Many Spaniards living in Switzerland spend the summer in Spain, visiting family, and at some point someone falls ill or has an accident. The question that always arises then is the same: do I have to pay myself, or is it covered by my Swiss insurance? The short answer is that the LAMal covers emergency care abroad, but with limits that you should be aware of before seeing a doctor.
What the LAMal covers in Spain, or in any EU country, is urgent and necessary medical care. It does not cover scheduled appointments, follow-up visits that you could easily have had in Switzerland, or dental treatment. Coverage is also limited to the cost that the same treatment would have incurred in Switzerland. In practice, this means that if the bill in Spain exceeds that limit, you have to pay the difference yourself. And there’s another detail: in most cases, you have to pay up front and then claim a refund from your health insurance provider, attaching the original invoices. It’s not a complicated process, but it does need to be done: a refund form, invoices, and sometimes a translation if the insurer requests it.
If you have international supplementary health insurance, the level of cover is considerably better: many health insurance funds offer supplementary cover that covers non-urgent care abroad and removes the limit based on Swiss rates. If you spend weeks or months in Spain every year, or if you have family visiting who might need medical care, it’s worth checking with your health insurance provider exactly what your policy covers. With basic cover, you’re covered in an emergency. But only in an emergency. Many people realise this far too late.