The 11 most frequently asked questions about hospital stays

In general, yes. Basic insurance covers the costs of stays in hospitals that are included in the cantonal list of hospitals of your canton of residence.

For elective treatments in a listed hospital outside the canton of residence, basic insurance only covers costs up to the tariff in your canton of residence. You will have to pay any costs above this tariff yourself. This does not apply if you have taken out HOSPITAL Semi-Private or HOSPITAL Private supplementary insurance. These insurances also cover these costs. In addition, you benefit from more comfort and a free choice of doctor.

What happens when a hospital is not on the cantonal planning and hospital lists? In this case, entitlement to benefits only applies if Helsana has concluded a KVG contract with the hospital (see KVG contract hospital list).

In the case of Supplementary Hospital Insurance, it should also be noted that the costs of an inpatient stay at certain hospitals and under certain attending physicians are not covered or are only covered up to a limited amount (see list of hospitals and attending physicians without cost coverage or without full cost coverage).

We are here for you if have questions or doubts about your hospital stay: 0844 80 81 82.

Current message (15.05.2023)
We currently do not cover the costs for inpatient stays at the Private Clinic Bethanien or the Pyramide am See Clinic in Zurich. This applies to both costs under compulsory basic insurance (OKP) as well as HOSPITAL supplementary hospital insurance.*

*see listings on all three lists

This depends on the type of insurance cover. With basic insurance, you don’t have the choice. However, with our supplementary insurance HOSPITAL Semi-Private or HOSPITAL Private, you are free to choose the hospital doctor yourself. Even if your preferred doctor or hospital is not on the “List of hospitals and attending physicians without full cost coverage”, you will still be fully covered.

Are you facing inpatient hospital treatment? In thorough consultations, our advisors will be happy to help you with any questions you may have before, during and after your hospital stay. These may be about topics such as costs, admission formalities, organising transport to or from the hospital or support options at home. This service is available free of charge to all HOSPITAL Private and Semi-Private insurance policyholders.

The hospital will send out your admission forms. You should complete and return these as soon as possible. If you need any medications or specific products, please ensure that you take enough with you to last throughout your stay. Let your friends and family know how to contact you. For longer stays, it is worth having your mail redirected or temporarily held. Ask someone you trust to take care of your mail, plants, etc. Pay any bills in advance. Arrange to be dropped off at the hospital and picked up again. If you don’t have anyone to accompany you, our partner the Swiss Red Cross (SRC) offers a patient transport service. 

If you have taken out hospital insurance, you will receive contributions towards various support services – both for planned stays and emergency admissions. This includes household help, childcare service and professional childcare. Basic insurance does not pay anything towards these support services.

You don’t usually need to worry about paying the bills. The hospital will take care of this with Helsana directly. They will contact you if they have any questions. If you have your basic and supplementary insurance with different health insurers, provide the hospital with the details of both companies in good time.

Rooming-in is a benefit offered by our supplementary insurance HOSPITAL Semi-Private and HOSPITAL Private. It means that a close relative can stay overnight at the hospital with you and get their meals included, too. Many patients enjoy having a familiar face beside them. Some hospitals charge for allowing relatives to stay (food and accommodation). Helsana will cover part of this cost within the insured amount. With HOSPITAL Semi-Private, CHF 100 per day is covered for a maximum of 15 days per year; with HOSPITAL Private, CHF 200 per day is covered for a maximum of 15 days per year.

If you only have basic insurance, you can switch, but you will have to cover the cost of a semi-private ward yourself (room, free choice of doctor). Do you have HOSPITAL ECO supplementary hospital insurance? In that case, part of the upgrade will be covered. We’ll cover 40% of the benefits if you switch from a general ward to a semi-private ward, or 20% of the benefits if you switch from a general ward to a private one. You would still have to make the usual co-payment (hospital cost contribution of CHF 15 per day, deductible and excess). If you are planning to switch, we recommend that you request a cost estimate from the hospital.

If a transfer is necessary on medical grounds, the hospital where you are being treated will cover the transport costs. If you have requested the transfer yourself, you will have to pay.

Part of the transport costs for admission and in an emergency is covered by basic insurance and by some supplementary insurance policies. However, if you do not have supplementary insurance, some costs may not be covered. You would have to pay all costs that are not covered by your insurance.

No. You would have to pay for non-statutory benefits yourself. These include operations listed in the health insurance conditions under “Exclusions of benefits”. You would also have to cover the cost of special forms of treatment yourself if they are not recognised under the basic insurance policy because they are not of clinical significance (e.g. sterilisation, liposuction). As a general rule: in accordance with the Federal Health Insurance Act (KVG), only statutory benefits are covered under basic insurance. In the case of supplementary insurance, the exclusions of benefits go beyond those of the KVG. These are governed in the General Insurance Conditions. You would have to pay any personal expenses (e.g. phone calls, haircuts) yourself. If in doubt, you can ask us in advance whether a benefit would be covered or not.