Patients insured in Switzerland
From January 1st 2004, 4 types of basic insurance reimburse medical costs according to the TARMED rate (same rate as the public hospital):
- Lamal: Basic obligatory insurance
- LAA: Accident insurance (contracted by the employer)
- AMF: Federal military insurance
- AI: Disability insurance
Costs related to consultations or ambulatory surgery (without hospitalization) are covered 100% by the accident, military and disability funds and 90% by the health insurance (after deduction of a possible deductible amount which varies according to each insurance policy). No additional insurance is necessary.
In the event of hospitalization (at least one night in hospital), additional insurance is necessary, whether semi-private (room with 2 beds) or private (single room). The insurance policy describes the extent of the possible benefits.
Under certain conditions, hospital costs can be covered by basic insurance (Hopitalisation LAA): the pathology must belong to a list of services which have been negotiated with the insurers and that is from an accident fund (Swiss DRG).
In order to create an invoice corresponding to your insured profile, it is essential to provide all the data necessary for your reimbursement by insurance companies during the consultation:
- Name of basic insurance
- Name of complementary insurance (semi-private or private)
- Address of insurance
- Policy number
- AVS number
In order to avoid receiving invoices, in the event of an accident, the name of the insurance must be communicated as quickly as possible with the policy or claim number (accident report to the employer).
In case of illness, it is possible to assign a claim (by signing a paper at the office) authorizing the medical office to send the invoice directly to your insurer.
It is necessary to reach out to your insurance to find out the extent of the possible interventions by specifying that the rates applied are:
TARMED rate (identical to the public hospital rate)
- Surgical interventions:
Ambulatory (less than 24hrs): TARMED rate
Hospitalization rate (one night or more): it is essential to contact your insurer to ensure coverage, stating that the establishments are private.
Insurance for international organizations
Agreements have been signed with various hospitals allowing international officials to benefit from 80 to 100% coverage, depending on the insurance, for consultations or hospitalizations. Additional insurance taken out by the insured possibly allows to take care of the difference like in Switzerland.
Foreign patients or patients who do not fall under the aforementioned insurance policies
A quote on request can be made. A deposit of the amount of the quote will be requested on the day of admission to the hospital.