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 specialities list, 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 three specialist committees to draft and oversee the principles for the licensing of medical services, therapeutic products, analyses, aids 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 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).

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 02.08.2021

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