Lots of great changes

Hospitalisation insurance

CSS is increasing the amounts available under hospitalisation insurance for non-clinic-related additional services (e.g. travel and other non-medical costs) when undergoing outpatient procedures.

The new amounts are:

• maximum contribution of CHF 300 per calendar year under myFlex Balance Hospitalisation Insurance
• maximum contribution of CHF 500 per calendar year under myFlex Premium Hospitalisation Insurance
  

The new maximum amounts apply as of 1 July 2023.

Death or disability insurance

CSS is expanding its offer in relation to Accidental Death or Disability Insurance (ADI) and Illness-Related Death or Disability Insurance (IRDDI).

You can now take out cover for the following total benefit amounts:

• CHF 100,000 (death) / CHF 600,000 (disability)
• CHF 200,000 (death) / CHF 600,000 (disability)

The new total benefit amounts apply as of 1 September 2023.

Health Account

If you have taken out certain supplementary insurance policies with CSS, you benefit from the Health Account. This is our way of supporting your health-related activities. For example, we now pay amounts towards ocumeda eye check-ups and the Cardio Explorer heart health check-up. We also recognise all exercise and fitness courses run by Pro Senectute, and make contributions towards judo and karate club memberships for children and young people.

The new contributions from the Health Account apply as of 1 October 2023.

Outpatient insurance

CSS is expanding its list of aids under outpatient insurance and appliances to include Flow Neuroscience, a brain stimulation kit designed to support the treatment of depressive symptoms. In the myFlex Outpatient Insurance (Economy, Balance, Premium), 90% max. CHF 270 covered.

The new contributions apply as of 1 January 2024.

Promotion of generics and biosimilars

The Federal Council has increased the “higher retention fee” for certain medicines from 20% to 40% in order to encourage the use of generics and biosimilars and contain healthcare spending.

Once you have used up your deductible, your retention fee for medication is generally 10% of the costs. A higher retention fee is charged if the medicine you buy is more expensive than other available medicines with the same active ingredient. This higher retention fee will increase from 20% to 40% as of 2024.

Savings potential

The increase in the higher retention fee is intended to create an incentive to buy lower-cost generics and biosimilars. According to the Federal Office of Public Health, the savings potential is considerable and this measure should lead to a general reduction in healthcare spending.

If patients are not able to use the cheaper alternative on medical grounds, they are permitted to purchase the more expensive medicine without having to pay the higher retention fee. However, their doctor is now required to submit a supporting statement detailing the medical necessity.

More information is available in the Federal Office of Public Health fact sheet (in german).

We will publish the amended Callmed, Multimed and Profit Family Doctor Insurance regulations on our website nearer the time.

The new higher retention fee applies as of 1 January 2024.