In normal cases, German health insurances will undertake the costs for a prosthetic eye once a year. Prescription by an ophthalmologist is obligatory. For a smooth process, it is possible to ask the competent administrator from the respective health insurance to provide a detailed cost estimate, however this is not absolutely necessary based on SGB V and the concluded medical aid list.
For health insurance groups which haven’t joined the professional associations for ocularists and insurances, it is necessary to apply for a cost estimate, which can lead to increased bureaucracy and time expenditure.
In the case of a work-related incident, the provisions of professional associations apply. A corresponding application to the professional association is generally sufficient for the annual new ocular prosthetic.
For disabled ex-servicemen, it is sufficient to send an informal application in written form to the competent authority. In the Rhineland, this is the LRV regional authority.
In case of questions or uncertainties, please contact our Institute. We are happy to provide advice for all cost questions and reimbursements regarding your health insurance.