Emergency abroad: What does the health insurer pay?

A medical emergency abroad can become expensive quickly. This is because Swiss basic insurance often only covers treatment costs up to a certain extent – specifically up to twice the amount that would be paid for the same treatment in Switzerland. 

This coverage limit can be exceeded quickly, particularly in countries with high healthcare costs such as the US, Canada or Japan, resulting in substantial residual costs for you. This article explains what benefits your basic and supplementary insurance covers abroad, what you should do in an emergency, and how you can protect yourself against high costs. 

Emergency abroad: What should I do?

• Step 1: Get help. Call emergency services or consult a hospital or doctor.
• Step 2: Contact your travel insurance company if you have one. Our advisors will help you clarify the costs, answer your questions and help you organize the next steps.
• Step 3: Contact your health insurer or accident insurer and clarify which costs will be covered and whether additional proof is required. It’s important that you keep all invoices so you can submit them later.

What does my health insurance pay in the event of accident or illness abroad? 

In the event of illness, mandatory basic insurance covers the costs incurred abroad if you suddenly fall ill and returning to Switzerland is unreasonable or impossible. It does not matter which model you have chosen. In case of medical emergencies abroad, you are not required to contact your designated first point of contact prior to treatment. The costs are not covered if you go to a private hospital or travel abroad for a specific treatment.

In the event of an accident abroad, the health insurance will only cover the costs of treatment if you have taken out accident insurance. As a rule, anyone who works more than eight hours a week is insured through their employer against accidents in Switzerland and abroad. In this case, you must inform your place of work, which will notify the responsible insurer of the accident.

If you are not sure whether it is an emergency, we recommend contacting your health insurer.

What costs are paid for by basic insurance abroad?

Within EU and EFTA countries, you are entitled to the same benefits for emergency medical treatment as the insured residents of that country.

In the other countries, i.e. countries outside the EU/EFTA, the cost contribution from basic insurance in the event of an emergency is a maximum of twice the cost of the same treatment in your canton of residence. For countries with high health costs such as the USA, Canada, Australia, or Japan, twice this amount is often insufficient to cover the costs of treatment. This means that you have to pay the costs not covered by basic insurance out of your own pocket. To avoid this, it’s worth taking out additional insurance. AXA travel insurance offers comprehensive protection in such cases: Combining the Medical treatment costs abroad add-on module and the Personal assistance basic module will cover the costs that your health insurer will not pay for.

In any case, basic insurance does not cover costs relating to an accident or illness, for example for recovery, a search operation or transportation to the hospital. Rescue missions outside of Switzerland or transportation to Switzerland (repatriation) are also not covered. You need supplementary insurance for this. The Personal assistance basic module as part of AXA travel insurance covers, for example, rescue and recovery costs as well as the cost of transportation to the hospital or to return to Switzerland.

Is basic insurance enough to cover illness abroad?

Basic insurance generally covers the treatment costs for emergencies or unforeseen illnesses. However, it only covers up to twice the amount paid in Switzerland for comparable treatments. This means that you may have to pay some of the costs yourself while abroad. The costs of medical transportation are also not covered. For comprehensive coverage abroad, it is therefore advisable to take out supplementary insurance or travel insurance. In any case, you should always check your insurance coverage before you plan to travel and make sure that you are adequately insured. 

Why do I need the European Health Insurance Card (EHIC)?

You will find the European Health Insurance Card (EHIC) on the back of your Swiss insurance card. It is your official proof of entitlement to emergency medical treatment in the public health systems of the EU and EFTA countries and the UK.

In the event of illness, accident or maternity, you will receive services under the same conditions as locals.

The following costs are not covered:

• Treatments in private clinics
• Rescue, recovery and repatriation (return transportation to Switzerland)
• Planned treatments abroad

If you forget the card, you can pay the costs up front and claim them later, or request a replacement certificate from your health insurer.

How much does return transportation to Switzerland cost?

The cost of return transportation within Europe can be more than CHF 20,000 if you are flown home by air ambulance jet. The cost of a scheduled flight with medical support within Europe is less than CHF 10,000,  but in most cases it’s a big drain on your vacation budget.

Intercontinental travel is in a much higher price category: For example, the cost of return transportation from Bangkok by air ambulance jet currently ranges from CHF 80,000 to CHF 100,000.

Remember that these costs are not covered by basic insurance, regardless of whether you are sick or have had an accident. So that you don’t have to pay these costs yourself, you need international health insurance. AXA’s travel insurance combines the Personal assistance basic module with the Medical treatment costs abroad add-on module to provide comprehensive coverage for such emergencies.

What happens after return transportation to Switzerland?

If you have to go back to the hospital after being transported home, your accompanying medical crew will take you directly to a suitable hospital in your canton of residence. In this instance, "suitable" means that the hospital can treat your injury or illness. If you're flown back to Switzerland on a scheduled flight, an ambulance will be waiting at the airport for you and your medical support to take you to the hospital. If you're flown by ambulance jet, the rescue vehicle will be waiting for you directly on the tarmac.

However, if you've already been discharged and no longer need to go into hospital, you can go home directly. It's possibly a good idea to visit your own doctor.