Coverage of contact lenses for certain pathologies
List of pathologies
Contact lenses are only covered by health insurance for the following pathologies:
- ametropia greater than or equal to 6 diopters,
- irregular astigmatism under the condition that the improvement of the visual acuity attains at least 20% compared with ordinary glasses,
- unilateral and bilateral aphakia,
- anisometropia higher than 3 diopters,
- fixation nystagmus,
- corneal dystrophy,
- evolutive myopia,
- corneal or scleral trauma.
In the case of the following affections an authorization by the Medical board of social security is required:
- facial or cranial trauma making the usage of contact lenses painful,
- cutaneous hypersensitivity making the use of contact lenses impossible (allergy to the material).
In order to be covered by health insurance, the invoice must be accompanied by a medical prescription indicating the number of the pertaining pathology.
Contact lenses are reimbursed in accordance with the tariffs provided for by the agreement between the CNS and the professional association of opticians (Fédération des patrons opticiens et optométristes du Grand-Duché de Luxembourg).
Services and supplies included in the price of contact lenses
The supply of contact lenses whose coverage is provided by the health insurance also includes:
- Trial, adaptation and examination sessions held in an office specially fitted for these purposes with appropriate examination instruments.
- The first supply of special waterproof cases with a solution for sterilization, hydrophilic and isotonic treatment of the contact surfaces.
- Four trial, adaptation and examination sessions taking place within twelve months of the delivery of the contact lenses. If, within thirty days of the first trial session, an intolerance of the front section of the eye is noticed and for this reason, after two new trial sessions held within two months of the first trial, the contact lenses covered by the health insurance cannot be delivered, only three trial sessions can be billed.
- The exchange of contact lenses within the framework of the conventional guarantees.
The renewal period for a contact lens is 3 years, except in the case of a change of diopter as defined for eyeglasses or in the case of another specific medical indication.
Fixed coverage as a replacement for glasses
In the case where contact lenses are supplied to an insured person who does not meet one of the required conditions for coverage of contact lenses, but fulfills the requirements for coverage of a frame and glasses, the contact lenses are reimbursed by means of a fixed coverage.
The renewal period is three years.