HOSPITAL FLEX
Flexible supplementary inpatient hospital insurance with a free choice of ward on a case-by-case basis (with co-payment). Unrestricted choice of doctor and hospital with hospitals and doctors recognised by Helsana.
Insured benefits
With HOSPITAL FLEX supplementary hospital insurance, you receive the following benefits in addition to statutory benefits covered by basic insurance:
Hospital stays
You decide on a case-by-case basis whether you would like to be accommodated in a general (multi-bed), semi-private (2-bed) or private (individual room) ward. Depending on which type of ward you select, you pay for part of the costs yourself:
HOSPITAL FLEX 1
- General: you receive the costs in full.
- Semi-private: you pay 35% of the costs up to CHF 3,000 per calendar year.
- Private: you pay 50% of the costs up to CHF 9,000 per calendar year.
HOSPITAL FLEX 2
- General: you receive the costs in full.
- Semi-private: you pay 20% of the costs up to CHF 2,000 per calendar year.
- Private: you pay 35% of the costs up to CHF 4,000 per calendar year.
What does your basic insurance cover?
You will be reimbursed only for the costs of a stay, care and treatment in a general ward (multi-bed room).
Choice of hospital
You have free choice of hospitals in the whole of Switzerland. Please note that if you stay in hospitals that are not recognised by Helsana, you must pay for the costs yourself.
What does your basic insurance cover?
Basically you are free to choose any hospital in Switzerland that is on a cantonal hospital list (“listed hospitals”). If the hospital is on the list of hospitals in your canton of residence, the costs of a stay, care and treatment in a general ward (multi-bed room) are covered. This applies to emergencies or medically necessary treatments that are not offered in your canton of residence. However, if for personal reasons you receive treatment in a hospital outside of your canton, which is not included on the list of hospitals in your canton of residence, basic insurance only covers the amount that would be reimbursed in your canton of residence (basic rate). If the tariff for the hospital you select is higher, then you must pay the additional costs yourself.
Choice of doctor
If you stay in a semi-private or private ward, you have free choice of doctor throughout Switzerland in a hospital recognised by Helsana. This means you can have the head physician operate on you, for example.
Please note: if you choose a doctor that is not recognised by Helsana, you may have to pay for some of the costs yourself.
Different regulations governing the choice of doctor and hospital for customers with AICs issued in 2012 or 2014
Please note: The information provided on this page regarding the choice of doctor and hospital applies exclusively to insured persons who have taken out HOSPITAL FLEX insurance with the Additional Insurance Conditions (AIC) dated 1 January 2025.
If you have taken out HOSPITAL FLEX with the versions of the AICs dated 1 January 2012 or 1 January 2014, the information below applies to you:
Emergency and planned treatments abroad (inpatient)
For emergency inpatient or planned inpatient treatments abroad you receive up to CHF 1,000 per day for up to 60 days per calendar year. This means you can pay any costs for emergency treatments abroad that exceed the benefits covered by basic insurance. If you plan a treatment abroad, you can use this financial support to offset the costs of treatment, provided that you have obtained approval of the costs from us in advance.
Depending on which option you choose, you will be paid out the following contributions:
- HOSPITAL FLEX 1 variant: you receive CHF 500 per day for up to 60 days per calendar year.
- HOSPITAL FLEX 2: you receive CHF 1,000 per day for up to 60 days per calendar year.
What does your basic insurance cover?
Within the EU/EFTA/UK the costs of emergency treatments abroad are paid in accordance with the basic rate of the respective country. In other countries, it covers a maximum of twice the cost of the same treatment had it been provided in Switzerland (tariff of the canton of residence). However, in many countries this amount is not nearly sufficient to cover the costs of treatment.
It does not cover the cost of planned treatments abroad.
Depending on which version you opt for, you receive accommodation (including meals) in the hospital for an accompanying person closely connected to you (e.g. partner, parent or other close relative) and the following contributions towards costs:
- FLEX 1 variant: you receive CHF 50 per day for up to 15 days per calendar year.
- FLEX 2 variant: you receive CHF 100 per day for up to 15 days per calendar year.
What does your basic insurance cover?
Basic insurance does not cover the costs of rooming in.
Childcare service must be scheduled via our Emergency Call Centre. You can reach the Emergency Call Centre 24 hours a day on 058 340 16 11.
Childcare service is limited to Switzerland. It is not provided abroad. While you are in hospital, an experienced carer will look after your healthy children aged up to 15 from Monday to Friday. This will enable you to recover in hospital while your children are being looked after at home.
Requirements
- You have taken out the FLEX supplementary module.
- You as a parent need to spend time in hospital as an inpatient.
- As the parent who must be hospitalised, you have taken out HOSPITAL FLEX supplementary hospital insurance.
- You allow our Emergency Call Centre to handle every stage of the arrangements.
Invoice form
Haven’t received a detailed invoice? Please fill out the following invoice form in full and send it to us. You can find the submission options here.
What does your basic insurance cover?
Basic insurance does not cover any costs. Patients have to pay for the childcare service themselves.
For a home birth or a delivery in a hospital or birthing centre on an outpatient basis, you receive the following lump sums on birth, depending on which option you have chosen:
- HOSPITAL FLEX 1: you receive CHF 500 per birth.
- HOSPITAL FLEX 2: you receive CHF 1,000 per birth.
There is a waiting period of 365 days for maternity benefits from the start of insurance.
What does your basic insurance cover?
No benefits from the basic insurance. The mother does not receive any maternity allowance on giving birth.
Spa treatment
You receive CHF 100 per day for up to 21 days per calendar year for inpatient spa therapies at therapeutic spas in Europe.
Requirements
- You have taken out the optional FLEX supplementary module.
- The spa treatment is medically certified.
- The spa treatment is prescribed for you by a doctor for at least 14 days.
- The spa treatment is carried out at a therapeutic spa recognised by the Swiss Health Insurance Act (KVG). To find out which therapeutic spas are recognised by us, please contact our customer service team.
What does your basic insurance cover?
You receive CHF 10 per day for up to 21 days per calendar year.
Convalescent therapy
You receive CHF 100 per day for up to 21 days per calendar year for convalescent therapies in Switzerland.
Requirements
- You have taken out the optional FLEX supplementary module.
- The convalescent therapy is prescribed for you by a doctor and is medically necessary.
- The convalescent therapy is carried out at a convalescent facility recognised by us. To find out which convalescent facilities are recognised by us, please contact our customer service team.
What does your basic insurance cover?
Basic insurance does not cover any costs for convalescent therapies.
Spa stay in Bad Zurzach
If you are planning your spa stay in Bad Zurzach, your accompanying person will benefit from free overnight stays in the same room.
If an acute inpatient hospital stay or stay in a convalescent facility can be prevented or at least reduced by medically prescribed household help, then you receive up to CHF 50 per day for up to 30 days per calendar year.
What does your basic insurance cover?
Basic insurance does not cover any costs. Patients who require household help after a stay in hospital have to finance this themselves.
Requirements
- You have taken out the optional FLEX supplementary module.
- The acute or transitional care is prescribed for you by a doctor.
- The acute or transitional care immediately follows a hospital stay
What does your basic insurance cover?
Basic insurance does not cover any costs for convalescent therapies in a nursing home.
Please note that you will only receive contributions towards convalescent treatment, household help, the nanny service, and acute and transitional care if you have also taken out the FLEX supplementary model.
Advantages for persons insured with supplementary insurance
Frequently asked questions
Supplementary hospital insurance allows you to enhance your basic hospital insurance cover for inpatient treatment with benefits of your choice.
Basic insurance only reimburses you for the tariff set in your canton of residence for your stay and medical treatment in a general ward (multi-bed room), provided the hospital is on the hospital list in your canton of residence or for medical reasons you require treatment in an out-of-canton hospital. You must pay for all extra benefits yourself – such as household help following an acute hospital stay or childcare while you are recovering in the hospital. That is why these supplementary benefits give financial peace of mind.
HOSPITAL FLEX is ideal for those who want to be able to choose the type of ward each time they go to hospital. The selected type of ward then determines the room comfort and additional services:
- For minor operations a hospital stay in the general ward is usually sufficient. Then you do not have to pay any additional costs.
- For longer hospital stays you may prefer to have a quieter space with more privacy. In this case, for an additional charge (co-payment) you can choose a semi-private (double room) or private ward (individual room).
- You may want to have certain operations performed by a specific doctor – for example when highly complex surgery is needed. However, the free choice of doctor is only available in a semi-private or private ward.
HOSPITAL FLEX is so favourably priced because you only pay for what you actually need.
If you only want to cover expensive hospital costs, just take out the main module in the variant FLEX 1 or FLEX 2. If you also want contributions paid towards convalescent treatments, household help and other supplementary benefits, however, you can also take out the FLEX supplementary module.
A waiting period is the time (from the start of the contract) during which you do not yet have a claim to insurance benefits. The length of the waiting period can vary depending on the insurance benefit.
There is a waiting period of 365 days for maternity benefits. That means you cannot claim these benefits before the end of the first insurance year. Your maternity stay in a hospital in the first year would only be covered through basic insurance – for childbirth and postpartum, for instance. You receive the costs of a stay, care and treatment in a general ward (multi-bed room) based on the tariff in your canton of residence.
However, you are covered from the start of insurance for benefits paid as a result of illness or accident.
With HOSPITAL FLEX supplementary hospital insurance, you do not pay for hospital costs if you stay in a general ward.
If, on the other hand, you decide on a semi-private or private ward, you have to contribute towards your hospital costs:
Semi-private ward
- FLEX 1 variant: 35% cost contribution up to CHF 3,000 per calendar year
- FLEX 2 variant: 20% cost contribution up to CHF 2,000 per calendar year
Private ward
- FLEX 1 variant: 50% cost contribution up to CHF 9,000 per calendar year
- FLEX 2 variant: 35% cost contribution up to CHF 4,000 per calendar year
No. The free choice of doctor only applies to hospital stays in a semi-private or private ward. This means that if you select the general ward you cannot choose the doctor who operates on you.
Basically you are free to choose the hospital you want anywhere in Switzerland. However, certain hospitals and clinics or their wards or tariffs are not recognised by Helsana. As a result, you may have to pay for some of these costs yourself.
So please ask us before you are hospitalised, whether we will cover all the costs of your hospital stay.
You can take out this insurance if you meet the following conditions:
- Is your official residence in Switzerland?
- HOSPITAL FLEX 1: Will you be under the age of 70 when you take out the policy?
- HOSPITAL FLEX 2: Will you be under the age of 70 when you take out the policy?
- Then you are eligible for these options. For the purposes of risk assessment, we require you to fill in a health declaration.
The minimum term is one year. The contract is automatically renewed each year on the expiry date for a further year.
You can terminate the insurance on 31 December of each year and switch to another health insurance company in Switzerland. Three months’ notice of termination must be given. Notice of termination must reach us by no later than the last working day in September. If the insurance premium changes, a one-month notice period applies. In this case, notice of termination must reach us by no later than the last working day in November.
- For two or more family members insured under the same contract, we grant a family discount of 5% on this and other supplementary insurances; for three or more insured family members, the discount is 10%.
A room upgrade on its own isn’t possible. HOSPITAL FLEX is an insurance package and covers the costs for additional hotel-style services and free choice of doctor. If you wish a one-bed room, you will be treated as a private patient, including free choice of doctor and additional comfort, in which case you will also be responsible for the co-payment for a private ward. If you choose a general ward, we will pay the additional costs if you choose a hospital outside your canton of residence for your treatment.
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Other supplementary insurance
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