Does health insurance pay for laser eye surgery?

What basic health insurance pays

Laser eye surgery is the everyday term for refractive surgery: an operation changes the cornea so that the eye sees clearly without glasses. Basic health insurance only pays for a service if it is effective, appropriate and cost-effective (Art. 32 para. 1 of the Federal Health Insurance Act, KVG, in short the effectiveness, appropriateness and cost-effectiveness criteria). For medical services that it does not pay for, or only under conditions, the Confederation keeps a list: Annex 1 to the Health Care Benefits Ordinance (Art. 33 para. 1 KVG, Art. 1 KLV). The FOPH publishes it; this page is based on the edition of 01.07.2026.

Under no. 6 “Ophthalmology”, refractive surgery is listed with a narrow condition:

Anisometropia means that the two eyes have a markedly different refractive power. If a difference of more than 3 dioptres cannot be corrected with spectacle lenses and contact lenses are permanently ruled out, this is the case that basic health insurance covers. The aim is then not a life without glasses, but to bring one eye to values that can be corrected with glasses.

For the vast majority, who are short- or long-sighted and see well with glasses or contact lenses, laser eye surgery is not a benefit of basic health insurance. There, it counts as an alternative to a visual aid, and basic health insurance only contributes to visual aids for adults in special cases; details in the guide Glasses.

What supplementary insurance pays

For laser eye surgery outside the special case, only voluntary supplementary outpatient insurance comes into question. It is governed by the Insurance Contract Act (ICA); the law does not prescribe any contribution to eye surgery. Before you sign, the insurer must inform you about the scope and limits of cover (Art. 3 ICA). Typical rules in the general terms and conditions are:

• a separate contribution to refractive surgery, often as a one-off maximum amount,
• counting the operation towards the contribution towards spectacle lenses and contact lenses, i.e. the contribution for visual aids over several years,
• conditions such as a minimum period of insurance, a minimum number of dioptres or prior cost approval,
• the exclusion of laser surgery.

A supplementary insurance may not cover the deductible and retention fee of basic health insurance (Art. 64 para. 8 KVG). For laser eye surgery outside the special case, this does not matter, because basic health insurance does not pay at all. We are building a comparison of supplementary products under Supplementary insurance. What counts are the general terms and conditions and the information from your insurer.

Conditions

For the special case under basic health insurance, all points must be met:

• Diagnosis: The ophthalmologist finds anisometropia of more than 3 dioptres that cannot be corrected with spectacle lenses, and permanent intolerance of contact lenses.
• Aim of the procedure: One eye is corrected, namely to values that can then be corrected with glasses.
• Approval before the procedure: The insurer must give special approval in advance, taking into account the recommendation of its medical adviser. If you have surgery without approval, you risk bearing the costs yourself. How the request works is explained in the guide Cost approval.
• Recognised service providers: The procedure is carried out by a physician or hospital that may bill basic health insurance.
• Co-payment: If the insurer pays, the normal co-payment applies: first the deductible, then a 10 % retention fee up to CHF 700 a year for adults (Art. 64 para. 2 KVG, Art. 103 KVV).

For supplementary insurance, the conditions of your contract apply. Many require cost approval before the procedure, some a minimum contract period. If you only take out supplementary insurance when the procedure is already planned, the insurer can ask health questions and add a reservation or turn down the application.

Sample calculation

Example with fictitious people, an assumed price and an assumed contract contribution. Lara, 32, is equally short-sighted in both eyes and would like to live without glasses. She has both eyes lasered. We assume a price of CHF 2,500 per eye; this is a calculation value, not a tariff. Her supplementary outpatient insurance counts laser eye surgery towards the contribution for visual aids, in the contract example CHF 300 every three calendar years.

Because basic health insurance pays the same at all insurers, it is worth looking at the premium in the premium calculator. Whether supplementary insurance for visual aids pays off is a calculation of annual premium against possible contribution; you can find key figures on the insurers in the health insurer profiles.

How to proceed

1. Clarify the diagnosis: Have the ophthalmologist record whether there is anisometropia of more than 3 dioptres and contact lens intolerance.
2. Obtain approval: In the special case, the physician submits the request to basic health insurance. Only have surgery after written approval.
3. Read the general terms and conditions: Without a special case, check the general terms and conditions of your supplementary insurance: contribution, frequency, counting towards the visual aids contribution, cost approval.
4. Get a quote: Ask for a written quote with all items so that you know your own share and the contribution in advance.

Common mistakes

• Counting on basic health insurance. Without a special case under KLV Annex 1, it pays nothing, not even with a medical recommendation.
• Having surgery without approval. In the special case, approval is a requirement, not a formality.
• Counting the visual aids contribution twice. If the contract counts the operation towards the visual aids contribution, it may already be used up for glasses in the same period.
• Taking out supplementary insurance shortly before the procedure. Health questions, reservations and waiting periods can exclude the benefit.

You can find other benefits, from glasses to physiotherapy, in the overview What does health insurance cover?.