These medicines are not covered by basic insurance
For certain drugs and medicines, you usually have to cover the costs yourself. Supplemental insurance won't help here, either. Comparis answers the key questions.
15.07.2022
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1. What does LPPV mean and what is the LPPV list?
LPPV stands for: "Liste pharmazeutischer Präparate mit spezieller Verwendung" (list of pharmaceutical products for special use). The LPPV list contains drugs and medicines that are not used exclusively for treatment purposes.
So-called lifestyle and well-being products are therefore also on the list. The listed products are approved by Swissmedic. They are in dispensing categories A to D. The LPPV expert group updates the list on a monthly basis.
Medicines may only be sold in Switzerland if they have been approved by Swissmedic. Swissmedic divides the medicines into different dispensing categories:
Dispensing category A: dispensed once on medical or veterinary prescription
Dispensing category B: dispensed on medical or veterinary prescription In exceptional cases, pharmacists may also dispense medicines of this category without a medical prescription.
Dispensing category D: dispensed after expert advice from healthcare professionals
2. Does my health insurance pay for drugs and medicines from the LPPV list?
As a rule, you have to pay for products from the LPPV list yourself. This means that neither basic insurance nor supplemental insurance will cover the costs.
However, there is one exception: certain products are also included on the list of medicines for birth defects. If you have a birth defect, these medicines are covered by your disability insurance or basic insurance.
What is the difference between medicines not covered by basic insurance and medicines on the LPPV list?
Not all medicines will be paid for by compulsory basic health insurance. Such medicines are sometimes referred to as non-compulsory medicines. In some cases, outpatient supplemental insurance covers medicines not covered by basic insurance. The general insurance conditions of supplemental insurance define which non-compulsory medicines are covered. When it comes to medicines on the LPPV list, you usually have to pay for those yourself even if you have a supplemental insurance.
Overview: what medicines does your health insurance pay for?
| Drugs/medicines | Details of insurance cover |
|---|---|
| Specialities list (SL) (not available in English) | Basic insurance |
| List of medicines with a tariff (ALT) (not available in English) | Basic insurance |
| Birth defect medicines list (GGML) (not available in English) | Invalidity insurance (up to the age of 20), basic insurance after verification (from the age of 20) |
| Conventional medicines outside SL/ALT and GGML as well as complementary medicines | Supplemental insurance in some cases |
| LPPV (not available in English) | Not usually covered |
3. LPPV: which medicines are on the list?
Examples of products on the LPPV list are:
Painkillers such as Perskindol
Dietary supplements, e.g. Berocca, Burgerstein and Supradyn
Contraceptives such as Nuvaring
On the LPPV website, you can check whether a medicine is on the list. However, the list is not exhaustive.
4. Tips on billing your health insurer for medicines
Do you need a medicine and are unsure whether it will be covered by basic insurance? You can proceed as follows:
Is the medicine on one of these lists: SL, ALT or GGML? If so, the medicine is covered by basic insurance. If you can only find the medicine on the LPPV list, you will have to pay for it yourself.
Can't find the medicine on any of these lists? Check with your health insurance company, the prescribing doctor or the dispensing facility (e.g. pharmacy).
For SL medicines, ask for cheaper generic drugs.
Request a sales receipt from the dispensing facility.