Eye lasers, health insurance and reimbursement

Anyone who decides to have an eye laser surgery may, in the best case, completely dispense with a visual aid in the form of glasses or contact lenses. However, the cost of laser vision deficiency treatment is not very low. While it may be possible to save costs through operations abroad, you still have to finance the biggest factor yourself. How does it look in this regard with the Assumption of the costs by the legal and / or private health insurance out? Our guide explains.

The cost of an eye laser surgery at a glance

When it comes to the price of eye surgery, various factors are relevant to the calculation. Among other things, the price will be influenced by which eye laser provider you choose for the procedure. In addition, it depends on the cost of which you have defective vision corrected. Basically, the following treatment methods have good success rates:

The costs and takeover requirements of the laser surgery by the health insurance are quite similar in the cases mentioned above. Ophthalmologists of short-sightedness and farsightedness are the most frequent treatment, but too much curvature of the cornea (astigmatism or astigmatism) can be corrected by laser.

To complete the cost calculation for an eye laser surgery, you also need to know which method to use. There are some modern laser treatment options that can correct myopia and other vision problems. Particularly popular is the LASIK procedure, however, depending on the situation, the methods Femto-LASIK, LASEK, ReLEx Smile, PRK or other treatment options are also used.

Summarized: The costs of laser eye surgery are determined by the clinic, the causes of ametropia, the treatment method and the individual situation.

On average, it can be said that per eye approx 1,500 to 2,000 euros can count. However, there are many situations where the cost of surgery may be higher and lower. Especially abroad, operations are often carried out for less than 1,000 euros – a supposed bargain, in which, however, you should not compromise on hygiene and technical standards. With particularly favorable offers always highest caution is required. With expensive eye laser offers you should ask your insurance for advice. Your health insurance can at least estimate whether the operating costs are justified.

Insurance coverage

Since the cost of an eye laser surgery in a good clinic can easily exceed 3,000 euros, the subject is “eye lasers & Health insurance “very present for many patients. You would like to know if a reimbursement by their current health insurance would be possible.

Unfortunately, it is not always easy to obtain a reimbursement by the health insurance company. There are only a few cases where costs for eye lasers are covered by the health insurance. For patients, this is not understandable, because the laser eye is in most cases a permanent solution and makes the financing of other visual aids, such as the glasses, superfluous. Laser surgical procedures such as laser surgery cost health insurance companies only once an expensive operation, but the patient is cured. By contrast, when wearing contact lenses and glasses, follow-up costs are incurred, even for insurers.

You can read more about the reasons for the health insurance funds and ways of having the costs covered by the health insurance company in the following sections, which are aimed at health insurance patients and private patients.

Will the statutory health insurance cover the costs?

In principle Contract of a statutory health insurance (GKV), the acquisition of an eye laser surgery is not included. The reason is simple: A statutory health insurance sees an eye laser surgery not as medically necessary but arranges these operations as a beauty surgery or lifestyle surgery.

However, this view is not shared by all POS patients. By laser eye surgery, patients will generally be able to permanently dispense with visual aids in the future by completely correcting the visual defect.

Eyeglasses or contact lenses, on the other hand, could only temporarily correct a defective vision. A GKV is nevertheless only in exceptional cases ready to take over the eye lasers as health insurance. That’s the case, though

• the patient has an intolerance to contact lenses
• the patient has an intolerance to glasses

In these cases there is a medical necessity, the costs of which are borne by the statutory funds. In such cases, there were already some judicial judgments, where it has been determined that the health insurances will have to cover part or all of the cost of laser treatment.

Whether your health insurance company takes over the treatment of eye diseases or defective vision in your particular case can only be decided individually by the health fund. In order to claim the costs for the health insurance, you should always contact the health insurance in advance and obtain a decision by medical help. A refund after the operation will almost never take place, if you do not already have a commitment from your cashier.

The private health insurance covers the costs?

Although a private health insurance takes much more benefits and costs than health insurance, it is still difficult for a PKV in terms of eye diseases and vision defects. The members must inform themselves in advance whether the corresponding private health insurance will pay all or part of the costs and / or what proportion you have to pay yourself.

Ophthalmic surgery costs usually do not include general basic benefits. Insured must therefore also look at a private health insurance company exactly in which health class they are and whether the contract notes for an eye laser surgery were noted.

• If so, then the rule in the contract applies.
• If not, then, according to current case law, there are more and more cases in which the insurance coverage must be guaranteed.

The fact is that you also have better cards with a private health insurance, though

• there is a medical need (in case of incompatibility with glasses or contact lenses)
• or the use of glasses or contact lenses may be rendered superfluous by the treatment (however, this case is controversial as not all insurance companies consider that this is already sufficient to cover the costs).

Therefore, not only should you be aware of the risks of eye laser surgery, but also bear in mind that as a member of a health insurance fund (private and legal), you can not necessarily expect reimbursement.

The 10 best known health insurance companies in the check

There are countless health insurances on the market, where the reports partly differ significantly. The reason is simple: For some patients with ametropia, the primary concern is the simple question:

“I want to laser my eyes, pay the health insurance?”

For other insured is not the cost of insurance through insurance in the foreground, but the financial burden per month or even the service of the insurance.

Below we present you the ten best known health insurance companies and tell you how they are according to official information on eye surgery.

Almost all health insurance companies do not pay by default a classic eye laser surgery to treat poor eyesight. Although partial financial support for glasses or contact lenses is offered, but for an eye laser surgery, an individual application to the respective health insurance is required, which must make the appropriate decision to reimbursement or reimbursement by insurance. Most coffers but have offers for Supplementary insurances that go beyond standard benefits. In some cases, the cost of laser surgery will be reimbursed with eye replacement insurance. This additional offer can often be claimed but only after a health check. Whether this private supplementary insurance makes sense for you, as well as further details can be found here: Eye insurance comparison >>

Our conclusion

Many things speak in favor of eye laser treatment by LASIK or another method. Of course, the risks must be taken into account as well as the fact that most health insurances in “normal situations” take no charge or refund. If you are in a purely health-related case where eye laser surgery is medically necessary, you have a good chance – for example, with an intolerance to glasses or contact lenses, which is a medical necessity for an eye laser by most statutory and private health insurers -OP is classified.

Our tip: In many cases, applications for the cost of eye laser treatment are often rejected at first attempt. You can resubmit the application so that it is reviewed individually (and not just the policy). So it may be that a decision of your insurance takes longer, but may be positive for you and the operating costs are taken over. However, if your application is finally rejected and you have to pay for the operation yourself, there is a small consolation: For many eye laser providers is also an eye surgery with installment possible. Through small installments, the financial burden on the patient is significantly lower.

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