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HEALTH INSURANCE

Reader question: Am I liable for ambulance costs in Switzerland?

Ambulance call-out costs are a bit of a grey area in Switzerland, and there are things you should know before you dial 144 — the national number for urgent medical help.

Reader question: Am I liable for ambulance costs in Switzerland?
How much you will pay for this ride depends on how ill you are. Photo by Fabrice COFFRINI / AFP

Obviously, being driven to a hospital in an ambulance is not anyone’s idea of a fun ride, but there may be situations when this mode of transport could become necessary. Who pays for this service depends on several factors.

But first…this is what you should know about calling an ambulance:

If you or someone around you has a real medical emergency (see below), dial 144, wherever in Switzerland you may be.

A dispatcher will ask you what the nature of your emergency is, as well as other follow-up questions to determine if you need an ambulance in the first place.

Based on the linguistic region you are in, the dispatcher will speak German, French or Italian; they may also speak some English, but that is not guaranteed.

Once in an ambulance, you will be taken to a nearest hospital, although, depending on the seriousness of your symptoms, you may be given first aid on the way.

This a pretty standard procedure in most countries, not just in Switzerland.

How much does an ambulance call-out cost and who pays?

The cost of this service depends on where you live, ranging from about 900 to 2,100 francs, according to consumer site Comparis.ch

The compulsory health insurance (KVG in German and LaMal in French and Italian) covers half of this amount, but only up to 500 francs a year if the ambulance is called when there is no immediate danger to life but you are nevertheless unable to get to a hospital by other means of transportation, such as a car or bus.

It is not clear what urgent medical conditions would enable you to take public transportation, but that’s what the law says.

It is more reasonable to assume that in such a case someone will drive you to a hospital, but if that is not feasible either and you feel you need immediate medical help, then an ambulance may be your only option.

However, if ambulance is required for life-threatening conditions, KVG / LaMal will cover up to 5,000 francs of the cost of emergency transportation.

READ MORE: What is not covered by Switzerland’s compulsory health insurance

What is categorised as a ‘life-threatening condition’?

This is a true medical emergency, which, if not treated quickly and immediately, puts your life at risk.

This includes (but is not limited to) heart attacks and strokes, head trauma, severe respiratory distress, severe bleeding, serious injuries, and other conditions where any delay in treatment can put your life or health at risk.

Is there a coverage for ambulance rescue costs?

Some supplemental insurance policies guarantee a higher, or even unlimited, cover of all transportation and rescue costs.

Supplemental policies offer other advantages as well by paying for treatments and services not routinely covered by the basic insurance.

However, depending on your medical history and current health, it may be expensive or difficult to obtain.

While insurance companies must offer the same obligatory KVG / LaMal  coverage to everyone, regardless of health status, carriers can deny supplemental benefits to people deemed ‘at risk’.

This includes those with pre-existing medical conditions or history of repeated treatments.

However, if you are relatively healthy and have no chronic illnesses necessitating frequent treatments, you will not have a problem getting supplemental coverage.

More information can be found here:

Should you buy supplemental health insurance in Switzerland?

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HEALTH

Why Swiss patients pay too much for healthcare

Switzerland is an expensive place to live - and that includes healthcare costs. But a new report has revealed how doctors and hospitals are overcharging their patients on a regular basis.

Why Swiss patients pay too much for healthcare

Some doctors and hospitals in Switzerland overcharge their patients by either invoicing services that have not been provided or billing more than is necessary.

This practice is a problem particularly as health insurance premiums are expected to increase significantly in 2023 to reflect rising health care costs.

READ MORE: Why Swiss health premiums are set to rise — and what you can do about it

Swiss health insurers have confirmed that patients in Switzerland are charged three billion more than they should be each year by doctors and hospitals. 

Without these additional charges, healthcare premiums in Switzerland could be ten percent cheaper, estimate the country’s healthcare insurers. 

However, in order to do so, the system would need significant changes to ensure greater transparency. 

Cost gouging hard to prove

Matthias Müller, spokesperson for health insurance umbrella organisation Santésuisse, confirmed that certain doctors charge too much.

“We see this problem particularly in the outpatient care, where doctors can choose from numerous tariff positions”.

However, proving excessive charges is difficult, according to Felix Schneuwly, a health industry expert at Comparis price comparison service.

That’s because “patients do not sign a ‘work report’ for the medical services rendered”, so health insurance companies cannot check whether a service was provided at all and whether it was indeed necessary, Schneuwly said, explaining that an insurance company can only verify whether the quantities and costs of the services on the invoices comply with the law.

Patients also have very little power to prove that they have been overcharged, which effectively gives doctors and hospitals the freedom to charge more. 

Yvonne Gilli, of the Professional Association of Swiss Doctors (FMH) said that while they could not confirm whether these allegations were accurate, she was aware of instances where doctors had charged too much, although she reaffirmed that this “did not happen often”. 

FMH said there were 58 cases of overcharging in Switzerland in 2019, the last year before the pandemic, but that “Every doctor convicted in this regard is one too many”.

Schneuwly said hospitals and doctors should be required to produce “treatment reports” which would allow insurers to compare costs and the treatment provided. 

“(That way) the insurance companies can understand exactly which service was provided and for what reason.”

Müller notes that the same procedure can cost up to three times as much in different parts of the country and at different practices. 

As patients do not pay these costs directly they are less likely to question them, although they eventually pay more through their healthcare premiums.

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