Surgical operations are subject to the provisions of Rule VIII, paragraphs 4 and 7 of the Internal Rules.

If a surgery is performed on an inpatient basis (requiring overnight stay), surgeons’ and attendants’ fees are reimbursed at 90% with the application of the 'Supplementary Plan'. In addition to this, other expenses relating to surgery (such as anesthesia, dressings, operating theatre, etc.) are also reimbursed at 90% with the application of the Supplementary Plan. Outpatient surgeries are covered under 'Doctor's Visit & Consultation'.

Please note that surgeons’ and attendants’ fees are different from hospitalization costs.

If your medical condition falls under a different benefit type (e.g. dental surgery, optical surgery), the claim will be reimbursed according to the reimbursement rules of the given benefit type. 

If a member decides to obtain medical care (for example, hospitalization or a surgical operation) away from the duty station or the place of residence, at a place where medical costs are higher than in Geneva, reimbursement shall not exceed the customary pricing of the given treatment in the country where it is performed, or the cost of equivalent treatment provided in the canton of Geneva.

For operations in the canton of Geneva, the following ceilings apply regarding the assistant fees: the fee of the first assistant surgeon must not be higher than 25% of the surgeon’s fee, and in the case of the second assistant surgeon, 15%.

Breast surgeries can serve various purposes, both medical and aesthetic. Under UNSMIS, coverage depends on the type of procedure, its medical justification, and whether prior authorization has been obtained.

UNSMIS covers breast surgeries only when they are deemed medically necessary. This includes procedures such as breast reduction, implant removal, and reconstructive surgery following cancer, among other conditions.

Breast reduction is covered only when medically necessary due to an accident and/or emergency. The weight of tissue removed must be at least 500 grams per breast, and the patient’s Body Mass Index (BMI) must not exceed 25.

These procedures are reimbursed at 90%, including fees for the surgeon, anesthesia, operating theatre, and related medical supplies.

Prior authorization is always required. A medical report and a detailed cost estimate must be submitted to our Medical Adviser. The report must outline all symptoms supporting the medical necessity of the procedure and must be issued by a surgeon other than the one performing the surgery. It must also include a history of symptoms justifying the need for the surgery.