Health Insurance Benefits Division

The Health Insurance Benefits Division is responsible for defining the catalogue of benefits paid under compulsory health insurance, in particular the lists of analyses, aids and equipment, and for the health technology assessment.

As part of the Health and Accident Insurance Directorate, the division works with two specialist committees to draft and oversee the basis for the designation of medical and non-medical benefits, prevention and maternity benefits, analyses as well as resources and articles in the catalogue of benefits paid under compulsory health insurance. It also acts as a specialist arbiter in appeal proceedings before the Federal Administrative Court relating to rulings in the context of the above benefits. In addition, the division shapes the health insurance system by way of amendments to the law and ordinances governing the area of benefits outlined above.

Ryan Tandjung

Karin Schatzmann and Marc Schneider
Heads of Health Insurance Benefits Division

Further information

Benefits and tariffs

What medical care does compulsory (basic) insurance pay for? What hospital can you go to for treatment? What about maternity benefits? Which tariffs and prices are set by the authorities?

Health insurance: Supervision of insurers

Insurers offering compulsory health insurance are supervised by the Federal Office of Public Health (FOPH).

Health insurance: Description of services

Who decides what benefits compulsory (basic) health insurance pays? In this section you can find out who is responsible and the procedures for applying for coverage of new benefits.

Statutory foundation Health insurance

Find out here about the legislation regarding health insurance.

Health insurance: Current Revision Projects

Various revisions are under way in the field of health insurance. They affect legislation including the Federal Health Insurance Act (KVG/LAMal), the Health Insurance Ordinance (KVV/OAMal) and the Health Insurance Benefits Ordinance (KLV/OPAS).

Last modification 15.08.2024

Top of page

https://www.bag.admin.ch/content/bag/en/home/das-bag/organisation/direktionsbereiche-abteilungen/direktionsbereich-kranken-unfallversichrung/abteilung-leistungen-krankenversicherung.html