Transport costs and health insurance

For medically necessary patient transport, basic health insurance in Switzerland covers 50 per cent of the costs, up to a maximum of CHF 500 per calendar year. A medical prescription is generally required; the rest is paid by the patient, a supplementary insurance or, where applicable, supplementary benefits (EL).

Also called: cost coverage for medical transport · OKP transport costs · basic insurance transport · who pays for medical transport

Suppose you have transport costs of CHF 800 in a year. Half of that would be CHF 400; this is below the cap of CHF 500, so this amount is covered in principle. However, because the benefit is paid through basic insurance, your deductible and the 10 per cent co-payment also apply. If you have not yet used up your deductible in the current year, you will first pay that part yourself as well.

With many journeys — for example three times a week to dialysis — the CHF 500 cap is quickly reached. From then on, basic insurance pays nothing more for the rest of the year. This is where it is worth looking at supplementary insurance and supplementary benefits.

Because basic insurance covers only part of the cost, it pays to know the price before the journey. It depends on the type of transport, the distance and the level of assistance: a stretcher transport with two staff and waiting time costs more than a short seated journey. With the price in hand, you can estimate what you will have to pay yourself and, if necessary, check with your supplementary insurance.

For recurring journeys — dialysis, radiotherapy, therapy — it is advisable to make a rough estimate of the annual costs. That way you will see early on when the CHF 500 limit will be reached and can clarify in good time whether supplementary insurance or supplementary benefits will help cover the rest.