for vision aids and hearing aids
Glasses & contact lenses: costs covered
Do you need glasses or contact lenses or want laser eye surgery? It’s worth taking out supplementary insurance in these cases.
Cost share for glasses & contact lenses
In the case of defective vision caused by illness, basic insurance will contribute. Supplementary insurance covers normal short-sightedness or long-sightedness.
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What costs are covered under basic insurance?
In certain cases, basic insurance covers part of the cost of vision aids. For children, an ophthalmologist’s prescription must be submitted to us annually.
The following medical conditions apply to adults. Please contact our customer service team in advance if you are unsure whether costs will be covered:
- CHF 180 for glasses and contact lenses in the event of visual impairment due to illness, such as cataracts, diabetes and others following an operation (see the MiGel list of medical supplies and devices)
- CHF 270 every two years per eye for contact lenses if they significantly improve vision compared to glasses
- CHF 632 for irregular astigmatism (curvature of the cornea), keratoconus (bulging cornea), other corneal diseases or injuries and after corneal surgery or iris defects
- Children up to the age of 18 receive CHF 180 per year for spectacle lenses and contact lenses
More information is available in the List of medical supplies and devices (MiGel) (items 25.02.01.00.1, 25.02.02.00.1, 25.02.03.00.1):
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What costs are covered by supplementary insurance?
Our supplementary insurance covers the costs of visual aids, even without a prescription from an ophthalmologist. The costs for the eyeglass frames are also insured.
- Vital Basic: 100% of costs, max. CHF 300 within 3 years
- Vital Smart: 100% of costs, max. CHF 300 within 3 years
- Vital Premium: 100% of costs, max. CHF 600 within 3 years
- Jump*: max. CHF 300 every 3 years (from 18th birthday)
- Classic*: max. CHF 300 every 3 calendar years (from 18th birthday), max. CHF 200 per calender year (up to age 18)
- Family*: max. CHF 300 every 3 calendar years (from 18th birthday), max. CHF 200 per calender year (up to age 18)
* The Jump, Classic and Family supplementary insurance plans are no longer sold to new customers Existing customers continue to enjoy the usual benefits.
Additional products such as care solution or lens cases are not covered by supplementary insurance.
Cost share for laser eye surgery
Basic insurance only covers laser eye surgery if it is medically necessary. In all other cases, you can rely on Vital supplementary insurance.
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What costs are covered under basic insurance?
If laser eye surgery is medically necessary, for example for glaucoma or cataracts, basic insurance will cover the costs (according to the Tarmed tariff).
Basic insurance does not cover the costs of laser eye surgery to correct visual impairments.
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What costs are covered by supplementary insurance?
Our Vital supplementary insurance includes laser eye surgery. Sanitas covers the following costs for glasses, contact lenses and laser eye surgery:
- Vital Basic: 100% of costs, max. CHF 300 within 3 years
- Vital Smart: 100% of costs, max. CHF 300 within 3 years
- Vital Premium: 100% of costs, max. CHF 600 within 3 years
- Jump, Classic and Family: no costs covered.
* The Jump, Classic and Family supplementary insurance plans are no longer sold to new customers Existing customers continue to enjoy the usual benefits.
Cost shares for hearing aids
Normally, AHV/AVS or IV cover the costs. However, there are exceptions when basic insurance will cover the costs.
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What costs are covered under basic insurance?
Hearing aids are not covered by basic insurance. In most cases, AHV/AVS old-age and survivors’ insurance or IV disability insurance covers the cost of hearing aids.
Exception: Basic insurance covers the costs if a person meets the medical requirements for a hearing aid but not the conditions of AHV/AVS old-age and survivors’ insurance and IV disability insurance. As a rule, this applies to returning Swiss nationals living abroad and asylum seekers.
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What costs are covered by IV and AHV/AVS?
The AHV/AVS and IV social insurance funds contribute towards the cost of hearing aids. A medical prescription is required.
AHV/AVS contributes from a total hearing loss of 35% (both ears together). Every 5 years, people who are of retirement age or receive an AHV/AVS pension receive CHF 630 for one hearing aid or CHF 1237.50 for two hearing aids.
IV contributes from a total hearing loss of 20% (both ears together). Every 6 years, people who draw IV benefits receive CHF 840 for one hearing aid or CHF 1650 for two hearing aids.
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What costs are covered by supplementary insurance?
If AHV/AV and IV insurance do not fully cover the cost of the hearing aid, supplementary insurance will cover the difference.
- Vital Basic: 90% of costs, max. CHF 1,000 per calendar year
- Vital Smart: 90% of costs, max. CHF 1,000 per calendar year
- Vital Premium: 90% of costs, max. CHF 1,000 per calendar year
- Jump*: No contribution
- Classic*: 80% of costs, max. CHF 500 per calendar year
- Family*: 80% of costs, max. CHF 500 per calendar year
* The Jump, Classic and Family supplementary insurance plans are no longer sold to new customers Existing customers continue to enjoy the usual benefits.
The amounts stated apply to all areas of preventive medical care, not just check-ups.
What costs does Sanitas cover?
The Cover Check in the Sanitas Portal shows you at the click of a button which costs are covered by Sanitas.
