Prosthetic appliances are reimbursed at an 80% rate.

The following prosthetic appliances do not require prior authorization, only a doctor’s prescription:

• Walkers
• Corsets
• Mandibular prostheses
• Wigs in case of cancer
• Purchase or rental of breast pumps
• Insulin pumps
• Blood glucose meters and strips

Orthopedic shoes, electrical stimulation devices, light therapy lamps, and any other medical appliances not listed above require prior authorization from the Medical Adviser.

Internet purchases (including cross-border ones) for prosthetic appliances are reimbursable.
 

Made-to-measure orthopedic arch supports are reimbursed at 80%, with a ceiling of CHF 200.- per year. Coverage is limited to one pair per year, subject to a valid medical prescription. Prior authorization is not necessary, and the Supplementary Plan is not applicable.
 

Lumbar support belts and neck braces, as well as support appliances for joints are reimbursed at 80%, up to CHF 300.- per item, subject to a valid medical prescription. Prior authorization is not necessary, and the Supplementary Plan is not applicable.

Coverage for wheelchairs is subject to prior authorization from the Medical Adviser and requires the submission of a valid medical prescription along with a cost estimate. Once approved, expenses are reimbursed at a rate of 80%.

Reimbursement is limited to one wheelchair every five years, with the following ceilings:

• CHF 3,500.- for a manual wheelchair
• CHF 5,000.- for an electric wheelchair
• CHF 17,000.- for an electric wheelchair with verticalization functions

These ceilings include maintenance costs. The Supplementary Plan is not applicable.

Expenses related to hearing aids are reimbursed if their use is deemed medically necessary by an otologist. An audiogram must be submitted along with the invoice and the prescription.

Hearing aids are reimbursed at 80%, up to a ceiling of CHF 2,600.- per hearing aid or per ear, once every five years. Repair and battery costs are also covered and deducted from the five-year credit ceiling.

Prior authorization from the Medical Advisor is not required, and the Supplementary Plan is not applicable.

With a valid prescription, the initial trial period of breathing support devices, such as nCPAP, is covered at 80% for up to six months.

Purchase or long-term rental following an initial trial period is reimbursed at 80%, up to CHF 2,800.- per five-year period, on submission of a valid medical prescription. Repair costs and batteries are also covered within the five-year reimbursement limit.

If medically necessary following surgery or due to an incapacitating chronic illness, medical beds and mattresses are reimbursable at an 80% rate. Coverage is subject to prior authorization of the Medical Adviser and limited to CHF 3,000.- per five-year period.