03.04.2020

Covid-19: What does the health insurance cover?

Swiss Risk & Care answers frequently asked questions

In these particularly difficult times, many of you have questions about your health insurance cover regarding the coronavirus. You will find first answers here below.

All our advisors are working from home and remain at your service for help, guidance and to answer all your questions. Do not hesitate to contact us by email

fmsi@swissriskcare.ch

[Notice to readers] These are unprecedented times and some of the information given may change as the authorities respond to the economic crisis. Therefore, the information will be updated regularly.

Is the coronavirus test covered by Swiss obligatory health insurance?

Since June 25, 2020

The federal government will therefore be assuming the cost of all coronavirus tests (cf. Press release of June 24, 2020).

The persons tested do not participate in the costs through the deductible and the 10% retention fee.

Note that invoicing is always done through insurers.

This assumption of costs is subject to the following two conditions:

The prescribing doctor specifies directly on her or his lab request form whether the test is carried out because of illness or because prescribed by the cantonal head physician. Please be aware: There is no reimbursement for voluntary tests request solely by the person who wants to get tested.
The testing laboratory invoices the costs according to the doctor's prescription.

You will find more information on this subject on the leaflet of the FOPH (Federal Office of Public Health).

Between March 4 and June 24, 2020

Coronavirus tests done in Switzerland are covered by the health insurers as a benefit eligible for reimbursement through obligatory health insurance coverage and if the two conditions mentioned above are met.

Legal co-payment amounts (deductible and 10% retention fee) apply.

When infection of exposed healthcare professionals is being suspected, the law on epidemics applies. In such cases, the canton concerned covers the costs without any deduction of co-payment.

Before 4th March, 2020

The coronavirus tests were covered by the Confederation, i.e. the federal government.

Are protective masks, disinfectants and other preventive products reimbursed?

The health insurers don’t pay any benefits for protective masks, disinfectants and other preventive products.

Who pays for coronavirus treatments?

The obligatory health insurance reimburses both laboratory and medical costs, regardless of the test result.

Legal co-payment amounts (deductible and 10% retention fee) apply.

Are the costs of a hospital stay covered in case of COVID-19 infection?

If the insured member’s health requires hospitalisation, it is a compulsory benefit under the obligatory health insurance in accordance with federal law on health insurance KVG/LAMal.

Legal co-payment amounts (deductible and 10% retention fee) apply.

Our health insurance specialists are at your service

Health lies more than ever at the heart of our concerns. A comprehensive health insurance coverage protecting you against all health concerns is therefore very important. Do not hesitate to contact us for an assessment of your current coverage and potential for improvement.

Working together with most health insurance companies, our experts will be able to provide you with neutral and independent advice on covered benefits as well as on gaps in your current insurance coverage.