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Old 10.12.2013, 22:53
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Basic Swiss health insurance coverage while traveling to US

Hey,
I will be traveling to US for a couple of weeks soon and wonder if I need to buy an extra travel health insurance or if my basic Swiss health insurance covers emergency treatment abroad.
  • Does basic Swiss health insurance cover emergency treatment abroad (e.g. broken leg, car accident injuries, etc.)
  • If it does do I need to pay money of out my pocket, take the receipts and then have it returned or is it settled between my insurer and hospital directly?
  • Perhaps you could recommend travel health insurance (was looking at Allianz)

Thanks
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Old 10.12.2013, 23:11
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Re: Basic Swiss health insurance coverage while traveling to US

Treatment in the US is very expensive & will not be covered if full (possibly not at all). You need further insurance.
Swiss health insurance does not normally cover accidents at all, Accident insurance covers accident so speak to people at work who arrange your cover.

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Hey,
I will be traveling to US for a couple of weeks soon and wonder if I need to buy an extra travel health insurance or if my basic Swiss health insurance covers emergency treatment abroad.
  • Does basic Swiss health insurance cover emergency treatment abroad (e.g. broken leg, car accident injuries, etc.)
  • If it does do I need to pay money of out my pocket, take the receipts and then have it returned or is it settled between my insurer and hospital directly?
  • Perhaps you could recommend travel health insurance (was looking at Allianz)

Thanks
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Old 10.12.2013, 23:26
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Re: Basic Swiss health insurance coverage while traveling to US

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Hey,
I will be traveling to US for a couple of weeks soon and wonder if I need to buy an extra travel health insurance or if my basic Swiss health insurance covers emergency treatment abroad.
  • Does basic Swiss health insurance cover emergency treatment abroad (e.g. broken leg, car accident injuries, etc.)
  • If it does do I need to pay money of out my pocket, take the receipts and then have it returned or is it settled between my insurer and hospital directly?
  • Perhaps you could recommend travel health insurance (was looking at Allianz)

Thanks

Foreign travel is not usually covered in the basic insurance - you need the supplementary.
Of course, every company is different & you may be lucky that your basic insurance does cover you; but probably not.
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Old 11.12.2013, 00:09
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Re: Basic Swiss health insurance coverage while traveling to US

hmmm I had to have a couple of x-rays and trip to the ER whilst in the US once and the insurance covered it, and I can only get basic coverage due to pre-existing conditions.
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Old 11.12.2013, 00:16
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Re: Basic Swiss health insurance coverage while traveling to US

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hmmm I had to have a couple of x-rays and trip to the ER whilst in the US once and the insurance covered it, and I can only get basic coverage due to pre-existing conditions.
I believe they will pay twice the cost of treatment in CH, it could be way more expensive in the US.
x-ray's sound like an accident rather than illness so it depends on your accident insurance which is normally arranged throughout work.
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Old 11.12.2013, 10:06
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Re: Basic Swiss health insurance coverage while traveling to US

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hmmm I had to have a couple of x-rays and trip to the ER whilst in the US once and the insurance covered it, and I can only get basic coverage due to pre-existing conditions.
Interesting - I was told by my insurance company that basic insurance will not cover any treatment outside of Switzerland at all.

(I had ER treatment in the US - paid out of pocket. Not one Rappen covered by my Swiss insurance.)

To get coverage outside Switzerland we were told that one must have supplemental - but even the supplemental 'world wide' cover excludes treatment in the US. OH had to buy an additional policy beyond the 'world wide' one to cover him in the US - and even that requires an OK from the insurance company before treatment. It might be decided that flying him back to CH for treatment is preferable.
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Old 11.12.2013, 10:12
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Re: Basic Swiss health insurance coverage while traveling to US

It doesn't have to be full supplemental. Helsana offers an extra "bolt-on" option for basic insurance which then covers you for emergency treatment (not accident, that's covered by accident insurance).

My boss is from the UK, getting on in years and can't get supplemental but he travels regularly so was offered this option.
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Old 11.12.2013, 10:12
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Re: Basic Swiss health insurance coverage while traveling to US

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It might be decided that flying him back to CH for treatment is preferable.
Almost certainly would, they might pay for emergency treatment but thats it.
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Old 11.12.2013, 10:58
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Re: Basic Swiss health insurance coverage while traveling to US

My basic health insurance covers me for up to 80 days a year when travelling abroad and will pay up to twice what equivalent treatment in Switzerland would cost.
That doesn't cover accidents (unless you are not gainfully employed and insured for accidents by your health insurance). So check your accident insurance (your employer).
How does that leave you covered? Up to you to decide really. It probably doesn't give you 100% cover in the USA, but will cover a fair amount. In developing countries you're probably going to end up in expensive private care too, so also possible not 100% covered. Within Europe, you're unlikely to have much of an issue with that kind of cover.
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Old 19.04.2015, 19:17
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Re: Basic Swiss health insurance coverage while traveling to US

Citing www.ch.ch/en/health-insurance-cover-abroad
"In non-EU / EFTA countries you can recover the costs of medical emergency treatment, but only up to a maximum of twice what the same treatment would have cost in Switzerland."

You can also read this in the product sheet of Arcosana AG's basic health insurance (standard model). FYI: CSS Holding AG owns Arcosana AG, INTRAS Kranken-Versicherung AG & Sanagate AG.
www.css.ch/downloadpdf.html?fileRef=%2Fcontent%2Fdam%2Fcss%2F en%2Fdocuments%2Fprivatpersonen%2Fproduktblatt%2F5 31_e_css_okp.pdf&mimeType=application/pdf&_charset_=utf-8
"Cover for costs incurred in emergencies for outpatient or inpatient treatment in the general ward up to a maximum of twice the tariff of the canton of residence in Switzerland. Special conditions apply in EU States (incl. Iceland, the Principality of Liechtenstein and Norway) as determined in the Bilateral Agreements"

However, on the contract (or product sheet?) of Assura, nothing is mentioned regarding this (or I could not find it).
fr.assura.ch/assurance/products/conditions-generales-lamal.pdf

Worst case scenario, it seems that your insurance will pay up to twice what it would cost in your canton of residence in Switzerland. Which seem to only be possible in the USA, Canada, Australia & Japan.

Here is another good resource from a governmental website:
"Compulsory health insurance only covers reimbursable treatment and services carried out in Switzerland by licensed providers. Exceptions are made for medical treatment that is necessary during temporary stays abroad."
"- In countries outside the EU/EFTA area, the costs of emergency medical treatment will be reimbursed up to a maximum of twice what the same treatment would have cost in Switzerland."
www.bag.admin.ch/faq/index.html?lang=en&themen_id=7#faq_anker_564

--

The most reliable sources of information are probably this governmental web pages:

Last edited by AdrienBe; 19.04.2015 at 20:33. Reason: add most reliable source of information
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