HOSPITAL FLEX
Flexible supplementary hospital insurance with a free choice of ward on a case-by-case basis (with co-payment). Unrestricted choice of doctor and hospital with hospitals and doctors recognised by Helsana.
Insured benefits
With HOSPITAL FLEX supplementary hospital insurance, you receive the following benefits in addition to statutory benefits covered by basic insurance:
If an acute inpatient hospital stay or stay in a convalescent facility can be prevented or at least reduced by medically prescribed household help, then you receive up to CHF 50 per day for up to 30 days per calendar year.
What does your basic insurance cover?
Basic insurance does not cover any costs. Patients who require household help after a stay in hospital have to finance this themselves.
Please note that you will only receive contributions towards convalescent treatment, household help, the nanny service, and acute and transitional care if you have also taken out the FLEX supplementary model.
Advantages for persons insured with supplementary insurance
Frequently asked questions
Supplementary hospital insurance allows you to enhance your basic hospital insurance cover for inpatient treatment with benefits of your choice.
Basic insurance only reimburses you for the tariff set in your canton of residence for your stay and medical treatment in a general ward (multi-bed room), provided the hospital is on the hospital list in your canton of residence or for medical reasons you require treatment in an out-of-canton hospital. You must pay for all extra benefits yourself – such as household help following an acute hospital stay or childcare while you are recovering in the hospital. That is why these supplementary benefits give financial peace of mind.
HOSPITAL FLEX is ideal for those who want to be able to choose the type of ward each time they go to hospital. The selected type of ward then determines the room comfort and additional services:
- For minor operations a hospital stay in the general ward is usually sufficient. Then you do not have to pay any additional costs.
- For longer hospital stays you may prefer to have a quieter space with more privacy. In this case, for an additional charge (co-payment) you can choose a semi-private (double room) or private ward (individual room).
- You may want to have certain operations performed by a specific doctor – for example when highly complex surgery is needed. However, the free choice of doctor is only available in a semi-private or private ward.
HOSPITAL FLEX is so favourably priced because you only pay for what you actually need.
If you only want to cover expensive hospital costs, just take out the main module in the variant FLEX 1 or FLEX 2. If you also want contributions paid towards convalescent treatments, household help and other supplementary benefits, however, you can also take out the FLEX supplementary module.
With HOSPITAL FLEX supplementary hospital insurance, you do not pay for hospital costs if you stay in a general ward.
If, on the other hand, you decide on a semi-private or private ward, you have to contribute towards your hospital costs:
Semi-private ward
- FLEX 1 variant: 35% cost contribution up to CHF 3,000 per calendar year
- FLEX 2 variant: 20% cost contribution up to CHF 2,000 per calendar year
Private ward
- FLEX 1 variant: 50% cost contribution up to CHF 9,000 per calendar year
- FLEX 2 variant: 35% cost contribution up to CHF 4,000 per calendar year
No. The free choice of doctor only applies to hospital stays in a semi-private or private ward. This means that if you select the general ward you cannot choose the doctor who operates on you.
Basically you are free to choose the hospital you want anywhere in Switzerland. However, certain hospitals and clinics or their wards or tariffs are not recognised by Helsana. As a result, you may have to pay for some of these costs yourself.
So please ask us before you are hospitalised, whether we will cover all the costs of your hospital stay.
You can take out this insurance if you meet the following conditions:
- Is your official residence in Switzerland?
- HOSPITAL FLEX 1: Will you be under the age of 70 when you take out the policy?
- HOSPITAL FLEX 2: Will you be under the age of 50 when you take out the policy?
- Then you are eligible for these options. For the purposes of risk assessment, we require you to fill in a health declaration.
The minimum term is one year. The contract is automatically renewed each year on the expiry date for a further year.
You can terminate the insurance on 31 December of each year and switch to another health insurance company in Switzerland. Three months’ notice of termination must be given. Notice of termination must reach us by no later than the last working day in September. If the insurance premium changes, a one-month notice period applies. In this case, notice of termination must reach us by no later than the last working day in November.
A waiting period is the time (from the start of the contract) during which you do not yet have a claim to insurance benefits. The length of the waiting period can vary depending on the insurance benefit.
There is a waiting period of 365 days for maternity benefits. That means you cannot claim these benefits before the end of the first insurance year. Your maternity stay in a hospital in the first year would only be covered through basic insurance – for childbirth and postpartum, for instance. You receive the costs of a stay, care and treatment in a general ward (multi-bed room) based on the tariff in your canton of residence.
However, you are covered from the start of insurance for benefits paid as a result of illness or accident.
- For two or more family members insured under the same contract, we grant a family discount of 5% on this and other supplementary insurances; for three or more insured family members, the discount is 10%.
A room upgrade on its own isn’t possible. HOSPITAL FLEX is an insurance package and covers the costs for additional hotel-style services and free choice of doctor. If you wish a one-bed room, you will be treated as a private patient, including free choice of doctor and additional comfort, in which case you will also be responsible for the co-payment for a private ward. If you choose a general ward, we will pay the additional costs if you choose a hospital outside your canton of residence for your treatment.
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Other supplementary insurance
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