August, sunshine, family. And then suddenly a fever, an infection or something worse. The question many people ask themselves then is: does my Swiss insurance cover me here?
The answer is yes, but there are some important caveats. The LAMal covers urgent medical care outside Switzerland – that is, situations that cannot wait until your return. The financial limit is set by law at twice what the same treatment would cost in Switzerland. You are responsible for any costs exceeding this limit. And there is a practical catch: in many Spanish healthcare centres, particularly private ones, the actual cost may exceed this limit, and the insurance provider will not cover a single franc more than that.
The second point, which comes as a surprise to quite a few people: the LAMal does not cover routine medical appointments abroad. If you have an appointment with the dermatologist that you’ve been putting off for a while, or you want to make the most of your trip to have a general check-up, your health insurance won’t cover it. Only emergencies are covered. And in most cases, you’ll have to pay up front and submit the invoice in Switzerland afterwards, with all the details of the treatment clearly specified.
The aspect that is least often mentioned, and which can end up costing more than anything else: medical repatriation. If you have a serious accident in Spain and need to be medically evacuated to Switzerland, the LAMal does not cover it. That sort of transfer can cost 20,000 francs or considerably more. Some private supplementary insurance policies (LCA) do include this service. Another option is to become an annual donor to Rega, which includes assistance abroad for a voluntary contribution. It’s one of those details that hardly anyone thinks about in the summer and which some people only realise too late.