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.
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: CHF 3,000 with natura: CHF 6,000 per calendar year |
| premium | without natura: CHF 6,000 with natura: CHF 10,000 per calendar year |
| Natural treatments | |
| plus and premium |
80% of the costs |
| Recognised alternative therapies | |
| plus | 50% of the costs |
| premium | 80% of the costs |
| Advanced treatment methods | |
| plus | with natura: 50% of the costs, max. CHF 1,000 per calendar year |
| premium | with natura: 50% of the costs, max. CHF 2,000 per calendar year |
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.
| Vaccinations | |
|---|---|
|
plus and |
80% of the costs, up to CHF 220 per calendar year |
| Preventative check-ups | |
| plus | Up to CHF 300 per calendar year |
| premium | Up to CHF 600 per calendar year |
| 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) |
| Health-promoting courses | |
| (e.g. giving up smoking, dietary advice) | |
| plus | Up to CHF 150 per calendar year |
| premium |
Up to CHF 250 per calendar year |
| Sports contribution | |
| (e.g. gym, relaxation course or sports club) | |
| plus | Up to CHF 200 per calendar year |
| premium | Up to CHF 300 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 CHF 200
- Breastfeeding allowance: up to CHF 250
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
Recognised thermal baths in supplementary outpatient insurance >
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 CHF 270 per calendar year Aged 18 and over: up to CHF 270 within 3 calendar years |
| premium |
Aged up to 18: up to CHF 420 per calendar year Aged 18 and over: up to CHF 420 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 CHF 250 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 |
CHF 60 per calendar year |
| Orthodontic treatment (aged up to 25) | |
| plus | 70% of the costs, up to CHF 10,000 |
| premium | 70% of the costs, up to CHF 15,000 |
| 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 >
Therapy with a psychotherapist on prescription from a doctor is covered by basic insurance. Supplementary outpatient insurance covers illness-related treatment with therapists who are not subject to the Federal Health Insurance Act (“KVG”) (“independent therapists”).
|
plus |
50% of the costs, up to CHF 1,000 per calendar year |
| premium | 50% of the costs, up to CHF 2,000 per calendar year |