipment.
The new system simplifies and centralises the process: users receive a prescription from a doctor or a multidisciplinary team for complex cases, then contact a distributor who handles trials and submits a quote to national health insurance.
A 15-day “silence equals consent” rule – extended to two months for highly specific options – means the chair can then be provided without any advance payment or remaining charge.
According to the ministry responsible for people with disabilities, there are 1.1 million wheelchair users in France. Each year, 150,000 new wheelchairs are acquired.
The Elysée said the move “puts an end to an unjust and intolerable situation”, estimating annual costs could rise from €300 million to “€400 or 500 million”.
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Risk of supply shortages
A new national classification imposes price caps across 17 categories, from €360 for standard chairs to €21,000 for electric vertical-standing models.
Early negotiations were “tough” and risked excluding certain models, said Mazhoura Ait Mebarek of the National Union of the Medical Technologies Industry (Snitem), but the sector has since adapted. By late November, more than 430 approval requests had been submitted, with around 120 still pending.
Providers warn, however, that parts of the reform may strain the system. Short-term rental, used for temporary mobility needs and around 500,000 chairs annually, will be restricted to six months, with weekly rates cut from €16 to €11, less than €4 of which will be reimbursed.
“The risk is that, in time, fewer providers will offer rentals because the activity is costly,” said Julia Crépin of the distributors’ union UNPDM.
Long-term rental for people whose conditions progress rapidly, and the refurbishment of second-hand chairs, will not be operational immediately.
Lack of specialists
Technical approvals for some models may also take longer than planned. “The objective will be achieved, but not necessarily by 1 December,” said Nathalie Creveux of UPSADI – a new trade union for small and medium-sized home healthcare providers.
But the biggest constraint could be the availability of specialists. Complex chairs must be prescribed jointly by rehabilitation doctors or assistive-device specialists and occupational or physiotherapists.
“We live in a country with 'medical deserts' at every level,” said Malika Boubékeur of APF France handicap, calling for a national map of qualified centres.
A monitoring committee led by disability minister Charlotte Parmentier-Lecocq will meet monthly to oversee implementation of the reform.
(with newswires)
