Coverage Abroad
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Additional coverage abroad
Travels and stays abroad are frequent in a lifetime, either they are as tourist, worker or student.
This is one of the most important coverage to have as not all countries have the same fees and hospitalization abroad and repatriation are extremely expensive.
We are going to discover how LaMal covers us, detail additional coverage abroad, and go through the main issues.
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Additional coverage abroad
Travels and stays abroad are frequent in a lifetime, either they are as tourist, worker or student.
This is one of the most important coverage to have as not all countries have the same fees and hospitalization abroad and repatriation are extremely expensive.
We are going to discover how LaMal covers us, detail additional coverage abroad, and go through the main issues.
How does LaMal cover ?
First, we need to distinguish the costs inside UE/AELE and out of UE/AELE.
Inside UE/AELE
During a temporary stay, the policyholder can receive healthcare by presenting his/her European insurance card. This is only true in case of emergency or maternity.
It is however important to be aware that the reimbursement conditions are the ones of the country you are in. In most of them, there is a participation that have to be paid there.
For example, the hospitalization in France requires a 20 % participation from the patient.
Out of UE/AELE
During a stay out of UE/AELE, the European car will not be accepted and LaMal will take over the costs in case of emergency. This time we distinguish two things: emergency treatment and hospitalization.
Emergency treatment : Emergency treatments abroad are covered up to twice the price it would have cost in Switzerland.
Hospitalization abroad : this time LaMal will only take over 90 % of what it would have cost in Switzerland. Indeed, during a hospitalization in Switzerland, insurers pay 45% and the rest is taken by the Confederation. Indeed, 90% corresponds to twice their participation.
Caution : Some countries are way more expensive than Switzerland. We always give the US as an example. If you only have the LaMal, you could get a big bill in case of hospitalization.
What does additional coverage take ?
As often, the coverage is different in each company. Indeed, it is important to choose well because the difference can be huge and have consequences.
The best reimbursement : 100% of the costs abroad during 12 months
The traps : Some companies have a limited number of days (be careful for long stays). Others do not cover 100% and ask for a participation. Depending on the country, the participation can be high.
It is important to choose well. We recommend you to use our comparison tool to have a clear overview of the reimbursement levels.
Medicines bought abroad
Either with LAMal or additional coverage, it can be reimbursed in case it is judged necessary during an emergency.
Planned treatment abroad
In the LAMal : here is the rule : the treatment has to be necessary, unavailable in Switzerland, or have a too long waiting period. It is still the medical advisor from the insurance who will decide if it is accepted.
In additional coverage : As often, it has to be compared. Few companies offer a reimbursement for volunteer treatments abroad. It is often limited to emergencies.
However, some companies give a daily budget abroad to allow more freedom, so it can be possible.
Repatriation from abroad
With LaMal only, there is no reimbursement in case of repatriation from abroad.
As an example : a repatriation with a plane from Thailand or the USA will cost around CHF 100’000.-
Most additional insurances will cover repatriation 100%. However, it has to be from hospital to hospital and be necessary.
How does LaMal cover ?
First, we need to distinguish the costs inside UE/AELE and out of UE/AELE
Inside UE/AELE
During a temporary stay, the policyholder can receive healthcare by presenting his/her European insurance card. This is only true in case of emergency or maternity.
It is however important to be aware that the reimbursement conditions are the ones of the country you are in. In most of them, there is a participation that have to be paid there.
For example, the hospitalization in France requires a 20% participation from the patient.
Out of UE/AELE
During a stay out of UE/AELE, the European car will not be accepted and LaMal will take over the costs in case of emergency. This time we distinguish two things: emergency treatment and hospitalization.
Emergency treatment : Emergency treatments abroad are covered up to twice the price it would have cost in Switzerland.
Hospitalization abroad : this time LaMal will only take over 90% of what it would have cost in Switzerland. Indeed, during a hospitalization in Switzerland, insurers pay 45% and the rest is taken by the Confederation. Indeed, 90% corresponds to twice their participation.
Caution : Some countries are way more expensive than Switzerland. We always give the US as an example. If you only have the LaMal, you could get a big bill in case of hospitalization.
What does additional coverage take ?
As often, the coverage is different in each company. Indeed, it is important to choose well because the difference can be huge and have consequences.
The best reimbursement : 100% of the costs abroad during 12 months
The traps : Some companies have a limited number of days (be careful for long stays). Others do not cover 100% and ask for a participation. Depending on the country, the participation can be high.
It is important to choose well. We recommend you to use our comparison tool to have a clear overview of the reimbursement levels.
Medicines bought abroad
Either with LaMal or additional coverage, it can be reimbursed in case it is judged necessary during an emergency.
Planned treatment abroad
In the LaMal, here is the rule : the treatment has to be necessary, unavailable in Switzerland, or have a too long waiting period. It is still the medical advisor from the insurance who will decide if it is accepted.
In additional coverage : As often, it has to be compared. Few companies offer a reimbursement for volunteer treatments abroad. It is often limited to emergencies.
However, some companies give a daily budget abroad to allow more freedom, so it can be possible.
Repatriation from abroad
With LaMal only, there is no reimbursement in case of repatriation from abroad.
As an example : a repatriation with a plane from Thailand or the USA will cost around CHF100’000.-
Most additional insurances will cover repatriation 100%. However, it has to be from hospital to hospital and be necessary.
Additional coverage possible
Possible coverage
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