Health insurance for glasses and contact lenses

Does health insurance pay for glasses?

Compulsory basic insurance (KVG) does not usually cover the costs of glasses and contact lenses for adults in Switzerland. Basic insurance (KVG) covers glasses if there is a severe visual impairment or a special medical indication. For children and young people under the age of 18, the contributions for glasses and contact lenses are covered by the health insurance company with a doctor's prescription.

What does health insurance pay for the glasses?

Health insurance pays an average of 300 francs a year for glasses. The cost sharing varies depending on the health insurance company and the selected supplementary insurance. Some health insurance companies offer a lump sum or a percentage of the cost of vision aids up to a certain maximum, which is granted every three years.

When does health insurance pay for glasses or contact lenses?

In Switzerland, compulsory basic insurance (KVG) pays the costs for glasses or contact lenses in certain cases:

• Children and young people under the age of 18:

  Basic insurance covers the costs for glasses and contact lenses if there is a doctor's prescription. However, the cost sharing can vary depending on the health insurance company.

• Severe visual impairment or special medical indications:

  For adults, basic insurance usually only covers the costs of glasses or contact lenses if there is a severe visual impairment or a special medical indication. Such as after cataract surgery (cataracts) or in the case of certain eye diseases that require special visual aids.

Do I have to submit glasses to the health insurance company?

You must submit an application to the health insurance company for the cost of the glasses in order to receive a co-payment for the glasses from the health insurance company. You must follow the steps below to submit glasses or contact lenses to your health insurance company.

1. Make sure your insurance covers the cost of glasses or contact lenses. Check the conditions of your basic and/or supplementary insurance or ask your health insurance company directly.

2. Gather all the necessary documents, such as a doctor’s prescription for glasses or contact lenses (especially for children and young people under the age of 18 or in the case of severe visual impairments) and the invoice from the optician or ophthalmologist that shows the costs for the visual aids.

3. Submit the documents to your health insurance company. The documents can be sent by post, e-mail or via the health insurance company's online portal, depending on the requirements of your health insurance company.

4. Wait for the feedback from the health insurance company regarding the cost sharing. The health insurance company will review your application and reimburse you the approved amount, depending on the conditions of your insurance.

How much does supplementary insurance pay for your glasses and contact lenses?

Supplementary insurance pays between 100 and 420 francs per year for glasses and contact lenses. List of additional insurances that contribute to the costs of glasses/contact lenses:

Helsana

• COMPLETA:

  90% up to a maximum of CHF 300 per year

• COMPLETA EXTRA:

  100% up to a maximum of CHF 300/year – 100% up to a maximum of CHF 750/eye and calendar year for laser eye corrections.

Swica, Provita

• COMPLETA TOP:

  90% of the optician's bill, up to CHF 200 every 3 years.

• OPTIMA:

  +90% up to CHF 300 every 3 years.

• SUPLEMENTA:

  +90% up to CHF 300 every 3 years.

Sympany

• PLUS:

  up to CHF 270 for children, adults every 3 years.

• PREMIUM:

  up to CHF 420 for children, adults every 3 years.

Visana

• BASIC, AMBULANT 2/3:

  90% up to a maximum of CHF 300/year, adults every 3 years.

Sanitas

• Classic:

  up to CHF 200 for children per year, adults up to CHF 300 every 3 years.

What are the exceptions to glasses and contact lens insurance?

In Switzerland, compulsory basic insurance (KVG) does not normally cover the cost of glasses and contact lenses for adults. However, there are a few exceptions where basic insurance covers the cost of visual aids:

Children

For children under the age of 18, basic insurance covers the costs of glasses and contact lenses if there is a doctor's prescription confirming a change in vision. The cost sharing can vary depending on the health insurance company and the canton.

Teenagers

Similar to children, basic insurance for young people under the age of 18 covers the costs of glasses and contact lenses, provided there is a doctor's prescription confirming a change in vision. The cost sharing can also vary depending on the health insurance company and the canton.

people with specific illnesses

For adults, basic insurance only covers the cost of glasses or contact lenses if there is a severe visual impairment or a special medical indication. Examples for this are:

• After a cataract operation (cataract)

• For certain eye diseases that require special visual aids

• For congenital or acquired severe visual impairments

When are children's glasses covered by health insurance?

In Switzerland, compulsory basic insurance covers the costs of glasses and contact lenses for children under the age of 18 if there is a doctor's prescription confirming a change in vision. The cost sharing can vary depending on the health insurance company and the canton. It's important to check your health plan's terms and conditions to know exactly what services are covered.

Does health insurance pay for glasses for diabetes?

Health insurance usually does not pay for glasses specifically because of diabetes. Compulsory basic insurance only covers the costs for glasses and contact lenses in the case of severe visual impairments or special medical indications. However, if the vision is severely impaired due to diabetes, the cost of glasses or contact lenses may be covered. In such cases, it is advisable to contact your health insurer directly and check the terms of your insurance policy.

Does health insurance cover blue light filter glasses?

Compulsory basic insurance in Switzerland does not usually cover blue light blocking glasses as these are not considered medically necessary. If you still want a co-payment for blue light blocking glasses, you should check whether your supplementary insurance covers such glasses. The conditions and the extent of the cost sharing vary depending on the health insurance company and the selected insurance model. It is advisable to check the terms of your supplementary insurance policy or check with your health insurance company directly.

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