Medical aids and equipment

Respiration therapy equipment, compression stockings and prostheses help you with medical conditions. We can assume these medical aids from basic insurance. With PRIMEO, you have the ability to insure costs that exceed the limit. Our TOP, COMPLETA and OMNIA supplementary insurance models give you contributions towards medical aids that make everyday life easier or make you more independent, such as a wheelchair, electric nursing bed or walker.

What's worth knowing about medical aids and equipment

Walkers, inhalation and respiratory therapy devices, braces, crutches and incontinence aids help to treat or monitor an illness or its aftermath. They can be used by the person concerned on their own or by someone helping them. All aids and equipment that health insurers are allowed to cover under basic insurance are itemised in the List of Aids and Equipment (MiGeL). This list is organised according to the products' function and contains general product descriptions, but not individual brand names. This differentiates it from all other basic insurance lists. Other lists and agreements, separate from the MiGeL, cover medical products such as implants, aids that are not intended to treat or monitor an illness, and products that contain active substances.

Requirements

You will receive a contribution from basic insurance towards an aid or item of equipment listed in the MiGeL if it has been prescribed by a doctor and supplied by a recognised provider.

Maximum prices

As there is no price protection for aids and equipment, providers can set their own prices. Therefore, the MiGeL not only regulates which aids and equipment can be covered by basic insurance, but also prescribes the amount up to which an aid or item of equipment can be covered. The stated amount generally corresponds to the average market price. In this way, the law ensures that basic insurance is not paying inflated prices. However, this also means that you, as an insured person, must yourself cover an amount if the provider charges a higher price.

Limits

Insured products on the MiGeL must fulfil certain criteria if they are to be covered by basic insurance: They have a limit which may in particular depend on the quantity, duration of use, medical indication or age of the insured person. For example, per calendar year under basic insurance we may only reimburse the cost of two pairs of category A to D compression stockings up to the maximum price, or up to CHF 1,884 towards incontinence supplies in the case of total incontinence.

Special cases such as hearing aids and specially-made shoes

You receive an amount from IV or AHV insurance for certain aids and equipment such as hearing aids and specially-made shoes. Therefore, these items are listed in the MiGeL with a special note. You receive an amount from basic insurance for these products if the medical requirements under IV/AHV have been met but the insurance criteria have not been fulfilled.

Request for an amendment of the MiGeL

If someone would like to add, delete or change a product on the list, a written request must be sent to the Federal Office of Public Health (FOPH). The FOPH will then carry out the necessary clarifications and market analyses. It subsequently presents its results to the Swiss Federal Commission for Analyses, Aids and Artefacts (Eidgenössische Kommission für Analysen, Mittel und Gegenstände), which makes a recommendation to the Swiss Federal Department of the Interior. The Department then decides whether to make the addition, deletion or change. This process usually takes several months to a year.