BeneFit PLUS Telmed

Emergency treatment abroad (inpatient and outpatient)

The Agreement on the free movement of persons (AFMP) ensures that you have access to the same public healthcare services (doctors, pharmacies, hospitals and ambulances) within EU/EFTA/UK as the residents of the respective country. In the event of a medical emergency, you will therefore receive costs equivalent to the social tariff in the country of temporary residence.

In all other countries, you receive the costs of outpatient and inpatient emergency treatment up to twice the amount that would be covered by basic insurance in Switzerland (tariff in your canton of residence).

Transport

Overall, you receive 50% of the costs of planned transportation to a medical facility for medically necessary treatment, up to CHF 500 per calendar year.

Requirement

You choose a recognised mode of transport, such as a Spitex vehicle, a wheelchair-accessible taxi, a disability vehicle or an ambulance.

Rescue 

You receive 50% of the costs of rescue operations in Switzerland, up to CHF 5,000 per calendar year.

You receive the costs according to the tariff of the recognised specialist for the whole of Switzerland for treatment by federally certified doctors, chiropractors and medical support staff, such as physiotherapists, occupational therapists, nurses, midwives, speech therapists, etc.

Requirements

The treatment is prescribed by a doctor and listed in the benefits catalogue of the basic insurance.

You receive contributions towards the costs of the following types of complementary medicine:

• Anthroposophic medicine
• Classical homoeopathy
• Phytotherapy
• Pharmacotherapy within traditional Chinese medicine (TCM)
• Acupuncture
  

The costs are reimbursed according to the tariff of the recognised specialist for the whole of Switzerland.

Requirement

Your doctor holds a recognised certificate of competence awarded by the Swiss Medical Association (FMH) for these methods.

You receive the costs related to specific examinations for the early detection of illnesses and preventive measures that are prescribed or carried out by a doctor (e.g. isolated vaccinations).

The costs of a gynaecological check-up are covered for women every three years. The costs of mammograms are covered subject to certain conditions.

We would be happy to provide you with information on which examinations are covered by basic insurance in a phone call.

You receive the costs of medically prescribed aids and apparatus, such as crutches, blood glucose meters, inhalation/respiratory therapy equipment and compression stockings, up to the maximum amount specified by law.

Requirements

The medical aids are listed in the aids and equipment list and obtained from an authorised provider.

Check-ups and ultrasound examinations

• During a normal pregnancy, you are entitled to seven check-ups to be carried out by a doctor or by a midwife.
• We will also reimburse you for two ultrasound examinations carried out by a doctor.
• For a high-risk pregnancy, you will receive the costs of all necessary check-ups and ultrasound examinations.

Breastfeeding guidance                                                       

• You receive three sessions of breastfeeding guidance from a midwife or specially trained nurse.

Preparing for the birth

You receive CHF 150 per calendar year for

• birth preparation courses run by the midwife for individuals or groups
  

or

• a consultation with the midwife on the birth, planning and organisation of the postnatal period at home as well as preparations for breastfeeding.

Home birth

For a home birth, you receive the costs in accordance with the applicable tariff or contract of the midwife.

Hospital stays

If you have opted for an alternative insurance model, you will only receive these benefits subject to the following conditions:

• BeneFit PLUS General Practitioner: if the hospital stay has been prescribed by your GP or group practice.
• BeneFit PLUS Telemedicine: if the hospital stay has been prescribed by a doctor at the telemedicine centre.
• PREMED-24: if you have called the advice hotline and received non-binding health advice before the hospital stay.
  

You receive the costs of a stay in a general ward (multi-bed room), care and treatment in accordance with the standard rate in your canton of residence.

Exceptions

• If you need to find a hospital outside of the canton for medical reasons. 
• If an out-of-canton hospital is on the hospital list for your canton of residence.
  

Spitex

With care at home, the care specialist determines your expected care needs in terms of time required. We cover this cost based on the corresponding amount in Swiss francs specified by law. This is subject to the condition that Spitex (home nursing) is medically prescribed and that the chosen Spitex organisation or care specialist is qualified and recognised.

Nursing home

You receive the costs according to the applicable tariff for care services in a nursing home. The tariff is based on the level of care needed, as determined on your admission.

We cannot assume boarding costs (room and board at the nursing home) under basic insurance.

You receive CHF 10 per day for up to 21 days per calendar year for balneotherapy at recognised therapeutic spas in Switzerland.

Requirements

• The spa treatment is medically certified as necessary.
• The spa treatment is prescribed to you by a doctor.
• The spa treatment is carried out at a recognised therapeutic spa.