Hospitals not recognised by Helsana – what does this mean for you?
We regularly negotiate with hospitals to ensure your premiums remain affordable. During this process, we advocate for fair prices and transparent statements. If we are unable to reach an agreement with a hospital – for example, because the prices it is asking for are too high – no contract will be concluded for its private or semi-private wards.
This means that we do not recognise the hospitals in question or the physicians who work there. Depending on your supplementary hospital insurance, this may mean that you will have to pay some or all of the costs of additional benefits received in the private or semi-private wards of those hospitals. Please refer to the section in your supplementary hospital insurance to find out which hospitals are affected. We regularly update the relevant hospital lists.
Is my supplementary insurance affected, and how can I avoid additional costs?
If a hospital has not signed a contract with us, we will not assume any costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. In order to ensure that no uncovered costs arise, we will be happy to advise you and point out the possibility of being treated at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
If a hospital has not signed a contract with us, we will not assume any costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. In order to ensure that no uncovered costs arise, we will be happy to advise you and point out the possibility of being treated at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
If a hospital has not signed a contract with us, we will not assume any costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. In order to ensure that no uncovered costs arise, we will be happy to advise you and point out the possibility of being treated at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
Applies from 1 January 2025
If a hospital has not signed a contract with us, we will not assume the full costs for an inpatient stay in a private or semi-private ward under supplementary hospital insurance. The insured person pays some of the costs of the additional benefits via the 30% excess.
We would be happy to advise you to help ensure that no uncovered costs are incurred. You can receive treatment at other hospitals nearby. Please check the list below to make sure that we will pay the full costs of your inpatient hospital stay:
Applies until the end of 2024
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
If a hospital has not signed a contract with us, we will assume the reasonable costs of additional benefits provided in connection with treatment as part of the cantonal service mandate. Please contact your Customer Advisor if you have any questions about this.
If the additional benefits are provided in connection with treatments outside the cantonal service mandate, we will not cover the costs under either our basic insurance or our supplementary hospital insurance. These will therefore be borne by the insured person. We reserve the right to check the details of the invoiced benefits and prices. Please note the following list:
What terms apply to hospitals that do not have a service mandate from the canton?
The hospitals listed below, which do not have a service mandate from the canton, are recognised by us for the purposes of supplementary hospital insurance (Helsana KVG contract hospitals).
If you are admitted to one of these hospitals, the costs will be covered under your supplementary hospital insurance. Please check the following list:
Frequently asked questions
It is important to us to stabilise and maintain benefit costs and thus also premiums. In order to ensure that this is the case, we consistently negotiate with hospitals. That is why we decided to only conclude contracts with hospitals that do not charge unusually high costs for Helsana patients.
We strive to conclude contracts for semi-private and private wards with all hospitals that work well and efficiently. An unregulated situation only arises in exceptional cases, following the failure of multilevel negotiations.
It varies. An unregulated situation is undesirable for both the insurance company and the hospital: the insurance company annoys those customers that are affected and the hospital loses important income. Both sides therefore try to find a solution as quickly as possible. However, as the positions of the opposing parties can often be far apart in such cases, experience has shown that this kind of situation can persist for between two and six months, and even longer in rare instances.
If you have already received an undertaking to pay the costs of your medical procedure, you are not affected by this. If you are uncertain or no undertaking to pay costs has been given, it is particularly important to us that you contact us. We will gladly advise you at any time and do everything in our power to ensure that we can offer you first-class service. Together, we will find an equivalent hospital near you in which the costs are covered pursuant to your supplementary hospital insurance.
Depending on a hospital’s size and importance, we proactively inform the people insured with us of any unregulated situation and when it comes to an end.
In clear emergencies, every hospital is obliged to provide the necessary medical services. The costs of stays in the accident and emergency and/or general ward are borne by compulsory health insurance, and are covered as a matter of principle.
If a contract has not been concluded with the hospital, you will have to pay some or all of the costs for stays in a private or semi-private ward yourself.
Please note that the hospitals in question are obliged to inform patients about their unregulated status with respect to Helsana.
No. The same terms apply to both illnesses and accidents.
Please note that the hospitals in question are obliged to inform patients about their unregulated status with respect to Helsana.
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