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Optical
and dental credit:
What should I do to know if I have exhausted my rights to reimbursement? The hospitalisation
(in Switzerland):
Contributions
and voluntary protection:
Supplementary
benefits:
Cures:
Convalescence:
Physiotherapy:
Psychiatrist /
Psychologist:
Transportation
costs:
Optical and dental credit: What should I do to know if I have exhausted my rights to reimbursement? To get to know your availbale credits, please refer to your last reimbursement statement (the blue paper) where you can find your optical and dental credits. The hospitalisation (in Switzerland): What are the admission and exit formalities? - The insured member is not required to pay any amount in advance when entering the hospital or the clinic. However, you might be asked for a guarantee. The identification card of the Fund (which is blue) should generally suffice for this purpose and if need be, Shif can supply an attestation. - Once you have received your invoice, you usually have 30 days to pay it. - Before settling the bill, you can submit it to the Health Fund who in turn will reimburse you according to the conditions of the Schedule of Benefits, taking into account our agreements with our health care providers. - Once you have received reimbursement from by the Fund, it is your responsability to pay your invoice. N.B: If the hospitalisation occurs outside of Switzerland, the Fund can give you an advance. Contributions and voluntary protection: How much do I need to pay? - The contribution of the insured member for himself and his family amounts to 3.3 % of her/his salary as of 1st January 2006. - For the insured members who have a voluntary protection, the monthly contribution has been fixed as follows: Rates of contributions (US Dollars)
* For more information please refer to the Articles 3.5 and 3.6 of the Regulations. Supplementary benefits: What is this? - If the expenses of the insured (and his family) are less than US$ 10,000 per calendar year, the insured member will be responsible for 20% of his expenses (i.e. SHIF will reimburse 80%). - If the expenses of the insured (and his family) are over US$ 10,000 per calendar year, the insured member will be responsible for 5% of his expenses (i.e. SHIF will reimburse 95%). - For staff in duty stations outside Europe, the United States, Canada and Japan the threshold is set at US$ 3,000. Cures: Do I have the right to follow a thermal cure? - Benefit for treatment and accommodation for cures is only paid in respect of cures of at least two weeks (10-14 days) and is limited to one cure per calendar year. Maximum benefit for accommodation is set at US$ 20 per day and the maximum number of days for which accommodation may be paid is set at 14 days in any calendar year. - Costs for the medical treatment are reimbursed up to 80%. - It is necessary that SHIF be provided with precise and distinct information on both the accommodation and the medical care expenses. The global receipt made out by a travel agency will not be considered sufficient to authorise reimbursement. Convalescence: How does this work? Reimbursement is limited to 45 days per sickness, per protected person and per calendar year, unless the Medical Adviser certifies the continuing need for curative treatment. When this limit is attained, the insured member should address a complete medical report to the SHIF Medical Adviser in order to obtain authorization for the continuation of the stay. Physiotherapy: How many sessions will be reimbursed? Up to 30 sessions are reimbursed without prior approval. Beyond this amount, you will be asked for a medical report from your treating doctor. Is there a maximum amount per session reimbursed? The maximum benefit is set at US$ 68 per session. Psychiatrist / Psychologist: Do I need a medical prescription to visit the psychiatrist? And how about the psychologist? The psychiatrist is a doctor and therefore there is no need for a medical prescription. However, you will need a medical prescription to consult the psychologist. How many sessions will be reimbursed? The maximum benefit is set at 60 sessions or to US$ 6,000 of expenses, (therefore a benefit of US$ 4,800), whichever one comes first, per person in any period of three calendar years. Transportation costs: - In case of an emergency, SHIF covers the cost of a one-way transportation to the nearest place of treatment. SHIF also covers the costs of medical travel when adequate medical care is not available in the duty station/area of residence. The new Schedule of Benefits also provides reimbursement for transportation costs from one institution to another, for example from one hospital to a convalescence home. - Taxi fares and medical repatriation costs are not reimbursable by SHIF. |
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