A visit to my doc and a few x-rays later has shown that I may need an operation on my hip. This would have to be done in Canton Luzern. I was surprised to be asked if my health insurance covered all switzerland. I naturally assumed that it did, otherwise I am effectively uninsured against anythng serious as Obwalden hospital is very small.

Can this really be the case that insurance is your own canton only. Does this mean I will have to bear the cost personally. I imagime it would be expensive

Basic health insurance (KVG) as required by law is coverage only for the canton you are living in.
Supplementary insurance (VVG) to cover you in other cantons is available, and not really that expensive, but you will find it very difficult to get it now as you would have to disclose that you need surgery right away. Good luck...

Each canton covers the deficits of the hospitals in its jurisdiction. Hence, basic insurance only covers treatment within the canton of residence. Smaller cantons, without adequate hospital facilities, usually have contractual arrangements with another bigger canton nearby. Quite likely that OW has arrangements with LU but maybe not ZH. Under exceptional circumstances, the cantonal health department can approve special treatment at a hospital which is not contractually bound.

Normally basic health care is restricted to facilities in your canton, unless there is a good reason why you need to be treated elsewhere. If your doctor says that you need treatment that is not available in your canton, then it should be covered, although special approval may be required.

Jim

Thanks for the replies. Called my insurance company (klug) this morning to ask if my insurance covered all switzerland. They told me "Of course it did". She was very certain this was the case as if they didnt have any policies that didnt cover all switzerland. I hope she's right.

My doctor asked me if I wanted to return to UK to have it done. I told him that wasnt an option as I am not UK resident. Just surprised he thought I would even consider that.

You may have been talking at cross purposes. While you (may) have to use cantonal facilities, for emergencies you should find you're covered for the whole country. Perhaps that is what she was referrring to.

Basic policy usually covers out-patient (so-called "ambulant") everywhere in CH because there is a coordinated tariff (so-called TarMed).

However, hospitalization (so-called "stationary") is another story. This because each Canton must cover the hospital deficits in its jurisdiction. Hence, restrictions on hospital patients who are not resident in that Canton.

The decision maker is the Health Administrator of the Canton where you are domiciled. What your doctor says is one factor. But only the Admin is aware of the contractual arrangements between the domicile canton and the hospital canton.

The Admin may decide to reimburse:

• Only for hospitals in domicile Canton, or
• At hospitals in another Canton (contractually bound), or
• At a specific hospital which is specialized in complex treatment (e.g. heart transplant, neurosurgery, etc.)