Laser vision correction for farsightedness: Optimising insurance coverage
14 Apr 2025
8
Minutes
Katrin Straub
CEO at nextsure
Are you dreaming of a life without reading glasses but unsure about whether your health insurance covers the laser treatment for your farsightedness? Many people face this question. This article highlights your options and shows ways to obtain financial support.
The topic in brief and concise terms
Statutory health insurances (GKV) cover the costs for laser treatment for farsightedness only in rare exceptional cases; private health insurances (PKV) are often more accommodating, depending on the tariff.
A 2017 ruling by the Federal Court of Justice strengthens the rights of private health insurance policyholders regarding cost coverage for eye laser surgery, as visual impairment is considered a disease and the surgery a medical treatment.
The cost of laser treatment for farsightedness typically ranges from eight hundred to three thousand euros per eye; it is essential to obtain a cost estimate in advance and clarify the situation with private health insurance.
Coverage Realities: Statutory Health Insurance vs Private Health Insurance for Laser Vision Correction for Farsightedness
The coverage of costs for laser treatment of farsightedness by health insurance is a central issue for many affected individuals. As a general rule, statutory health insurance (GKV) does not cover the costs for refractive surgery such as laser eye surgery for farsightedness. This is because the procedure is usually not considered medically necessary as long as correction with glasses or contact lenses is possible. An exception may occur in the case of a proven intolerance to visual aids, although this is rare and subject to strict individual examination. The situation is often significantly better for those with private insurance (PKV). Many private health insurance tariffs provide partial or even full cost coverage, depending on the individual policy conditions. A landmark BGH ruling from 2017 has strengthened the rights of PKV policyholders in this area. Therefore, you should carefully examine the exact costs of private health insurance and their benefits.
Quick Facts: The Essential Information on Cost Coverage at a Glance
For a quick overview, we have summarised the key facts about cost coverage for laser treatment of farsightedness by the health insurance. These points provide you with an initial assessment of your situation.
Statutory health insurance (GKV) generally does not cover the cost of laser eye surgery for farsightedness, as it is often not considered medically necessary.
Private health insurance (PKV) more frequently covers these costs, depending on the tariff and contract, up to one hundred percent.
A Federal Court of Justice ruling (IV ZR 533/15) from 2017 significantly strengthens the position of those insured with PKV.
The cost of laser surgery for one eye to correct farsightedness is often between eight hundred and three thousand euros.
Medical necessity for GKV is only given in very rare exceptional cases, for example in the case of proven contact lens intolerance and the simultaneous impossibility of wearing other visual aids.
Before the procedure, an estimate should always be submitted to the health insurance company, especially with PKV.
This overview serves as an initial orientation, but does not replace individual advice and review of your insurance contract.
Practice Perspective: Requirements and Typical Costs for Farsighted Patients
In practice, the possibility of laser treatment for farsightedness depends on several factors. Typically, the visual impairment must be stable for at least a year, and the individuals should be at least 18 years old. The cornea must have sufficient thickness, and there should be no other eye conditions that would exclude the procedure. The costs for laser treatment of farsightedness vary greatly. For Femto-LASIK, a common method, you can expect costs starting at around two thousand two hundred euros per eye if, for example, a farsightedness of up to plus four diopters is corrected. Many clinics now offer financing models to spread the one-time financial burden. It is advisable to obtain several offers and carefully examine the conditions for eye laser treatment with private health insurance. Additionally, glasses insurance or visual aid insurance may cover costs for visual aids, but not the laser surgery itself.
Expert Depth: Legal Foundations and Medical Necessity
From a legal perspective, the coverage of costs for laser surgery for farsightedness by health insurance is clearly regulated, albeit differently for statutory and private health insurance. The statutory health insurance is obligated to the principle of economic efficiency and considers glasses or contact lenses as sufficient provisions, as long as there are no serious medical reasons against them. The guidelines for aids by the Federal Joint Committee (G-BA) define when visual aids can be prescribed at the expense of statutory health insurance. For statutory health insurance to cover the cost of laser surgery, very high medical necessity must be demonstrated, which goes beyond the mere correction of visual impairment. This is extremely rare in the case of farsightedness. For those privately insured, the aforementioned Federal Court of Justice ruling from 29 March 2017 (Ref. IV ZR 533/15) brought an important clarification. According to it, a visual impairment is considered a disease, and laser surgery is considered a treatment. Insurers may not generally refer to cheaper aids if a recognized treatment method exists. Our expert tip: Always present your private health insurance with a detailed cost estimate and, if necessary, an ophthalmologist's report that substantiates the necessity and suitability of the procedure. The regulations for glasses under statutory insurance are not transferable here.
Strategies for Cost Coverage: Your Roadmap to Success
To increase the chances of your health insurance covering the costs of laser eye surgery for your farsightedness, a structured approach is essential. Here are some steps you should consider:
Carefully check your insurance contract, especially the benefits for visual aids and refractive surgery. This is particularly important for private insurance holders.
Obtain a detailed cost estimate from the eye clinic. This should list the diagnosis, the planned method, and the exact costs per eye.
Submit the cost estimate along with a formal request for cost coverage to your health insurance provider – with private insurance, this is standard; with statutory insurance, it is at least worth a try to receive a formal denial.
Have your ophthalmologist certify the medical necessity, if there are supporting arguments (e.g., high dioptre values, intolerance to contact lenses whilst also wishing for independence from glasses).
If rejected by private insurance: Review the reasoning and refer to the Federal Court of Justice ruling from 2017, if applicable. An appeal can indeed be successful here.
Consider the possibility of claiming the costs as an extraordinary burden for tax purposes if the health insurance does not cover them.
Careful preparation and communication with your insurer can make all the difference. Regular ophthalmologist check-ups with the health insurance are important but usually do not directly influence the decision on covering laser surgery costs.
Consider alternative financing and tax aspects
If the health insurance does not cover the costs of laser treatment for your farsightedness, or only partially covers them, there are further considerations. Many eye clinics offer installment models or financing options, often even interest-free for a specific period, such as 24 months. This can significantly reduce the financial hurdle. Another important option is the tax deductibility. The costs of an eye laser operation can be claimed as extraordinary expenses in the income tax return under certain conditions. Generally, this requires that the procedure was medically indicated, which is often the case with a visual impairment such as farsightedness. Keep all invoices and receipts carefully. It is advisable to consult with a tax advisor in this regard to utilize the optimal deduction possibilities for your individual situation. Thus, financial relief can be achieved even without direct cost coverage by the health insurance.
nextsure: Your partner for tailored insurance coverage
The question of whether health insurance covers the cost of laser surgery for farsightedness highlights the importance of choosing the right insurance. At nextsure, we understand that individual needs and tailored solutions matter, especially in the field of health. While we do not directly cover the costs of laser operations, we offer comprehensive advice on private health insurance and additional health insurance that can provide valuable support in many health matters. A strong private health insurance policy can, for example, cover the costs of eye laser treatments depending on the plan. Let us work together to see how your insurance coverage can be optimized to be best prepared for future health expenses. We help you maintain clarity in the complex insurance market. The right protection gives you peace of mind, not just for questions about vision.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive specific optimization suggestions.
More useful links
Wikipedia provides comprehensive information about hyperopia (farsightedness).
Wikipedia explains the phenomenon of presbyopia (age-related farsightedness).
The DOG and BVA offer a joint statement on the evaluation and quality assurance of refractive surgical procedures.
The Professional Association of German Ophthalmologists (BVA) provides a PDF document on quality assurance in refractive surgery.
The Deutsches Ärzteblatt delivers fundamental knowledge about refractive surgery.
The German Ophthalmological Society (DOG) makes statements and recommendations available for doctors.
The German Society for Intraocular Lens Implantation and Refractive Surgery (DGII) provides a PDF with basic knowledge on refractive surgery.
augeninfo.de, an information site of the Professional Association of German Ophthalmologists, provides information about refractive surgery and seeing without glasses.
The Federal Joint Committee (G-BA) publishes press releases on important decisions and regulations in healthcare.
The Stiftung Warentest offers advice and a test report on laser eye surgery.
FAQ
Does my statutory health insurance cover the cost of laser treatment for my farsightedness?
Unfortunately, in most cases, no. Statutory health insurers often classify laser eye surgery for farsightedness as a cosmetic procedure or comfort service, as long as correction with glasses or contact lenses is possible. Costs are only covered in very rare, medically compelling exceptional cases.
What are the chances of cost coverage by my private health insurance (PKV)?
The chances are significantly better with private health insurance. Many plans cover the costs for laser eye surgery for farsightedness either fully or partially. A ruling by the Federal Court of Justice in 2017 strengthened the position of policyholders. It is crucial to review your plan and submit a cost estimate in advance.
What is the approximate cost of laser treatment for farsightedness?
Prices vary greatly depending on the clinic, the method used (e.g., Femto-LASIK), and the diopter value. Expect costs between eight hundred and three thousand euros per eye. You can obtain exact prices with a personalized cost estimate.
Is there an age limit for laser treatment of farsightedness?
Yes, patients usually need to be at least 18 years old. However, more important than age is having a stable vision for a period of at least one year before the procedure.
What can I do if my health insurance refuses to cover the costs?
If rejected by the GKV, the options are limited unless there is a rare medical exception. If rejected by the PKV, you should review the reasoning and, if necessary, lodge an appeal by referencing the BGH ruling from 2017. Alternatively, you can claim the costs as an extraordinary burden for tax purposes.
What role does the dioptre number play in cost coverage?
The number of dioptres itself is usually not the sole criterion for cost coverage by statutory health insurance. In the case of private health insurance, the level of dioptres can support the medical argument in individual cases, but since the BGH ruling, it is no longer the sole decisive criterion for the fundamental obligation to provide benefits in cases of medical necessity. However, the cost of the procedure can depend on the number of dioptres.
