Conditions for coverage
Medical prescription
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.
Tinted glasses
Additional charges for tinted glasses are covered by the health insurance for the following pathologies:
- chronic conjunctivitis,
- keratitis,
- iritis,
- some congenital central cataracts including aphakia,
- glaucoma,
- ciliary neuralgia,
- secondary photophobia to an affection of the retina, choroid and optical nerve or an intracranial affection,
- albinism,
- blindness.
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).
Progressive glasses
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.
Renewal period
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.
| Diopter change | |||
| Left eye | Right eye | ||
| Old diopter | New diopter | Old diopter | New diopter |
| +2.50 | +2.00 | +2.50 | +2.50 |
| +2.50 | +2.50 | +2.50 | +2.00 |
| +2.50 | +2.25 | +2.50 | +2.75 |
| No diopter change |
|||
| +2.50 |
+2.25 | +2.50 | +2.50 |
| +2.50 | +2.25 | +2.50 | +2.25 |
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).
Coverage of costs
Method of payment
The insured person pays the optician's bill and requests reimbursement from their competent health insurance fund.
The insured submits the original, paid and receipted invoice to their competent health insurance fund. The 13-digit national identification number must be provided.
An original medical prescription must be submitted with the invoice if reimbursement is claimed for tinted lenses or for glasses for a child under 14 years of age (the prescription is not required for the replacement of damaged lenses within the first six months of the first purchase).
For a first reimbursement claim, a certificate of banking details (relevé d'identité bancaire RIB) must be enclosed. Letters sent to the CNS from within Luxembourg do not require a postage stamp.
Reimbursement of costs
The frames
Insured persons are free to choose their frames. In addition to the frames for which the salesperson can freely fix the prices, insured persons have the right to choose between four men's models and four women's models of frames whose price cannot be higher than the amount covered by the health insurance. The frames are covered up to an amount of thirty euros (30.00 €). These frames must be available at all times.
The frames
Insured persons are free to choose their frames. In addition to the frames for which the salesperson can freely fix the prices, insured persons have the right to choose between four men's models and four women's models of frames whose price cannot be higher than the amount covered by the health insurance. The frames are covered up to an amount of thirty euros (30.00 €). These frames must be available at all times.