Treatment for undernutrition and obesity is covered upon a doctor’s prescription. Coverage is determined based on the Body Mass Index (BMI) and is reimbursed as follows:
- BMI below 15 or above 30:
Medical treatment and consultations with an approved dietician are reimbursed at 80%, up to a maximum of CHF 70.- per session, with a limit of 10 sessions per lifetime. - BMI above 15 and below 30:
Medical treatment and consultations with an approved dietician are reimbursed at 80%, up to a maximum of CHF 70.- per session, with a limit of 10 sessions per lifetime.
Prior authorization from the Medical Adviser is required for reimbursement. - BMI above 35:
Medical treatment provided in a hospitalized establishment is reimbursed at 80%.
Prior authorization from the Medical Adviser is required. The maximum duration of treatment is subject to the patient’s condition and the approval of the Medical Adviser. - BMI above 40:
Hospitalization and surgical procedures may be reimbursed as a regular hospitalization (please see Benefit 1, 2, and 3 in our Internal Rules).
Reconstructive surgery may be covered if weight loss exceeds 35% of the initial body weight and is stabilized over 12 consecutive months.
Prior authorization from the Medical Adviser is required for reimbursement.
Medicinal weight-loss treatments are covered under the category ‘Expensive Medication’ and must be prescribed by an endocrinologist. For details, please consult the corresponding page.