Nursing care prescribed for a period shorter than 30 days is considered short-term and is reimbursed at a rate of 80%.

Nursing care prescribed for a period exceeding 30 days is considered long-term and is reimbursed at a rate of 80%, with a daily ceiling of CHF 80.-.

As opposed to short-term nursing care, prior authorization must be requested from the Medical Adviser. Prior authorization is only required for the initial request and is not needed for renewals.

In the case of basic personal care services (FR: soins de base), i.e., assistance with personal hygiene and mobility, the reimbursement limit is set to a daily maximum of CHF 45.-. Basic care also includes services such as bandaging the patient’s leg, making them do exercises, and making their bed.

When convalescence does not entail hospitalization, short-term home help or basic care services (FR: soins de base) required after an illness or a surgery may be reimbursed at a rate of 80%, with a daily ceiling of CHF 45.-. The coverage of long-term home help services is subject to prior authorization of the Medical Adviser, and reimbursement is limited at CHF 250.- per month.

In the prescription, the attending doctor must clarify the patient’s state of health and degree of dependency, as individuals already in receipt of home care or hygiene and mobility benefits (Internal Rules, Annex III, Item 10) may not receive benefits for services in this category at the same time.
 

Medical or paramedical benefits related to a long stay in a medicalized retirement home—including nursing, geriatric care, and other services normally provided by the establishment—are covered at a rate of 100%, up to CHF 120.- per day.

Prescription is not required for the coverage of this benefit.
 

Outpatient nursing and home help services are covered at a rate of 100% up to CHF 120.- in case of total dependency and CHF 60.- in case of partial dependency. For this reason, the Medical Adviser must first approve a detailed medical report stating the degree of dependency of the patient with regard to basic activities of daily life, e.g., eating, getting in and out of bed, continence, personal hygiene, dressing, or mobility indoors.