Emergency abroad: What does the health insurance pay?
An accident or illness can affect anyone – suddenly and without warning. In Switzerland, we know where to get medical help and what our basic or supplementary insurance covers. But what is it like in Portugal, Vietnam or the Maldives? What should I do if I become seriously ill abroad? What benefits are covered?
Emergency abroad: What should I do?
The best thing to do is to contact your health insurance company directly. On the one hand, to avoid financial surprises. And on the other hand, the insurance company will help you with questions about the foreign health system and advise you on the next steps.
As a customer of AXA Health Care, for example, you can get help around the clock in the event of an emergency abroad on +41 58 218 11 11. Our partner Medicall immediately initiates the necessary measures and, if necessary, also organizes a return transport.
The most important thing: Keep calm in the event of illness or an accident.
When does the health insurance company pay in the event of an accident or illness abroad?
Basic insurance covers the costs incurred in the event of an emergency abroad. It does not matter which insurance model you have chosen. An emergency exists, for example, if you are temporarily abroad and need medical treatment, but a return trip to Switzerland would be unsuitable. However, if you go abroad specifically for medical treatment, basic insurance will not cover the costs. The law excludes planned treatment abroad.
The costs of treatment after accidents abroad are covered by health insurance if you have taken out accident insurance with your health insurance. If you work more than 8 hours per week, you are usually automatically insured against accidents at home and abroad through your employer.
What costs does basic insurance cover abroad?
In the event of an emergency abroad, compulsory basic insurance usually covers the costs of medical treatment. It is not possible to conclusively answer whether medically necessary transports abroad are covered. In Switzerland, basic insurance covers 50% of the costs up to a maximum amount of CHF 500.
What costs does supplementary insurance abroad cover?
The benefits of the supplementary insurance differ depending on the provider. Supplementary health insurance from AXA covers, for example, rescue operations, repatriation or visits by a loved one. In addition, you will receive further reimbursements if the costs of the hospital stay are not fully covered by compulsory basic insurance.
Tripping hazard travel insurance
Travel insurance companies focus their benefits mainly on cancellation costs, vehicle and personal assistance, but not on medical costs. Be sure to pay attention to the benefits covered by the insurance you have taken out. So that you also benefit from the protection that is important to you.
Is basic insurance sufficient in the event of illness or accident abroad?
Within the EU and EFTA countries, you are entitled to the same benefits as residents insured in that country for emergency medical treatment.
In the other countries, i.e. countries outside the EU/EFTA, the cost contribution of basic insurance in the event of an emergency is no more than twice as high as the cost of the same treatment in your canton of residence. However, for countries with high healthcare costs, such as the USA, Canada, Australia or Japan, the double amount is often not enough to cover the costs of treatment. This means that you have to pay the costs not covered by basic insurance out of your own pocket.
In any case, costs related to an accident or illness, for example for a rescue, a search operation or transport to hospital, are not covered. You will need additional insurance for this.
How does a return transport from abroad work?
First, it is assessed whether repatriation or repatriation is "medically necessary" or "medically sensible". The distance to Switzerland is generally decisive for the choice of means of transport. The ambulance is used for an operational area of up to 750 km. If the distance is greater, an airplane is needed.
If you travel back by plane, it depends on your state of health. If you no longer have to go to hospital after your return, your return flight will be booked for you by Medicall, but you will travel independently on a scheduled flight. If you are admitted to hospital after your return, you will be accompanied by a doctor from Switzerland. Depending on your condition, you will travel normally seated or in a so-called stretcher. A stretcher is an area separated by a curtain in which there is a lounger. If you are being transported as an intensive care patient or if repatriation is essential despite the high risk of infection, you will travel in an ambulance jet.
This is the procedure if you have supplementary health insurance with AXA. The procedure of other insurance companies may differ from this.
How much does it cost to transport back to Switzerland?
The cost of repatriation within Europe can be more than CHF 20,000. Namely, when you are flown home by ambulance jet. The costs for a scheduled flight with medical accompaniment are significantly lower in Europe at less than CHF 10,000, but still nothing for the petty cash.
Intercontinentally, completely different costs are incurred. For example, the cost of repatriation from Bangkok by ambulance jet is currently CHF 80,000 to CHF 100,000.
Wichtig dabei: Diese Kosten werden nicht von der Grundversicherung getragen. Hier benötigen Sie eine Zusatzversicherung oder eine spezifische Auslandskrankenversicherung für den optimalen Versicherungsschutz.
Was passiert nach einem Rücktransport in die Schweiz?
Wenn Sie nach einem Rücktransport erneut ins Spital müssen, werden Sie von Ihrer medizinischen Begleitcrew direkt in ein geeignetes Spital in Ihrem Wohnkanton gebracht. Geeignet bedeutet in diesem Fall, dass das Spital Ihre Verletzung oder Ihre Krankheit behandeln kann. Wenn Sie mit einem Linienflug in die Schweiz geflogen sind, erwartet Sie und Ihre ärztliche Begleitung vor dem Flughafen ein Krankenwagen, der Sie ins Zielspital bringt. Wenn Sie mit einem Ambulanzjet geflogen sind, wartet der Rettungswagen direkt auf dem Vorfeld auf Sie.
If, on the other hand, you have already been discharged and no longer need to go to hospital, you can go home directly. It may be advisable to visit your family doctor afterwards. Our partners at Medicall will also make a recommendation here.
Conclusion: Supplementary insurance for abroad is worthwhile
To avoid a horrendous bill fluttering into the mailbox after emergency treatment during the holidays, it is worth checking that you take out supplementary insurance before you leave. Be sure to check that the supplementary insurance covers the full costs of emergency treatment abroad. Costs for rescue operations and transport home as well as search and recovery operations were also to be covered. So that you are comprehensively insured in an emergency.