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Partial reimbursement hospital contribution

Helsana reimburses its customers for any excess hospital cost contributions. From 2020, co-payments will be deducted in accordance with current legislation.

On 14 May 2019, the Federal Supreme Court ruled that the co-payment billing practice supported by the Federal Office of Public Health was not lawful. Previously, health insurers first charged the deductible. If it was used up, customers paid a 10% excess up to a maximum of CHF 700 per year. Finally, the hospital cost contribution of CHF 15 per day was charged for hospital stays. As a result, customers paid CHF 1.50 too much per day in hospital (10% of CHF 15).

Now, in the event of a hospital stay, the hospital cost contribution is deducted first, followed by the agreed deductible and then the excess. The systems were switched over on 1 January 2020, and Helsana will comply with the applicable legislation as of 2020.

From the date of the ruling – i.e. 14 May 2019 – the customers concerned will be reimbursed the amount overcharged to their customer account. The amount will be credited to the customer account on 30 January 2020. To keep administrative costs as low as possible, Helsana has opted not to inform customers by letter.

If you have any questions, we will be happy to help you.