Conditions for coverage
A duly justified medical prescription is mandatory for:
- tinted glasses, as well as
- glasses for children under the age of 14, except for the replacement of damaged glasses within a period of six months after the initial purchase.
Mineral glasses are glasses made out of natural glass, scratch-resistant but sensitive to impacts.
Mineral and organic glasses
The other supplies (mineral glasses and organic glasses, frames) can be obtained at the expense of the health insurance without a medical prescription, provided that the insured person has a visual deficiency in at least one eye.
Organic glasses are glasses made out of plastic, impact-resistant but sensitive to scratches. In order to increase their resistance, a particular treatment (hardened treatment) is necessary. Other possible treatments include tainting, smudgeproofing, anti-reflective, anti-U.V. etc.
Additional charges for tinted glasses are covered by the health insurance for the following pathologies:
- chronic conjunctivitis,
- some congenital central cataracts including aphakia,
- ciliary neuralgia,
- secondary photophobia to an affection of the retina, choroid and optical nerve or an intracranial affection,
In order to be covered by the health insurance, the concerned invoice must be presented together with a medical prescription indicating the number of the pertaining pathology.
Special glasses with high refractive index
In the case where the insured person has an ametropia greater than or equal to 6,00 diopters in at least one eye, the health insurance covers two glasses with high refractive index (glasses made out of titan, thinner and lighter).
The health insurance covers two progressive glasses in the case where the insured person has an addition of +2.50 diopters in at least one eye, even if the arithmetic sum of the power of the long-sight vision and the addition is equal to zero.
The health insurance covers for one vision only a supply that corresponds to one frame and one pair of glasses every three years, except in the case of a diopter change greater than or equal to +/- 0.50.
A diopter change of 0.50 is considered to have occurred when the change is +0.25 for one eye and -0.25 for the other eye.
A 0.50 diopter change is not considered to have occurred when the change is 0.25 in the same direction for both eyes.
|Left eye||Right eye|
|Old diopter||New diopter||Old diopter||New diopter|
|No diopter change
For children under the age of 14, the health insurance covers glasses without any renewal period.
The first pair of glasses (lenses and frame) following the 14th birthday is covered by the health insurance (without any medical prescription) and constitutes the starting point for the calculation of the first renewal period of 3 years.
The calculation of the renewal period starts from the date of the last coverage by the health insurance (not the date of purchase).