Medical treatments in Switzerland
Submit an invoice for reimbursement
You have claimed a medical treatment in Switzerland and need information on the reimbursement process.
International mutual benefits assistanc
The Gemeinsame Einrichtung KVG coordinates the assessment of claims, examines invoices in respect of conformance to the legal regulations as well as the contractual and negotiated conventions for the whole of Switzerland. It settles treatment costs and subsequently invoices the competent health insurance abroad.
Cash benefits are not paid by the Gemeinsame Einrichtung KVG but have to be claimed direct from the competent health insurance abroad.
Requirements
With your legal insurance cover in the EU/EFTA or the UK, you are entitled to the same benefits as insured persons in Switzerland and contribute to the costs of treatment. On behalf of your health insurance company, we will cover the costs of medical treatment in Switzerland and pass them on to your health insurance company (international benefits assistance). Without this insurance cover, it is not possible for us to provide care or cover the costs.
Our benefits are based on the Agreement on freedom of movement between Switzerland and the EU1 and are only possible when the requirements of the EU coordination law are fulfilled. This will be reviewed in close co-operation with your health insurance company and information will be exchanged.2
1Annex II of the Agreement on the Free Movement of Persons, art. 17, 24, 26 Regulation (EC) No 883/2004, art. 24 Regulation (EC) No 987/2009
2Art. 76-78 Regulation (EC) No 883/2004
Reimbursement
The service provider issues the invoice in accordance with the applicable cantonal contracts and tariffs. The treatment costs can be invoiced in two ways:
1. The service providers issue the invoice to the Gemeinsame Einrichtung KVG (tiers payant)
2. The service providers issue the invoice to the insured persons (tiers garant)
If you pay the invoice yourself, you will be entitled to a refund. To ensure a quick and free refund, we will need the invoice, a copy of your proof of entitlement and your full bank details:
IBAN (International Bank Account Number)
BIC (Bank Identifier Code)
Name and Address of the Bank
Account holder and address
Send us your documents as a PDF file by e-mail to info@kvg.org.
Account statement
The account statement shows which treatments and benefits have been covered and how much you have paid towards the costs. You can see which outstanding amounts (tiers payant) are to be paid and whether there is a credit balance in your favour (tiers garant). The relevant information on the single cost participation, share, hospital contribution and not covered benefits is also listed. The details of the medical service provider and the dates of treatment are also shown.
Invoice rejection
If the invoice was rejected due to missing documents, please send the necessary documents together with the reclaim receipt and a reference to the insurance number as a PDF file by e-mail to info@kvg.org. The requirements for reviewing the refund can be found in the checklist.
Tariff protection
The service providers are obligated to provide you with legal health insurance coverage from the EU/EFTA or the UK under the same legal benefits and conditions as a person insured in Switzerland. The entitlement to benefits, the applicable tariffs and the cost sharing in the event of a treatment are determined by the Swiss health insurance law. The Swiss Health Insurance Law KVG allows you to choose freely among the service providers authorised for health insurance who are qualified for the treatment.