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Optional supplementary insurance

Supplementary insurance for outpatient treatment

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Coverage abroad and more: TOP supplementary healthcare insurance

TOP coverage abroad: whether you need outpatient or inpatient emergency treatment, transport and rescue, or repatriation to Switzerland – with TOP supplementary insurance you enjoy the best health insurance abroad as well.

In addition, you also receive contributions for spectacle lenses and contact lenses, medications not covered by statutory health insurance, medical aids, transport and rescue in Switzerland, non-medical psychotherapy, braces for children, and much more.

For visual aids, coverage abroad, medications, psychotherapy and more: TOP includes the most popular supplements to basic insurance.

Insurance benefits

With TOP supplementary insurance, you receive the following insurance benefits in addition to the statutory basic insurance benefits:

Abroad 100% of excess costs

Emergency treatment abroad (outpatient)

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care locally and take care of all the necessary formalities.

For outpatient emergency treatment during a temporary stay abroad of up to 12 months you will receive 100% of the costs that exceed the cover provided by basic insurance.

Conditions:

  • A journey home or transportation to Switzerland is not reasonable.
  • You arrange for our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

For emergency treatment in EU/EFTA countries, basic insurance covers the costs in accordance with the social tariff 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). This is nowhere near enough in some countries, such as the US, Canada, Japan and Australia.

Details about basic insurance >

Emergency treatment abroad (inpatient)

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care locally and take care of all the necessary formalities.

For inpatient emergency treatment during a temporary stay abroad of up to 12 months you will receive all of the costs in a general ward that exceed the cover provided by basic insurance.

Conditions:

  • A journey home or transportation to Switzerland is not reasonable.
  • You arrange for our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

For emergency treatment in EU/EFTA countries, basic insurance covers the costs in accordance with the social tariff 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). This is nowhere near enough in some countries, such as the US, Canada, Japan and Australia.

Details about basic insurance >

Aids to vision (spectacle lenses and contact lenses) 90% up to CHF 150 per year.

You get 90% of the costs of spectacle lenses and contact lenses up to CHF 150 per calendar year.

What does basic insurance cover?

Children and young people up to the age of 18 receive CHF 180 per year towards spectacle lenses and contact lenses. Adults have to pay for these themselves.

Details about basic insurance >

Medicines 90%

You receive 90% of the costs of medically prescribed medications that are not covered by basic insurance ("non-reimbursed medications").

This is subject to the condition that the medication is approved by the Swiss Agency for Therapeutic Products Swissmedic for the treatment of the existing illness.

Medications on the list of pharmaceutical products with special application (LPPV) or its supplementary list are excluded.

Further information

What does basic insurance cover?

Only medically prescribed medications that are on the specialities list (SL) are covered. Patients have to pay for any medications not covered by statutory health insurance themselves – even if it was prescribed by a physician.

Details about basic insurance >

Transport and rescue in Switzerland CHF 100'000.-

Transport at home

In addition to the transportation benefits provided by the basic insurance, you receive CHF 100,000 per calendar year for transportation that is required on medical grounds within Switzerland.

The total amount is payable to cover all rescue, recovery, relocation and emergency transportation services.

What does basic insurance cover?

Only 50% of the costs are reimbursed, with an annual maximum of CHF 500 for transport and an annual maximum of CHF 5,000 for rescue.

Details about basic insurance >

Rescue at home

CHF 100,000 is the total amount payable to cover all rescue, recovery, relocation and emergency transportation services.

Transport and rescue abroad (personal assistance) 100%

Transport abroad

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

You receive the costs overall for transportation to the nearest suitable hospital.

Conditions:

  • You have to organise the necessary through the emergency call centre.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Rescue abroad

For rescue abroad it is necessary to organise the necessary through the emergency call centre. You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

For rescue you receive the overall costs for transportation to the nearest suitable hospital.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Search and rescue

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

You receive up to CHF 20,000 in any one calendar year for search and recovery operations undertaken for the purpose of rescuing or recovering you.

  • Conditions:
  • You allow our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Repatriation

Your health is our top priority – including if you become ill or suffer an accident abroad. Our emergency call centre is available around the clock on +41 58 340 16 11.

They will coordinate medical care at the location and take care of all the necessary formalities.

You receive all of the costs of repatriation to your place of residence or to a hospital in Switzerland.

Conditions:

  • You allow our emergency call centre to handle the organisation at every stage.
  • A doctor authorised by us confirms that your repatriation is a necessity.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves. However, repatriation often costs tens of thousands of francs – for example, when a patient needs to be repatriated by air in an ambulance jet.

Details about basic insurance >

Travel for visitors

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

If you have to spend more than seven days in a foreign hospital, our emergency call centre will organise and pay for round-trip travel for a close friend or relative (proven costs, up to a maximum of the price of one economy flight). You will also receive the proven costs of up to CHF 1,000 per event for your visitor's room and board.

Conditions:

  • You allow our emergency call centre to organise every stage of the visit.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Return journeys

You can reach the emergency call centre 24 hours a day on +41 58 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

If you are prevented by hospitalisation from boarding your return flight, you will receive the flight re-scheduling fees for your return flight. If you cannot be booked onto another flight, you will receive the fees for a return flight in economy class.

Conditions:

  • You allow our emergency call centre to handle the organisation at every stage.
  • You submit your expired return flight ticket.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Treatment of tooth misalignment 75% up to CHF 10'000.–

Teeth are misaligned if they do not fit ideally into the dental arch; this has a negative cosmetic impact. Braces can be used to correct such misalignments.

If you undergo this treatment abroad, you can claim the actual costs up to the amount which the treatment would have cost in Switzerland. Treatment in Switzerland is subject to the scale of fees published by the Swiss Association of Dentists (SSO).

Until you reach the age of 20, you receive 75% of the costs up to CHF 10,000 per calendar year for the treatment of misaligned teeth (e.g. dental braces).

Our contribution will be reduced by any contribution to costs that you have received from school or youth dental care programmes in Switzerland.

You are not entitled to any contribution for dental products such as toothbrushes, toothpaste or dental floss.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for planned corrective measure for misaligned teeth themselves. However, braces can cost thousands of francs per year.

Details about basic insurance >

Medical aids and equipment 90% up to CHF 1,000 / Fixed amount

You receive 90% of the costs of medically prescribed aids and equipment that improve restricted body functions, such as blood pressure monitors and orthopaedic shoe inserts, up to CHF 1,000 per year.

This is on condition that the aids and equipment are recognised by us.

For reusable aids, you receive costs up to the fixed amount. You can find these in the list of reusable aids and equipment.

Further information

What does basic insurance cover?

Only the statutorily defined maximum costs for medical aids and equipment prescribed by a doctor that is included on the list of aids and equipment (MiGeL) are covered

Details about basic insurance >

Special forms of treatment 75% up to CHF 3,000

Psychotherapy

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You can claim 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Non-medical psychotherapy belongs to this group.

Conditions:

  • The therapy is prescribed by a doctor.
  • The therapy is carried out by a psychotherapist recognised by us.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Sterilisation

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You can claim 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Sterilisation is one of them.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Vasectomy

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You receive 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Vasectomy is one of them.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Foot care

75% of the costs for medical foot care, podology, shall be covered (for a flat-rate attendance fee of no more than CHF 110).

Conditions:

  • Treatment is provided by an accredited chiropodist who is a member of a chiropodists' association and is additionally qualified to treat diabetics.
  • Treatment has been prescribed by a doctor.
  • The precise diagnosis is stated in the prescription.

If you do not have diabetes and need foot treatments, please ask us in advance whether and under what conditions you would receive a contribution to help cover the costs from your supplementary insurance policies.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Healthcare and foreign legal expenses insurance Up to CHF 250,000 per case

Legal protection in health matters

  • Legal advice and representation for legal disputes.
  • You can claim up to CHF 250,000 per dispute (or CHF 50,000 in cases outside Europe) to cover lawyers' fees, court and procedural expenses, expert witnesses, court fees and compensation for the other party.
  • This policy covers disputes with doctors, hospitals and providers of social insurance and private liability insurance.
What does basic insurance cover?

Costs are not covered by basic insurance. Costs are not covered by basic insurance. The insured parties have to pay for legal protection benefits themselves.

Details about basic insurance >

Legal Protection Abroad

  • Legal advice and representation for legal disputes.
  • You can claim up to CHF 250,000 per dispute (or CHF 50,000 in cases outside Europe) to cover lawyers' fees, court and procedural expenses, expert witnesses, court fees and compensation for the other party.
  • The policy covers disputes in your capacity as the driver, hirer or user of transportation or as a pedestrian during holidays and while attending foreign schools (including transport to and from the school).
What does basic insurance cover?

Costs are not covered by basic insurance. The insured parties have to pay for legal protection benefits themselves.

Details about basic insurance >

Travelcheck Inclusive

You benefit from free telephone travel advice from Travelcheck. This service provides you with 24-hour individual information about health risks in the country you are visiting: +41 43 340 16 22.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. The insured parties have to pay for this service themselves.

Details about basic insurance >

Calculate premium / request quote

Select your desired insurance cover. You can then request a quote or conclude the insurance directly online.

Premium calculator

FAQs

Answers to frequently asked questions about TOP supplementary healthcare insurance:

Why do I need supplementary healthcare insurance?

Many treatments are covered only partially, if at all, by basic insurance, even though many really need them. This is why it is often a good idea to take out one or more supplementary insurance policies for outpatient treatment – also known as supplementary healthcare insurance. These not only cover the cost of conventional outpatient treatment, but also pay contributions towards the cost of fitness courses and gym memberships, cover abroad, medication, dental treatment and much more.

In short, by taking out supplementary insurance you can expand the benefits you receive under basic insurance based on your needs and can fill important gaps in coverage.

I’m travelling to the US for three weeks. Do I need special travel insurance?

No, with TOP supplementary insurance you are sufficiently insured against medical emergencies while travelling abroad:

  • Within the EU/EFTA, the costs for outpatient and inpatient emergency treatment are already covered by your basic insurance. Under the agreement on the free movement of people, you are entitled to the same access to public healthcare – doctors, pharmacies, hospitals and ambulances – as residents of the country you are staying in. You only pay any applicable local statutory co-payments.
  • In other countries, your basic insurance will cover up to twice the cost of the same treatment in Switzerland. If treatment costs abroad are more expensive – which is often the case in countries with high medical costs, such as the US, Japan, Canada and Australia – TOP covers the costs in excess of this amount.

In the event of an emergency abroad, you should always contact our Emergency Call Centre on +41 58 340 16 11.

Do I need a prescription from a doctor or an ophthalmologist for my glasses?

No, not if the strength of your eyeglasses (in dioptres) is indicated on the optician's invoice.

My child needs braces. Does Helsana accept dentists in Germany?

TOP covers 75% of the costs up to CHF 10,000 per year for your child's orthodontic treatments until they reach age 20.

If your child undergoes this treatment abroad, you can claim the actual costs up to the amount the treatment would have cost in Switzerland. Treatment in Switzerland is subject to the scale of fees published by the Swiss Association of Dentists (SSO). However, this is subject to the condition that the foreign dentist has training equivalent to dentists in Switzerland.

Who can take out this insurance?

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

  • You have your official place of residence in Switzerland.
  • You are under the age of 65 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 and when can I terminate the insurance?
  • 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 on 31 December of each year, subject to three months' notice.
  • If the premium is adjusted, a shortened notice period of one month applies.

Details about termination >

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

Details about long-term policies >

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.

  • For maternity benefits, there is a waiting period of 365 days. That means you cannot claim these benefits before the end of the first insurance year.
  • However, you are covered from the start of insurance for benefits paid as a result of illness or accident.
Is there a discount? How can I save on premiums?

If you conclude a three or five-year insurance policy, you receive a premium discount of 3% or 5% respectively.

Details about long-term policies >

If you have equivalent accident insurance, you can exclude the accident cover and thus reduce your premium by 10%.

Details about accident cover exclusion >

For two or more family members insured under the same contract we grant a family discount of 5% on this and other supplementary insurance; for three or more insured family members the discount is 10%.

Details about the family discount >

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