Inpatient treatment

HOSPITAL FLEX hospital insurance (flexible choice of ward)

With HOSPITAL FLEX supplementary hospital insurance you enjoy free choice of ward whenever you go into hospital: costs are always fully covered in the general ward. If you would like more comfort, privacy or a free choice of doctor, you can select a semi-private or private ward and share the cost up a set amount.

  1. What benefits are covered?
  2. For whom is this insurance recommended?
  3. Good to know
  4. How you can save premiums
  5. What is the purpose of hospital insurance?

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What benefits are covered?

Hospital stays in Switzerland
Flexible choice of ward

Hospital stays

In acute-care clinics, there is no time limit on the benefits you receive, while in psychiatric clinics you receive them for up to 180 days per calendar year.

You decide on a case-by-case basis whether you would like to be accommodated and treated in a general (multi-bed room), semi-private (two-bed room) or private (one-bed room) ward. Depending on which type of ward you choose, 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.

Depending on which version you opt for, you receive, for "rooming-in", i.e. the accommodation (including meals) in the hospital of an accompanying person closely connected to you (e.g. partner, parents or other close relatives) the following contributions towards costs:

FLEX 1

  • You receive CHF 50 per day for up to 15 days per calendar year.

FLEX 2

  • You receive CHF 100 per day for up to 15 days per calendar year.

Choice of hospital

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) general, half-privat and privat ward; in such cases, you may incur costs for which you alone will be responsible.

Further information

Choice of doctor

You have an unrestricted choice of doctor in any hospital in Switzerland if you stay in a semi-private or private ward. For example, you can even choose to be operated on by the head physician.

Hospital stays abroad
CHF 500 or CHF 1,000 per day

Emergency treatment abroad (inpatient)

In the event of emergency inpatient treatment abroad, you will receive the following contribution to costs that exceed the cover provided by basic insurance, depending on the option you have chosen.

HOSPITAL FLEX 1

  • You receive up to CHF 500 per day for up to 60 days per calendar year.

HOSPITAL FLEX 2

  • You receive up to CHF 1,000 per day for up to 60 days per calendar year.

Planned treatment abroad (inpatient)

The Swiss Health Insurance Act applies as the basis for cost reimbursement.

You will receive the following contribution to costs for planned inpatient treatment abroad, depending on the option you have chosen:

HOSPITAL FLEX 1

  • You will receive up to CHF 500 a day for up to 60 days per calendar year if you have obtained a confirmation of cost reimbursement from us in advance.

HOSPITAL FLEX 2

  • You will receive up to CHF 1,000 a day for up to 60 days per calendar year if you have obtained a confirmation of cost reimbursement from us in advance.

Lump sum on birth
CHF 500 or CHF 1,000

Home birth

For a home birth 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.

Balneotherapy and convalescent therapy
CHF 100 per day

Spa treatment

To find out which therapeutic spas are recognised by us, please contact your customer service team.

The duration of benefits for spa and convalescent therapies is 21 days in total.

You receive CHF 100 per day for up to 21 days per calendar year for spa therapies at recognised therapeutic spas in Switzerland.

Conditions:

  • You have selected the optional FLEX supplementary module.
  • The spa treatment is medically certified as necessary.
  • The spa treatment has been prescribed by a doctor.
  • The spa treatment is carried out at a therapeutic spa recognised by us.

Convalescent therapy

To find out which therapeutic spas are recognised by us, please contact your customer service team.

The duration of benefits for spa and convalescent therapies is 21 days in total.

You receive CHF 100 per day for up to 21 days per calendar year for convalescent therapies in Switzerland.

Conditions:

  • You have selected the optional FLEX supplementary module.
  • The convalescent therapy has been prescribed by a doctor.
  • The convalescent therapy is carried out at a therapeutic spa recognised by us.

Household help
CHF 50 per day

Following an acute inpatient hospital stay, you will receive CHF 50 per day for up to 30 days per calendar year for medically prescribed household help.

This cover is available provided you have also chosen the optional FLEX supplementary module.

Intensive and transitional care
CHF 100 per day

You will receive CHF 100 per day for up to 14 days per calendar year for the costs of boarding (room and board) in a nursing home during inpatient acute and transitional care.

Conditions:

  • You have selected the optional FLEX supplementary module.
  • Acute or transitional care has been prescribed by a doctor.
  • Your acute or transitional care immediately follows a hospital stay.
Nanny service
30 hours

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11.

You receive up to 30 hours of nanny services per calendar year if you have to be admitted to hospital as an inpatient.

While you are in hospital, an experienced carer will look after your healthy children aged up to 15 years on weekdays. This will enable you to recover in hospital at your leisure, while enjoying peace of mind that your children are being lovingly looked after at home.

Conditions:

  • You as a parent need to spend time in hospital as an inpatient.
  • You took out the insurance for the hospitalised parent (not for the child).
  • You have selected the optional FLEX supplementary module.
  • You arrange for our emergency call centre to handle the organisation at every stage.

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For whom is this insurance recommended?

  • People who would like to decide on a case-by-case basis what level of comfort and additional medical services they require.

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Good to know

Who can take out this policy?

You can take out this policy if you meet the following conditions:

  • You are officially resident in Switzerland.
  • HOSPITAL FLEX 1: You are under the age of 70 when you take out the policy.
    HOSPITAL FLEX 2: You are under the age of 50 when you take out the policy.
  • We accept your application. For the purposes of risk assessment, we require you to fill in a health declaration.
How long does the policy run?

You can also take out a multi-year policy for three or five years. That way, you benefit from a premium rebate and other notice periods apply.

  • 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 policy as of 31 December each year. There is a notice period of three months.
  • If the premium is adjusted, a shortened notice period of one month applies.
Is there a waiting period?

The waiting period is the period between the date on which the insurance cover under your policy begins and the date from which you can claim benefits.

  • With this insurance, a waiting period of 365 days applies in cases of pregnancy. That means you cannot claim benefits before the end of the first insurance year. During the first insurance year, any pregnancy-related stays in hospital – for example for childbirth or rooming in – are covered only by your basic insurance. The latter covers the costs of a stay in a general ward (multi-bed room) and medical treatment in accordance with the standard rate in your canton of residence.
  • By contrast, you are covered from the start of insurance for benefits paid as a result of illness or accident.

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How you can save premiums

Multi-year policies
Minimum 3% discount

The longer the term of the contract you select, the more discount you receive:

Term of the contract Saving
Five years, 3 months notice period (standard) 5% discount
Three years, 3 months notice period (standard) 3% discount
One year, 3 months notice period (standard) No discount

Please note that it is not possible to have contracts with different terms, so you have to take out all supplementary insurance policies over the same term.

Accident cover excluded
10 % discount

The accident cover in our supplementary insurance complements certain benefits that are not covered, or are only insufficiently covered, by your employer's compulsory accident insurance (or compulsory basic insurance if you are employed by an employer for fewer than eight hours a week).

That means you can exclude the accident cover from voluntary supplementary insurance if you have equivalent private accident insurance or are well covered by your employer's accident insurance – for example, for a private or semi-private ward instead of the compulsory general ward in the hospital. This reduces the premium for your supplementary insurance by 10%.

If you are not sure which benefits your accident insurance covers, please contact your employer to ask before excluding accident cover from your supplementary insurance.

Family discount
Minimum 5 % discount

Currently, you get the following family discounts on supplementary insurance from the Helsana Group:

  • 5% discount if there are two people in the same household
  • 10% discount if there are three or more people in the same household

Details on family discount

Children’s starting discount
50% discount

If you meet the following criteria as a new client of the Helsana Group (Helsana or Progrès), you get a 50% premium discount on supplementary insurance in the first year:

  • You are under the age of 18 when you take out the policy.
  • You take out basic insurance with us at the same time or have taken it out not more than a year previously.
  • Your previous health insurer for compulsory basic insurance is not a member of the Helsana Group.
  • At least one adult member of your household has basic insurance in a shared family policy.

After the end of the first year of insurance, the full supplementary insurance premium becomes payable, so the premium statement you'll receive from us for the following year will be for a higher amount.


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What is the purpose of hospital insurance?

Hospital insurance allows you to enhance your basic hospital insurance cover for inpatient treatment with benefits of your choice.

Basic insurance covers only the cost of accommodation and medical treatment in a general ward (multi-bed room) in line with the rates in your canton of residence. You have to pay for anything in excess of that yourself, e.g. additional benefits for greater comfort, care or free choice of doctor/hospital – precisely the things that can make a stay in hospital considerably more pleasant.


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