Outpatient supplementary insurances

The term, which I find a little barbaric (please keep it between us), put simply, refers to the services offered in less than 24 hours and that do not require a stay at the hospital.  

This namely includes, dental care, everything related to sight (glasses, contact lenses), natural and alternative medicines, treatments abroad, sport, but also various fields of domestic care, in-home care or preventive vaccines. 

In this article, we will focus on the main topics, those for which we most often use the services of a supplementary insurance. 

For example, I am a cross-eyed sportive person. 

My eyes are just like a bad camera, in the middle of a rainy night. From far, everything is blurry and the lights shine around me. 

In my free time, I go to the gym twice a week, I go for jogs in the forest twice a week as well and I play badminton with my friends on the weekend. 

I thus need a supplementary insurance that will, on the one hand, partially cover my glasses and contact lenses costs and, on the other hand, refund part of my sport and recovery (osteopathy and other massages) costs. 

A combined supplementary insurance 

Insurance companies came up with packs of outpatient services in order to make up for the gaps in mandatory health insurance. Each company includes a certain number of services in the supplementary insurance. Most of the time this includes: 

Visual aide

(between 100 and 300 CHF per year)

Companies make a certain amount available annually or every three years in order to cover the costs of corrective lenses and eyeglass frames. 

Sport incentive

(between 200 and 800 CHF per year)

A doctor a day keeps the doctor away, take deep breaths, make sure you exercise.  Mens sana in corpore sano: the healthier you are, the less risk you represent for your insurance. Therefore, most of insurance companies have programmes encouraging various types of sportive activities. 

Refunding your gym membership, contributing to the membership fees of a club… Supplementary insurances offer various solutions to make your favourite sport more affordable. However, your gym must be recognised by a quality label (Qualitop or Fitnessguide, from three stars and up). 

Supplementary medicine

The basic insurance covers five types of so-called natural medicines. It does so because it considers that these medicines do not go against orthodox medicine but rather complements it: 

• Anthroposophical medicine. 
• Traditional Chinese medicine. 
• Homeopathy. 
• Neural therapy. 
• Phytotherapy. 

Natural and alternative medicines that are covered by supplementary insurances do not require, unlike the basic insurance , for the therapist to have been trained in classical medicine. 

The list of alternative medicine reimbursed therefore significantly increases: 

• Etiopathy
• Kinesiology
• Osteopathy
• Sophrology
• Shiatsu
• Mesotherapy
• Fasciatherapy-pulsology
• Bio resonance
• Psychology
• Etc

Coming up with an exhaustive list is impossible: it is constantly evolving and varies depending on the insurance companies. The cost reimbursed is usually partial and can include a limited number of sessions. 

Treatments abroad 

Treatments abroad are, in principle, covered by the mandatory insurance. However, in certain countries, medical expenses exceed Swiss prices by far. For this reason, companies integrated in this supplementary insurance a wider cover than that of the mandatory insurance: 

• In emergency cases: 100% of the costs are covered (treatment, repatriation, transportation, etc…), because the amounts reimbursed by the LAMal are extremely low and almost always exceeded. 
• In case of a non-urgent outpatient treatment: between 90% to 100% of the costs are covered.

Medicine

In Switzerland, everyone has the right to access medicine but that does not mean that every medicine is reimbursed. Mandatory healthcare covers only medicine that was prescribed by a doctor and which is on the speciality list (SL). 

This supplementary insurance covers the cost of drugs for academic medicine as well as supplementary medicine. 

Ocular supplementary insurance 

Eyecare: glasses and contact lenses 

Even though the basic insurance contributes to the cost of glasses and contact lenses for up to 180 CHF per year for children (0-18 years old), a supplementary insurance reveals itself to be essential once you reach adulthood. 

As a general rule, a comprehensive supplementary insurance will cover between 200 and 800 CHF of the cost of glasses and contact lenses, without having to sit on your ophthalmologist’s comfy white leather seat. You can simply visit your favourite optician instead.  

However, if you also would like to be covered for surgical corrective lenses, then you will have to go through a supplementary insurance created for this sole purpose. 

Dental care

Each and every one of us eventually had to lay on the nerve-wrecking chair (and under the blinding LED lamp) of a dental office. 

And though the metallic noise of the dentistry instruments clinking against each other is enough to give us goosebumps on its own, the most frightening part remains the final bill! 

While supplementary insurances only rarely fully cover the latter, they do greatly contribute to it. Whether it be for a descaling, a check-up, an outpatient treatment such as cavities or crowns or for orthodontia. 

Our advice: for your child, you should take out a dental care insurance as soon as possible. Health insurance companies agree to insure children without a medical questionnaire until their third or fourth year. 

After that, if your child has to complete a medical questionnaire and that the health insurance company considers that a need for an important dental correction is likely, it is allowed to refuse to insure him or her. 

In each company, there are particularities, franchises, exclusions, capped prices, health questions that are more or less flexible and so forth… 

What I can tell you for sure, is that taking out a supplementary insurance can be done very easily, but it would truly be a very bad advice to tell you to do so without taking the time to compare and understand your options. Finally, and most importantly, you should remember to do it before you start having health problems.