FAQ: insurance cover abroad

How does insurance cover abroad work? Things you need to know.

What is classed as an emergency?

An emergency is when you experience an accident or illness abroad, you require immediate medical treatment and a return to Switzerland is not feasible.

Do I have enough insurance cover in case of an emergency abroad as well?

In the case of medically necessary treatments in EU and EFTA countries, benefits are paid in accordance with the health insurance system in the country where you are staying. If you pay the invoice on site, you can subsequently submit it to Helsana for checking. The maximum cover is twice the amount of costs that would be incurred in Switzerland for the same treatment. Please note that basic insurance only covers treatments by public service providers in the country of residence. Services provided by private doctors are not covered.

If you have taken out TOP, COMPLETA, WORLD or OMNIA supplementary insurance, you will be reimbursed for the full costs of outpatient and inpatient treatments in the general ward that exceed the benefits covered by basic insurance. The costs for medically necessary repatriation to Switzerland are also covered. You also benefit from the payment of costs for inpatient services that are not covered by basic insurance with Supplementary Hospital Insurance.

Good to know

A health declaration is not required to take out WORLD because pre-existing conditions are generally not covered. This means that you cannot make any claims for the cost of treatment for medical conditions or accidents which had already arisen or were known to you before the commencement of the insurance cover or the date on which you booked your travel.

More information about health insurance cover abroad (in German) Overview: what’s covered abroad
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What do I need to do in the event of an emergency abroad?

Present your insurance card when receiving treatment in EU and EFTA countries. State-recognised hospitals, doctors and pharmacists will accept this and can process costs directly. Please contact the Helsana Emergency Call Centre if you are not in an EU or EFTA country, or if you require additional assistance. The number is printed on your insurance card.

What to do in the event of an accident

If you work for the same employer for at least eight hours a week, you are insured against occupational and non-occupational accidents via your employer. You should therefore inform your employer as quickly as possible if you have an accident abroad.

How does the Helsana Emergency Call Centre support me?

The employees of the Helsana Emergency Call Centre are here for you 24 hours a day and take the immediate measures required. They provide the hospital with the cost coverage guarantee so you do not have to make any advance payments. If you need to be repatriated to Switzerland for medical reasons, the Helsana Emergency Call Centre will arrange this for you. However, you can also count on the employees of the Emergency Call Centre to help you find a local doctor or hospital – quickly, reliably and without any red tape.

Do I need to pay doctor’s and hospital invoices on site?

In some cases, yes. Ask for proof of payment if you must pay for benefits on site. Then send the invoice, the proof of payment and the medical report to Helsana. Also submit the form "Survey on illnesses or accidents while abroad". We will review the documents and refund you the insured costs.

How much will repatriation to Switzerland cost me if I do not have supplementary insurance?

It depends entirely on where you are. If you are repatriated in an ambulance jet from Greece, this will cost around CHF 20,000. If you need to be repatriated from Thailand or the USA, the invoice will be around CHF 100,000.

Good to know

The compulsory accident insurance pursuant to the Federal Accident Insurance Act (UVG) pays the costs for medically necessary rescue, recovery, travel and transport costs up to one-fifth of the currently insurable maximum amount. That is equivalent to a maximum of CHF 29,640.

An illness is a different matter. The Federal Health Insurance Act (KVG) specifies that repatriation to Switzerland is not reimbursed. 

What do I need to look out for if I travel abroad at short notice?

In order to take out TOP, COMPLETA and OMNIA supplementary insurance, you have to complete a health declaration. It takes four to six weeks to check it. The WORLD product is suitable if you travel abroad at short notice: it is possible to take it out without completing a health declaration as of the first of the following month in each case.

What else do I need to think about when I travel abroad?

If you have to apply for a visa, you need confirmation from your health insurance company for this purpose. Also make sure you take a well-equipped travel first aid kit with you and always have your insurance card on you.

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