What is the reimbursement rule for hospitalisation?

On a general ward in a public hospital, 100% of the costs will be reimbursed.

The costs of hospitalisation on a semi-private ward in an approved clinic or a public hospital will be covered in accordance with the General Rule.

In a non-approved clinic, 80% of the costs will be reimbursed, with no limit on the costs borne by the member (no FCA accumulation).

In all cases, the supplement for a private ward is borne by the member.

 

Establishment Approved Not-Approved
  Common division (cantonal hospitals) Semi-private division Private division Semi-private division Private division
Choice of practitioners (surgeon, obstetrician) No Yes Yes Yes Yes
Number of beds 2 to 8 beds Max. 2 beds 1 bed Max 2 beds 1 bed
Reimbursement of medical treatment costs 100% General Rules General Rules 80% 80%

Semi-private
accommodation
(2nd class)

Not applicable General Rules General Rules 80% 80%
Private accommodation (1st class) Not applicable Difference between 2nd and 1st class at member's sole expense Not applicable Difference between 2nd and 1st class at member's sole expense

 

 

FAQ category