Glasses and contact lenses: what does health insurance pay?

Vision aids and basic insurance: the starting point

The benefits of compulsory basic insurance (OKP) are identical by law at every insurer. Glasses for adults — like dental treatment (except after an accident or in the case of serious illness) — are among the services that basic insurance does not cover and for which supplementary insurance exists. For vision aids, basic insurance distinguishes strictly by age: there is a fixed annual contribution for children and adolescents, and in principle none for adults.

Children and adolescents: CHF 180 per calendar year

For children and adolescents until their 18th birthday, basic insurance reimburses CHF 180 per calendar year towards spectacle lenses or contact lenses. A medical prescription is required (basis: MiGeL).

You claim the contribution through the normal invoicing process: submit the invoice to your insurer via the app (photo), customer portal or by post, and keep the original receipts. Submit invoices even if the deductible has not yet been reached — this is the only way the deductible balance is recorded correctly and the annual statement is accurate. Reimbursement is usually made within 2–4 weeks.

Adults: only in exceptional medical cases

In principle, adults receive no contribution from basic insurance towards glasses or contact lenses — the normal correction of a refractive error is a private matter. Exceptions exist only for certain eye diseases or after operations, for example cataract or keratoconus. Whether such a case applies is determined by the treating ophthalmologist.

Outpatient supplementary insurance: higher contributions — as a package

If you want higher contributions towards vision aids, you will find them in outpatient supplementary insurance: depending on the product, typically CHF 100–300 per year towards glasses or contact lenses is insured. Amounts and conditions vary widely — the AVB of the specific product are always decisive.

Be honest with your sums: a contribution towards glasses alone rarely justifies an annual premium. Outpatient supplements, however, usually bundle several benefits that together tip the balance:

• Contributions towards gym memberships, sports courses and check-ups
• Cover abroad: outside Europe, basic insurance pays at most twice the Swiss tariff — in countries with high healthcare costs, that is often not enough; many outpatient supplements close this gap.
• Rescue and transport: basic insurance pays 50% of rescue costs in Switzerland up to a maximum of CHF 5'000 per year — many outpatient supplements cover rescue and repatriation from abroad without limit.
• An advantage for vision aids: many outpatient supplements have no waiting periods — these are more common in dental and daily allowance insurance.

Rules under the VVG: health check and deadlines

Outpatient supplements are supplementary insurance under the VVG — voluntary and governed by private law. The insurer may ask health questions, impose reservations or reject an application. Answer the questions truthfully, as false information can put the contract at risk. And the golden rule when switching: only cancel existing supplementary insurance once you have the new insurer's written acceptance confirmation.

The deadlines are also stricter than in basic insurance: many products have minimum terms — often three years, sometimes one year. Under revVVG Art. 35a, every supplementary health insurance can be cancelled at the latest as of the end of the third year and annually thereafter (three months' notice, in text form). At most insurers, the cancellation must arrive by 30 September for the contract to end on 31 December. The ideal start for the new policy is 1 January; for this, it is best to submit the application by mid-August — that leaves time for the acceptance confirmation and the 14-day revocation period.

Checklist: how to proceed

So that nothing gets overlooked with glasses and contact lenses:

The easyall comparison deliberately starts with the benefits: easy, our AI guide, can look up contributions towards glasses and the conditions for each product directly in the AVB.

• Children up to 18: use the basic insurance contribution of CHF 180 per calendar year — get a medical prescription and submit the invoice.
• Adults: clarify whether a medical exception applies (certain eye diseases, after operations) — otherwise basic insurance pays nothing.
• For supplementary cover, assess the whole package: contribution towards glasses plus benefits abroad, rescue and fitness — compare the benefits first, then the price.
• Answer health questions truthfully; only cancel your old supplementary insurance after the written acceptance confirmation (receipt by 30 September for the contract to end on 31 December).
• For your children: register them for supplementary insurance before birth if possible — then there is no health check.