Medication
What does health insurance cover?
Basic insurance covers the costs of countless medications – but many are not covered. Supplementary insurance protects against costly surprises.
Basic insurance policyholders are familiar with anxiously asking themselves will the medication prescribed by the doctor be covered by health insurance or not? This question is justified. This is because basic insurance only covers a clearly defined catalogue of medicines.
Gaps in medication cover – that doesn’t have to be the case
For medication to be covered by basic insurance, it must be prescribed by a doctor and listed either on the Specialities List (SL) or on the List of Medicines with Tariff (ALT). The remaining medications are not covered. They are also referred to as medications not covered by compulsory insurance.
This means that many medicines, especially alternative medical preparations, cannot be covered by basic insurance. This is referred to as a gap in basic insurance cover.
With supplementary insurance, you can close this gap in cover for medication. Sympany’s supplementary outpatient insurance expands the benefits of basic insurance in a targeted manner. This gives you a wider range of suitable medicines which you do not have to pay for yourself.
Medication: What does insurance cover?
What medication does basic insurance pay for? And what does supplementary insurance cover? You can find everything you need to know at a glance here:
The Specialities List (SL) and the List of Medicines with Tariff (ALT) specify which medications can be covered by basic insurance. As with all benefits under basic insurance, policyholders must contribute to the costs via the deductible and retention fee.
- The Specialities List (SL) shows which branded preparations and generic drugs are covered by basic insurance. However, these are only paid for if they are prescribed by a medical professional with the relevant qualification certificate.
- The List of Medicines with Tariff (ALT) includes preparations, active ingredients and excipients that are combined into special prescriptions in pharmacies.
Supplementary insurance begins where basic insurance ends. It contributes to the costs of medications that are officially approved and registered with the Swiss Agency for Therapeutic Products Swissmedic. These include, in particular, medicinal products from alternative and complementary medicine.
Conclusion: Close gaps in cover
From alternative and complementary medicine to preventive care, Sympany’s supplementary outpatient insurance also offers valuable protection against gaps in cover for medication.
Supplementary policyholders can rely on Sympany: The plus and premium supplementary outpatient insurance policies cover 90% of the costs of insured medications not covered by compulsory insurance. The prerequisite is that a doctor’s prescription is available.
If you like to use alternative medical methods for your treatments, you can enjoy even more benefits with plus natura or premium natura.
There are no lists for medications not covered by statutory health insurance that are covered by supplementary outpatient insurance. Sympany would be happy to provide you with information about whether a specific medication is insured. In this case, Sympany will cover 90% of the costs.
Useful information
Savings that pay off
The most important tip is to ask your doctor or pharmacy about generic drugs. These imitation products are the same as the original drug, but are significantly cheaper. This eases the burden on your wallet when buying medication and helps with rising health insurance premiums. More about the benefits of generic drugs >
Thanks to the cooperation with the Zur Rose mail-order pharmacy, you can save even more money, because you can get a 10% discount if you buy medically prescribed generic drugs and biosimilars from the Swiss mail-order pharmacy. More about the Zur Rose mail-order pharmacy >
Not all remedies are insured
Supplementary insurance covers the costs of numerous medications prescribed by a doctor. However, there are also remedies that are not covered by either basic insurance or supplementary insurance. These include hair growth agents, dietary supplements and cannabis oil, for example.
If a product is on the List of Pharmaceutical Preparations for Special Use (LPPV) or on Sympany’s negative list, you will have to pay for it yourself. More about the medications not covered (in German) >
What would you like to do now?
Advice
I want to make an individual appointment in one click.
Supplementary outpatient insurance
I would like to view Sympany’s different supplementary outpatient insurance models.
Contact
I want to get in touch with Sympany now.