Benefits

Ambulance and rescue helicopter: You may have to pay

INFORMATION
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If an ambulance is called out to you, it can get quite expensive. Source: iStock / cookelma

Whether you have an accident in the mountains or a heart attack in your home, the emergency services will come to your assistance. However, the invoice for these services could be a nasty surprise. Here are the answers to the 8 key questions:

In an emergency, every second counts. The emergency services will transport the patient to the nearest hospital without delay. The costs of such emergency transport vary significantly between cantons. For example, as Swiss television recently reported, if someone has a heart attack in the canton of St. Gallen, the cost for the emergency services to attend is 1,881 francs, while in the canton of Aargau it is only 832 francs.

If you have accident insurance through your employer or a private insurer, this will cover all the emergency transport costs. However, if the emergency transport is the result of an illness, or if you have accident insurance through your health insurance scheme, the costs of emergency transport can soon mount up, as the following answers demonstrate.

When does basic health insurance pay for emergency transport?

Basic health insurance policies will pay a share of the costs for emergency transport if it is a medical necessity. If the patient could have travelled by private car or public transport, basic health insurance policies will not pay out for emergency transport.

How much will my basic health insurance pay for emergency transport?

Basic health insurance will cover 50 per cent of the costs, up to a pre-determined maximum limit. The maximum limit for the cost of rescuing you from a life-threatening situation is 5,000 francs per calendar year (rescue costs). If the situation is not life-threatening but transport by ambulance is still medically necessary, basic health insurance will pay up to a maximum of 500 francs per calendar year (transport costs).

Will my basic health insurance pay out if I take a taxi to hospital?

If it was not possible for you to get to hospital by private car or public transport for medical reasons, your basic health insurance will cover a proportion of the cost.

Is there an insurance policy which covers all the costs?

Yes. There are supplemental insurance policies which guarantee a higher level of cover. Some are even unlimited and will cover all the transport and/or rescue costs. Individuals must decide for themselves what level of cover is right for them.

What happens if I have an accident abroad?

Basic health insurance policies will pay a proportion of the emergency transport costs abroad as well. The conditions for this are the same as if you were in Switzerland. However, the situation is not the same for rescue costs. Basic health insurance policies do not cover rescue costs abroad. If you are travelling abroad, it is sensible to take out supplemental insurance, as transport and rescue costs abroad can easily run into thousands or tens of thousands of Swiss francs. It is important to ensure that you have enough cover in the event of an accident abroad. Before you travel, check to see if you have sufficient insurance.

I'm a Rega Swiss air ambulance patron – do I still need supplemental insurance?

Rega is not an insurance provider. Furthermore, you do not have a legal entitlement: Rega is permitted to provide its services, but is not obliged to do so. Rega can waive the costs of repatriation involving its patrons in the event that insurance companies or any other third party are not liable to pay and thus are either not required to reimburse the costs or required only to reimburse a proportion of the costs. This applies to repatriation on a Rega jet as well as on scheduled flights. Moreover, Rega does not pay for emergency treatment abroad. Cover for such treatment can be obtained from your health insurance scheme (basic health insurance and supplemental insurance) or via a foreign health insurer.

Who pays if I need to be transferred from one hospital to another?

If a patient needs to be transported from one hospital to another for treatment and due to medical necessity, the costs are covered completely by basic health insurance. In this case, the transfer is part of the inpatient treatment.

Someone calls an ambulance for me but I don't need one. Who pays?

If an ambulance is called and paramedics attend the incident, then costs are incurred. As a rule the patient or their insurance company must cover these costs. The actual person who called the ambulance is not required to reimburse any costs – unless the call was an intentional nuisance call, of course.

All the above answers apply to persons who have accident insurance through their health insurance scheme and to transport in the event of illness.

 

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