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HEALTH INSURANCE

Reader question: Will my Swiss insurance cover me if I catch coronavirus abroad?

Being ill is bad enough while you are at home, but getting infected with Covid-19 while in a foreign country makes the situation much worse. This is what you can expect from your insurance provider in Switzerland.

Published: 9 April 2021 15:50 CEST
Reader question: Will my Swiss insurance cover me if I catch coronavirus abroad?
If you hospitalised abroad due to Covid, your care should be paid for. Photo by Anna Shvets / Pexels

Everyone living in Switzerland is required to take out at least the basic health insurance coverage, the so-called KVG in German, and LaMal in French and Italian.

This insurance will pay for medical emergencies abroad, whether you have an accident, need urgent surgery, or —  as in the case of coronavirus — become ill and require immediate treatment.

If you do need urgent care while out of the country, you will have to notify your carrier by calling the number indicated on the back of your insurance card.

Keep in mind, however, that when it comes to insurance coverage, not all countries are created equal.

If you get sick in one of the EU or EFTA (Norway, Iceland, and Liechtenstein) nations, the European Health Insurance Card (EHIC) — that is, your regular Swiss insurance card — entitles you to receive the same paid services as someone who is insured in that country.

But if you are unfortunate enough to contract Covid and require hospitalisation while in the United States, where the cost of medical care is notoriously high, your LaMal coverage will not suffice to cover whatever costs you incur.

READ MORE: Should you buy supplemental health insurance in Switzerland?

That’s because the insurance will reimburse up to a maximum of twice what the same treatment would have cost in Switzerland.

If, however, you have a supplemental private insurance, your carrier will cover more costs. And if you took out additional health insurance to cover the cost of treatment abroad, it would pay for most (if not all) of the costs which are unrefunded by your main insurance.

Typically, you will have to pay for your medical care immediately. Then, when you return to Switzerland, send the documents you received from a foreign doctor or hospital to your insurance for a refund.

In order to be reimbursed, you will have to fill out a form (which is available either online or which your carrier will mail you), detailing the history of your illness or accident — how and where it happened, and what medical care you received.

Then send it back to the insurance company along with the invoice from the hospital, proof of payment, and medical records showing what tests, treatment, and medication you were given, and how much you were charged for each.

Make sure you have all this paperwork before you ask for a refund. If your documents are incomplete or an important piece is missing, the insurance may refuse to pay.

Relating specifically to coronavirus, you will also need a written certificate from a foreign health authority stating that you are fully recovered and able to travel.

And, at least for the time being, you must have a negative Covid test to come back to Switzerland.

Reader question: What documents do I need to enter Switzerland?

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For members

HEALTH INSURANCE

How Switzerland’s two crucial health insurance referendums could impact you

The price of Swiss health insurance premiums has been rising significantly in the past few years, prompting political parties to launch two cost-cutting initiatives. The votes will take place in June and there's a lot at stake.

Published: 24 April 2024 15:33 CEST
How Switzerland's two crucial health insurance referendums could impact you

On June 9th, the Swiss will cast their votes on two issues aiming, though in different ways, to curb the continually increasing cost of the obligatory health insurance (KVG / LaMal).

This is what’s at stake.

The ’10-percent’ initiative

In view of the high (and rising) premiums and other costs of living, which eat up a big chunk of the budgets of low- and middle-income consumers, the Social Democratic Party has spearheaded a national vote to cap the insurance rates at 10 percent of income.

Anything over this limit should be paid for by the federal and cantonal government, the party says.

While this strategy may sound enticing to everyone tired of paying high premiums, the government warns that while this proposal looks good on paper, the ‘yes’ vote could unleash some serious consequences.

Its main argument is that this measure would cost several billion francs per year, and does not provide any incentives to control health costs.

Instead, the Federal Council and the parliament have concocted their own ‘counter initiative’ that they want voters to approve.

Under this proposal, cantons will have to increase the amount of financial help they pay toward health premiums for low-income people. 

READ ALSO: How do I apply for health insurance benefits in Switzerland?

‘For Lower Premiums’ initiative

For its part, the Centre party has come up with its own proposal to reduce health insurance costs, which will also be voted on June 9th.

It provides for a ‘brake’ on health costs, which should evolve according to the economy and wages.

This brake would work in the same way as the federal spending brake. Therefore, when healthcare costs exceed wages for a given year by 20 percent, the government must take action to bring the  costs down.

The government is asking voters to turn down the Centre’s proposal because it doesn’t take into account factors such as demography, technological progress in healthcare, as well as the dependence of salaries on economic developments.

Here too, the Federal Council and parliament have put out their own counter-project, providing for more targeted measures, including specific cost control objectives for healthcare services.

Are there any other proposals on the table aiming to curb the cost of insurance premiums?

Yes.

While they are not on the ballot, two ideas have been debated in past months.

One calls for scrapping multiple private carriers  in favour of a government-run single health insurance scheme, similar to that in the EU. 

The other idea floating around is to replace the current system where rates are determined by factors such as age and canton of residence, and base them on wages instead. 

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