How can I pay less for glasses?
Social Association VdK Germany e.V.
Entitlement to glasses: health insurers pay a fixed allowance
Many people with statutory health insurance do not know that, under certain circumstances, they can have their glasses subsidized by their statutory health insurance. We show who is entitled to the grant and how much it is.
The statutory health insurance companies pay children and young people the full cost of their glasses *. This is different for adult insured persons. However, the Medicines and Aids Supply Act (), which came into force in 2017, has brought improvements, at least for adults with severe ametropia, which many legally insured persons are not familiar with: According to the new rules, anyone who has more than six diopters or four diopters for astigmatism can benefit from the health insurance get a grant for his glasses.
The Central Association of Opticians and Optometrists () assumes that this affects around 1.4 million of the total of 41.2 million defective German citizens.
Subsidy: Prescription from an ophthalmologist or optician?
If someone belongs to this group of people, he or she first needs a prescription from an ophthalmologist. This is the prerequisite for being able to claim the grant. The optician, who also determines the eyesight, cannot issue such a prescription.
Glasses: fixed amounts of the cash registers
Health insurance only subsidizes the glasses, not the frame. And even with the glasses, that does not mean that the full amount will be reimbursed by the statutory health insurance. There are fixed amounts for visual aids that have been in effect since 2008. If the price is higher than this basic care paid by the health insurance fund, the insured person must pay the difference himself.
According to the Central Association of Statutory Health Insurance, the fixed amounts range from ten to a maximum of 112 euros per glass and depend, among other things, on the material of the glasses.
The cash registers do not pay for extras on the glasses such as anti-reflective coatings.
Funding from the health insurance fund for contact lenses?
Legislators generally assume that glasses will be supplied. In contrast, the right to be supplied with contact lenses only exists in exceptional cases that are medically imperative.
If the prerequisites for contact lens care are not met and the insured person chooses contact lenses instead of glasses, the health insurance company will pay as a subsidy at most the amount that it would have to pay for the required glasses.
However, the supply of contact lenses does not exclude the provision of additional glasses, since contact lenses can only be worn to a limited extent. However, insured persons can only have either glasses or Allow contact lenses to be subsidized.
Allowance for glasses: Insured persons have to pay the difference themselves
Insured persons should ask the optician if he can make them an offer for visual aids for the amount of the fixed allowance. If a spectacle or contact lens is not available at a fixed price, the insured person can submit a separate application to the health insurance company. The health insurance fund is obliged to provide the insured person with the glasses or contact lenses free of charge or to refer them to a local optician who can offer the required visual aids for a fixed amount.
Do you have any questions about the statutory health insurance subsidies for visual aids or aids? The social association VdK provides information and advice to its members in its numerous offices across Germany. You are not yet a member of the VdK? No problem - here you can find out more about the advantages of membership.
* The fact that children and adolescents are entitled to free vision aids does not mean that they can choose any glasses and the health insurance company has to pay for them. The fixed amounts for the care prescribed by the doctor apply. You can only apply for full cost coverage if the medically necessary care cannot be provided.
Read and see more:
When do you get prescription glasses? (UT)
TagsGlasses | Fixed grant | Assumption of costs | Cost | Health insurance | Diopters | Aids | Astigmatism
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