The benefits of supplementary outpatient insurance
For needs not met by basic insurance
Supplementary outpatient insurance builds on the cover for medical treatment provided by basic insurance and offers you additional benefits for preventative measures, aids, complementary medicine, maternity and more.
Benefits plus and premium
You can find a detailed overview of the supplementary outpatient insurance benefits in the benefit overview. Please also note the General Terms and Conditions of Insurance in accordance with the VVG and the Special Terms and Conditions for supplementary outpatient insurance. The insurance can only be taken out if you are resident in Switzerland.
The medications paid for by basic insurance are strictly regulated by statutory lists of medicines. The rest are not covered. The supplementary outpatient insurance models plus and premium contribute the following amount to those that are registered with the Swissmedic Agency for Therapeutic Products and are not on the list of medications and drugs that are not covered (in German):
If prescribed by a doctor: 90% of the costs, unlimited
Only a few alternative medical treatment methods are covered by basic insurance, namely acupuncture, anthroposophic medicine, traditional Chinese medicine (TCM) pharmacotherapy, classic homeopathy and phytotherapy. If you would like to use others, it is worth having supplementary outpatient insurance.
Sympany contributes to the costs of complementary medicine insofar as the treatment is medically necessary, effective, purposeful, economical and performed by one of our recognised service providers. Search for therapists of alternative medicine ›
natura: With this supplement, you receive higher contributions towards alternative medical treatments and aids and you can choose to use additional alternative medical treatment methods (“advanced treatment methods”).
Alternative medicine methods ›
| Maximum cover for alternative medicine | |
| plus | without natura: 3000 CHF with natura: 6000 CHF per calendar year |
| premium | without natura: 6000 CHF with natura: 10,000 CHF per calendar year |
| Natural treatments | |
| plus and premium |
80% of the costs |
| Recognised alternative therapies | |
| plus and premium | without natura: 50% of the costs with natura: 80% of the costs |
| Advanced treatment methods | |
| plus | with natura: 50% of the costs, max. 1000 CHF per calendar year |
| premium | with natura: 50% of the costs, max. 2000 CHF per calendar year |
Alternative therapies that are carried out as part of a holiday or other longer (e.g. spa-like) stays are not covered.
As a general rule, outpatient treatment in emergencies is covered by basic insurance. In some cases, however, it does not cover the full costs, for example if a treatment costs more than twice as much as it would in Switzerland. This can happen especially outside Europe. The uninsured costs are covered by the supplementary outpatient insurance.
Our tip: With tourist or tourist subito travel health insurance you can play it safe, wherever you are in the world. In addition to covering the cost of treatment, it also offers other benefits that are useful should you fall ill.
The benefits of basic insurance are limited if you have to go to hospital by ambulance and/or need to be seen by an emergency doctor. It covers only 50% with maximum contributions. The supplementary outpatient insurance increases the contribution to
100% unlimited
Please note: The statutory cost share is incurred for the portion from basic insurance.
Numerous preventive measures are covered by basic insurance, for example, most vaccinations or some check-ups where there is increased risk or from a certain age. These measures are regulated in the Health Insurance Benefits Ordinance. However, some are not covered or are only covered every few years, such as routine gynaecological examinations: under basic insurance, these are only covered every three years. The supplementary outpatient insurance ensures that this annual check-up is in fact carried out each year and the costs covered. It also supports other preventative measures, because prevention is better than cure.
Good to know: Early diagnosis, prevention, check-ups – what’s what?
| Vaccinations | |
| plus and premium |
80% of the costs, up to 220 CHF per calendar year |
| Check-up (to check general state of health) | |
| plus | Up to 300 CHF per calendar year |
| premium | Up to 600 CHF per calendar year |
| Good to know: Early diagnosis, prevention, check-ups – what’s what? | |
| Precautionary gynaecological examinations | |
| plus and premium |
90% of the costs, one examination per calendar year during the years not covered by basic insurance (see Basic insurance benefits) |
| Good to know: Early diagnosis, prevention, check-ups – what’s what? | |
| Health-promoting courses | |
| (e.g. giving up smoking, dietary advice) | |
| plus | Up to 150 CHF per calendar year |
| premium |
Up to 250 CHF per calendar year |
| Sports contribution | |
| (e.g. gym, relaxation course or sports club) | |
| plus | Up to 200 CHF per calendar year |
| premium | Up to 300 CHF per calendar year |
Basic insurance stopped paying the breastfeeding allowance a long time ago. Sympany supports new mothers and mothers-to-be, which is why under the supplementary outpatient insurance we cover:
- Prenatal classes with a recognised specialist: up to 200 CHF
- Breastfeeding allowance: up to 250 CHF
Swimming is healthy, especially in warm, mineral-rich spring water. It can help to relieve the symptoms of rheumatism and arthritis and other diseases. Basic insurance only covers spa treatments at recognised health spas, but not at other thermal baths.
plus and premium cover:
If prescribed by a doctor: 50% of the costs, up to 12 visits a year
Aids are necessary to compensate for limitations, to monitor one's health or to train weak muscles. The list of medical supplies and devices MiGeL (in German) defines which of these are paid for by basic insurance. Supplementary outpatient insurance pays towards the costs of many others.
| Glasses or contact lenses | |
|---|---|
| plus |
Aged up to 18: up to 270 CHF per calendar year Aged 18 and over: up to 270 CHF within 3 calendar years |
| premium |
Aged up to 18: up to 420 CHF per calendar year Aged 18 and over: up to 420 CHF within 3 calendar years |
| Other medical aids (e.g. blood pressure monitor, tailor-made insoles, pelvic floor training device) | |
|---|---|
| plus and premium |
50% of the costs, up to 250 CHF per calendar year |
Basic insurance only covers dental treatment if it is required due to an illness. All other benefits are divided between supplementary dental insurance and supplementary outpatient insurance. plus and premium cover:
| Check-ups (aged up to 25) | |
|---|---|
| plus and premium |
60 CHF per calendar year |
| Orthodontic treatment (aged up to 25) | |
| plus | 70% of the costs, up to 10 000 CHF |
| premium | 70% of the costs, up to 15 000 CHF |
| Extraction of wisdom teeth | |
| plus and premium |
90% of the costs |
Here you can find out more about which benefits are covered by supplementary dental insurance and which are covered by supplementary outpatient insurance: Supplementary dental insurance FAQ ›
Request advice or a quote
Please contact us - via the contact form or by telephone on +41 58 262 39 70.
Early diagnosis, prevention, check-ups – what’s what?
Early diagnosis/prevention
Early diagnosis – known as “preventive care” in Switzerland – includes medical examinations that help to detect specific illnesses as early as possible
Examinations for early diagnosis are covered by basic health insurance. In certain cases, supplementary insurance also contributes towards the costs.
Examples:
Basic insurance
- colonoscopy (see colorectal cancer screening)
- mammography
- gynaecological screening (every three years)
Supplementary insurance
- gynaecological screening (benefit from plus and premium: 90% of the costs, 1 examination per calendar year in the years that are not covered by the basic insurance)
Check-ups
A check-up is a groundless examination in which various tests are performed to check the general state of health.
A check-up is a benefit covered by supplementary insurance.
Examples:
Supplementary insurance
- Medical examinations, laboratory examinations and any other examinations, such as an electrocardiogram (ECG)