Whether private health insurance pays for glasses is decided by your tariff. Some tariffs reimburse vision aids up to a maximum amount within a fixed period, while others restrict the benefit heavily or exclude it. Statutory health insurance pays adults for glasses only in exceptional cases, and never for the frame.
The key points at a glance
- PKV reimburses vision aids only to the extent the tariff provides for them. Typical features are the reimbursement rate, a maximum amount and a fixed period.
- Statutory health insurance pays adults for glasses only in cases of severe visual impairment or high dioptre values. It never pays for frames.
- Many tariffs set waiting periods for vision aids. Their length is stated in the terms.
- Contact lenses are often governed separately. Check whether they count towards the same maximum amount as glasses.
- Whether a prescription is needed is decided by the tariff. Clarify this before you buy.
Does private health insurance pay for glasses?
Yes, if the tariff provides for vision aids. PKV has no uniform rule like statutory insurance. Each tariff determines whether and how much it reimburses for lenses, frame and contact lenses. Glasses count as medical aids, and the basic principle is explained in the article on medical aids in PKV.
First ask whether vision aids are included in your tariff at all. Then look at four points: reimbursement rate, maximum amount, period and requirements such as a dioptre limit or a prescription.
What does statutory health insurance pay for glasses?
Adults are entitled only in cases of severe visual impairment or at certain dioptre values. If you have minus 3.5 dioptres and are not severely visually impaired, the fund pays nothing towards your glasses.
| Feature | Statutory health insurance (adults) |
|---|---|
| Short-sightedness or long-sightedness | Entitlement above 6.0 dioptres |
| Astigmatism | Entitlement above 4.0 dioptres |
| Severe visual impairment | Entitlement regardless of dioptres |
| Frame | Never covered |
An independent consumer advice service can clarify the details of the exceptions. Different rules apply to children and young people, which are not covered here.
Which reimbursement limits do PKV tariffs set for vision aids?
Tariffs set limits at several levels. In practice, they work together.
- Reimbursement rate: the insurer pays a percentage of the invoice. For medical aids, 75, 90 or 100 percent are common.
- Maximum amount: reimbursement stops at a set sum.
- Period: the maximum amount applies per calendar year or across several years combined. If you spend a lot in one year, you may have nothing left in the following year.
- Type of benefit: some tariffs treat lenses, frames and contact lenses alike, others separate them.
- Requirements: these include dioptre limits or a prescription from a doctor.
Waiting periods: when vision aids are reimbursed
Many tariffs set a waiting period for vision aids. It usually starts at the beginning of the insurance, and during this time the tariff does not reimburse glasses, or only to a limited extent. If you switch tariffs, check whether a new waiting period applies to the new benefits.
So if you need reimbursement, do not plan glasses or lens purchases for the first months after the contract begins. The length and exceptions, such as accidents, are set out in the terms. Ask your insurer before you buy what status your waiting period has.
Typical tariff models compared
The following models describe types of design, not specific offers. Which form your tariff takes is set out in its terms.
| Model | How reimbursement works | What to watch |
|---|---|---|
| Annual maximum amount | Reimbursement stops at a fixed sum per calendar year | Is the sum enough for glasses and frame in the same year? |
| Budget across several years | A maximum amount applies over a period of several years | How is the budget spread if a lot falls due in one year? |
| Reimbursement rate with deductible | A percentage of the invoice is reimbursed after a deductible has been deducted | How high is the deductible, and does it apply per year? |
| Separate limits | Glasses, frames and contact lenses each have their own limits | Is there a separate maximum amount for lenses? |
| No vision aid benefit | The tariff covers neither glasses nor lenses | Is an add-on or a separate reserve worthwhile? |
What does this mean in practice? A calculation example
Example with assumed figures: Mia, 24, has minus 3.5 dioptres. In the first year she buys glasses for 320 euros, and in the second year contact lenses for 200 euros. At this value, the statutory fund pays nothing. Two invented tariffs show the difference. Tariff X reimburses 80 percent, up to 250 euros across two calendar years combined. Tariff Y reimburses 100 percent, up to 150 euros per calendar year.
| Item | Cost | Tariff X | Tariff Y |
|---|---|---|---|
| Year 1: glasses | 320 euros | 250 euros reimbursed (80 percent would be 256 euros, so the maximum applies) | 150 euros reimbursed |
| Year 2: contact lenses | 200 euros | 0 euros reimbursed (maximum used up) | 150 euros reimbursed |
| Total reimbursement | 520 euros | 250 euros | 300 euros |
| Total own share | 270 euros | 220 euros |
Tariff X reimburses more in the first year, Tariff Y across both years. The period for which the maximum amount applies determines the result here. Your needs may differ, so your own buying rhythm matters when you purchase glasses.
Does PKV pay for contact lenses?
Whether contact lenses are reimbursed is governed by the tariff. Some treat them like glasses and count them towards the same maximum amount, others set a separate limit. For daily lenses, monthly lenses and care products, ask separately whether they count as reimbursable benefits.
The term “contact lens insurance” is used in different ways. Sometimes it means reimbursement within the health insurance tariff, sometimes a separate supplementary contract. When you receive an offer, read exactly what is insured and what is excluded, how high the maximum amount is and which waiting periods apply.
Do you need a prescription for reimbursement?
That depends on the tariff. Some tariffs require a prescription from an eye doctor, others accept a measurement by an optician. The terms state the requirement. Keep the invoice and the prescription and submit both together. Privately insured people pay the bill first. The deadline for submission is set by the tariff and stated in its terms.
What applies to laser eye surgery in PKV?
Whether a tariff reimburses laser eye treatment is stated in the terms and depends on the agreed benefits and exclusions. Clarify this in writing before the procedure. Submit the practice’s cost estimate and ask whether, and to what extent, the insurer will cover the costs.
Frequently asked questions
Do private health insurers pay for glasses?
Yes, if the tariff provides for vision aids. How much is reimbursed depends on the reimbursement rate, maximum amount and period. Check the terms before you buy glasses.
Does PKV also pay for the frame?
The tariff decides. Statutory insurance never pays for the frame, while PKV may include frame and lenses. The terms state how the split works.
How often does PKV pay for new glasses?
The tariff also determines this. Often a maximum amount applies per calendar year or across several years combined. Check the period in the terms before you buy new glasses.
Are contact lenses reimbursed in the same way as glasses?
That depends on the tariff. Check whether contact lenses count towards the same maximum amount as glasses and whether care products are included.
What to do now
- Search the terms of your tariff or offer for the section on vision aids.
- Note the reimbursement rate, maximum amount, period, waiting period and requirements.
- Estimate how often you renew glasses or lenses, and work through an example of what you pay yourself.
- Before buying, clarify whether a prescription is needed, and keep your invoices.
- Submit the paid invoice within the deadline.
Related
- PKV benefits for students: the overview
- PKV and medical aids: which benefits count
- PKV and patient transport: what you should know
- Studying at 30: opportunities, financing and everyday life
- Glasses at the health insurer’s expense: entitlement in statutory health insurance
Sources
Information, not individual advice.
Editorial team: Academycon · Status: October 2026
Want to go through your tariff? You will find the Academycon online check on our website.
Status: October 2026. This article provides general information and does not replace individual advice.
