Doctor's Visit & Consultation

Doctor’s fees, including online consultations with a medical doctor, are reimbursed at 80% with the application of the 'Supplementary Plan'. No prior authorization is needed, but like with all claims, please ensure you follow the correct procedures for submitting a claim.

Outpatient medical fees are reimbursed in the same manner as doctor’s fees so long as the medical treatment took place in a medical establishment.

For the sake of clarity, outpatient medical fees are intended as medical expenses sustained for medical treatment that does not require overnight stay in hospital, clinic, or medical facility, and is not covered under any other benefit.

Common examples include—but are not limited to—consultations with a general practitioner or specialist (e.g., a dermatologist), specialized examinations (e.g., sleep studies, exercise stress tests, colonoscopies), as well as ambulatory care and certain outpatient surgical fees.

Preventive medical check-ups without diagnosis are covered up to CHF 1,000 per year, with a valid medical prescription (detailing required exams and medical reason). 

Exception

Aesthetic procedures without a medical basis are generally not covered.

Main Plan & SPP (excl. secondary dependents) Temporary contract (shorter than 3 months) Secondary dependents
Applicability Yes Yes Yes
Prescription Not required Not required Not required
Prior Authorization Not required Not required Not required
Reimbursement Rate 80% 80% 80%
Supplementary Plan Yes N/A N/A