Insurance: Ambulance costs

Question - I had to call an ambulance a week or two ago following a fall of a family member, and they came - did some tests, and suggested that staying at home for the time being was a good idea.

I got the invoice (just shy of 1k), and paid it; but uploaded it to the insurance company site (accident + sickness - basic).

Today I got a payment of 50% of the bill, the remaining 50% being "not covered".

Looking through the detailed invoice, there isn't anything that aligns with 50% as a line item, so it really feels like a 50% "copayment". That said, this isn't a copayment, this isn't a deductible, now is this a hospital copayment (those are itemised separately).

Any ideas if this is normal? In case of an accident, does the health insurance not cover the full cost?

Yep. Transport costs are not properly covered. They only cover 500 per year I think, total!!! 😳

but it’s not a transport cost - it’s an ambulance (technically a rapid response vehicle, but samesame) that came to the house…
They did an ECG, monitored for 30 minutes, checked nothing was broken - and then left…

EDIT: Also, are you sure about that? This suggests otherwise:


Ok, ambulance & helicopter services have a max pay out of 500 a year (or 5000 if you are in mortal danger eg heart attack).

“Cost coverage via basic insurance

This is different from an emergency service due to illness – or if you are only insured against accidents via through basic insurance: in this case, your compulsory health insurance applies. It covers 50% of the costs– after subtracting the deductible and coinsurance.

In addition, a maximum amount applies: in the case of medically assisted patient transportation, the health insurance company covers up to 500 francs per year. This also applies to emergency transportation abroad.”…wagen-ambulanz

Thanks - weird that the BAG site is so different in messaging.

It’s probably talking about accident insurance via an employer. They are not equal.

But in your case, there wasn't any necessary travel, transport and rescue costs.

I don’t think the rules change if you call the services but don’t go to hospital. Part of me wonders if this rule is to discourage people from calling the emergency services, un like in the UK where some people call them out for very minor issues.

That's accident insurance, not health. They're distinct.