Cost participation

Insured persons have to participate in the costs of their medical treatment. This participation includes a fixed annual amount (franchise), plus 10% of the costs exceeding the amount of the franchise (share). Further, in case of in-patient hospital treatment, a daily contribution has to be paid.

  • The lump sum (franchise) amounts to CHF 300 per calendar year. No franchise is charged for children.
  • The maximum yearly amount of the 10% share amounts to CHF 700 for adults and CHF 350 for children up to the completed age of 18.
  • The daily contribution to the costs of an in-patient hospital stay amounts to CHF 15.00 for persons over the age of 25.
  • Normally, no cost participation is charged for maternity benefits.

If the invoice is paid by the Gemeinsame Einrichtung KVG direct to the medical service provider (tiers payant), the cost participation will be charged to the insured person separately afterwards. In case of a reimbursement (tiers garant) to the insured person, the cost participation will be deducted from the amount due.

Reimbursement of costs

The invoicing by the medical service provider occurs according to the different Cantonal contracts and tariffs, either to the Gemeinsame Einrichtung KVG (tiers payant) or to the insured person (tiers garant).

To be able to deal with a reimbursement efficiently and free of charge, we need the original invoice, a copy of the claim certificate as well as the complete bank details of the insured person:

  • IBAN (International Bank Account Number)
  • BIC (Bank Identifier Code)
  • Name and address of the bank
  • Name and address of the account holder

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