How are optical costs covered under the KVG/LAMal?

After the age of 18, basic insurance no longer covers the cost of glasses or contact lenses except in the case of illness, such as age-related muscular degeneration (or AMD) or muscular pathologies (diabetes, cataract or glaucoma etc.).)

In the event of illness, basic health insurance covers up to CHF 180 per eye per year. In this case, a medical prescription from a specialist specifying the patient's pathology will be required.

Note that in the case of glasses, the frame remains at the patient's expense.

It's clear that basic health insurance has gaps in terms of glasses/lens reimbursement, although the costs are often high. However, policyholders have the option of taking out supplementary insurance covering optical expenses.

These supplementary insurances offer cover on an annual basis or every 3 years.

Be careful, however, when choosing your supplementary insurance. It's important to choose an offer that suits your needs while respecting your budget.