In certain cases, persons resident and insured in Switzerland can be treated abroad. The conditions for reimbursement of the costs vary, depending on the type of service and the country in which it is provided.
Temporary stay in an EU/EFTA country
During a temporary stay in an EU/EFTA country, policyholders can be treated if they present their European Health Insurance Card (EHIC), which is to be found on the back of the Swiss health insurance card. In the event of illness, accident or maternity, policyholders are then entitled to receive all benefits in kind considered medically necessary given the type of treatment and expected length of their stay. The list of reimbursable items is subject to the law of the country in which the treatment is carried out. Co-payment is subject to the regulations of the country concerned and is generally payable directly. Co-payment in Switzerland is then not applicable. Nor is co-payment in an EU/EFTA country taken into account for the Swiss deductible or retention fee.
If policyholders do not have their EHIC with them, their health insurer may issue a temporary certificate.
For more information, see “Temporary stay in an EU/EFTA country” (available in French/German/Italian) on the website of the Common Institution under the KVG (Swiss liaison body).
Temporary stay in a non-EU/EFTA country
During a temporary stay in a country outside the EU/EFTA, the costs of emergency treatment for illness or accident (in cases where a return to Switzerland is not possible for medical reasons) will be reimbursed up to a maximum of twice the amount that would be paid if the treatment were provided in Switzerland. In the case of inpatient treatment, this means that the insurer will reimburse no more than 90% of the costs that would have arisen for hospitalisation in Switzerland. This is because, in the case of hospital treatment in Switzerland, at least 55% of the costs are borne by the cantons, which is not the case for hospital stays abroad.
Other medical treatments abroad are not generally covered by compulsory health insurance.
Planned treatment abroad
In certain cases where a treatment is not available in Switzerland or waiting periods are too long, the costs may be reimbursed for these particular treatments abroad. In such cases, the policyholder’s attending physician must submit an application (explaining the reasons) to the health insurer’s independent medical adviser. In consultation with the latter, the insurer will decide whether the costs of the treatment abroad can be reimbursed (see the conditions specified in the information letter dated 8 April 2008 on medical treatment abroad; available in French/German).
Medicines purchased abroad
The costs of medicines purchased abroad will only be reimbursed if they are required by the policyholder because of illness during a temporary stay abroad.
Last modification 26.05.2021