Insurance cover abroad: frequently asked questions

If you need medical treatment while you are abroad, the costs involved are often higher than in Switzerland. Most accidents are covered under the compulsory accident insurance. Health insurance cover abroad or a supplementary insurance containing cover abroad gives you added protection from the financial consequences of unforeseen illness when you are travelling or during longer stays abroad.

Travel insurance is designed to cover general incidents on short trips. It covers people on holiday for emergencies such as

• cancellations
• lost luggage items
• lost property

And what about medical emergencies?

Most travel insurance doesn’t provide insurance cover in these cases. And even if it does, travel insurance only covers specifically defined short-term emergency medical treatment. As soon as you are fit to travel, you must make your own arrangements to travel back to Switzerland. And with certain travel insurance policies, you even need an upgrade to ensure that medical expenses abroad are covered.

Health insurance cover abroad covers, for example, your costs for

• Outpatient and inpatient emergency treatment worldwide. This applies to certain benefits provided in a general ward of a hospital that are not covered by basic insurance.
• Repatriation to Switzerland or transportation to the nearest suitable hospital if this is medically necessary.
• Missing person searches, rescue and recovery.

The Helsana supplementary insurances TOP, COMPLETA and WORLD cover these exact benefits*. Find the insurance best suited to you here:

* This is only applicable if: you contact our Emergency Call Centre immediately on +41 58 340 16 11 in the event of an emergency.

The costs of medical treatment abroad are often much higher than in Switzerland. Compulsory basic insurance as set out in the Federal Health Insurance Act (KVG) does not fully cover these costs for you in many countries. Even if you have to return to Switzerland for urgent treatment, the costs for repatriation are not covered.

In EU and EFTA countries, basic insurance under the Federal Health Insurance Act (KVG) covers costs for medically necessary treatment in public hospitals in accordance with the health insurance system of the relevant country. If you have to pay the invoice on site, the maximum amount covered is double the amount of the costs that you would pay for the same treatment in Switzerland. What is definitely not covered by basic insurance is inpatient treatment in private hospitals in European countries.

In all other countries, basic insurance under the Federal Health Insurance Act (KVG) covers a maximum of double the amount of the costs that you would pay for the same treatment in Switzerland. These costs are often higher than this amount in many countries.

It gets even more expensive for you if, for example, you have to return to Switzerland for an urgent operation. Compulsory accident insurance only pays costs for medically necessary rescue, recovery, travel and transport costs up to one-fifth of the currently insurable maximum amount. If you fall ill, insurance cover is even more limited. Compulsory basic insurance under the KVG does not reimburse any costs for repatriation to Switzerland.

For example, for a semester abroad or if you emigrate, health insurance cover abroad is often not only sensible, it is compulsory. Depending on the destination country, the legal requirements regarding insurance cover for long-term residents change.

But also if you are travelling abroad for short periods, it is worth getting health insurance cover abroad to protect yourself against any financial consequences. Medical treatment abroad is very often extremely expensive, and is not sufficiently covered under statutory health insurance. The US and Singapore are two of the most expensive countries, for example.

It depends on where you are. If you are repatriated in an ambulance jet from Greece, for example, this will cost around CHF 20,000. If you need to be repatriated from Thailand or the US, the bill will be around CHF 100,000. In short, the costs are high – and they are not fully covered unless you have health insurance cover abroad.

There are plenty of health insurance cover products for when abroad. The choice can be confusing. When deciding on your health insurance cover for abroad, consider:

• How long you will be travelling. Depending on the supplementary insurance, different time restrictions apply for cost coverage.
• Whether you belong to a risk group. Do you have any pre-existing conditions, are you pregnant or do you do sport for a living? This could mean that special conditions apply in your case.
• The benefits you want to be covered for. Maybe you want to have planned medical treatment done abroad? Or you only want to be insured for unforeseen emergencies? Get the ideal insurance cover for you – tailored to your needs:

It particularly makes sense to get health insurance cover abroad for countries outside the EU. This is because in these countries, you are only covered for a maximum of double the amount of costs which you would have to pay in Switzerland for the same treatment. And compared to Switzerland, some other countries have very expensive healthcare systems – for example the US, Australia, Singapore and Japan.

And what about in the EU?

In EU or EFTA countries, benefits are paid in accordance with the social insurance system in each particular country where you are staying. This applies for inpatient and outpatient treatment – but only in a general ward of a hospital. If you are in France or Spain, for example, and have to go to a private hospital in an emergency, or if your European Health Insurance Card is not accepted, the costs for necessary medical treatment can quickly shoot up. And basic insurance doesn’t cover repatriation either. So if you aren’t insured for something when you are there, this can have dramatic financial consequences for you.

An example: although the cost of inpatient treatment in France is covered by the European Health Insurance Card, you will still be charged a 20% excess for the costs. This can lead to big costs that are not covered.

In order to take out a TOP or COMPLETA supplementary insurance, for example, you have to complete a health declaration. It takes four to six weeks to have this checked. Want to travel at short notice? In this case, the WORLD product is best: you can take out this insurance without completing a health declaration as of the first day of the following month.

• Many countries require you to have a visa to enter. If you want to apply for a visa, you need confirmation from your health insurance company for this.
• Take a well-stocked travel first aid kit with you. Every country has its own risks. Find out what these are and equip yourself for any minor emergencies and first aid needs.
  You can get help from the Travelcheck hotline, for example. It is available free to anyone with TOP or COMPLETA insurance.

• Always carry your insurance card with you. The uniform back of the card is valid as a European Health Insurance card. It is accepted by all public hospitals, doctors and pharmacies in EU and EFTA countries. If for any reason the card is not accepted: our Emergency Call Centre is available for you around the clock.

Present your insurance card when you are in EU and EFTA countries. It is accepted by all public hospitals, doctors and pharmacies. In all other countries, you should do the following:

• Ask for proof of payment.
• Send the invoice, the proof of payment and the medical report to Helsana.
• Submit the form “Survey on illnesses or accidents while abroad”.
• We will review the documents and refund you the insured costs.

In EU and EFTA countries, unforeseen treatment for illness, accident or maternity that becomes medically necessary during your planned stay abroad is classified as an emergency.

In all other countries, an emergency is when you have an accident or illness, you require immediate medical treatment and a return to Switzerland is not feasible.

In an EU or EFTA country:

• Go to a state-recognised hospital or a state-recognised medical practice or pharmacy.
• Present your insurance card. State-recognised institutions will accept it and can process the costs directly. The medical care you receive will be subject to the fees and legal provisions of the country in question.

Outside the EU:

• Contact the Helsana Emergency Call Centre immediately. The number is on your insurance card.

What about if I have an accident?

Also inform your employer as soon as possible. This is because you are insured for accidents through your employer if you work more than eight hours per week for the same employer. This applies to both occupational and non-occupational accidents.

The employees of the Helsana Emergency Call Centre are available for you 24 hours a day. They take care of any immediate measures required.

• They provide hospitals with a cost payment guarantee so you do not have to make any advance payments (in line with supplementary insurance provisions).
• They arrange your repatriation to Switzerland if you have to be transported back for medical reasons.
• They help you to find a local doctor or hospital wherever you are.