Frequently Asked Questions
Choice of doctor in the HMO health system
HMO health insurance is a special form of compulsory health insurance involving a limited choice of service providers. The HMO health organisation provides comprehensive care and treatment for HMO policyholders in all matters relating to their health, with the benefits guaranteed by the HMO health insurance system corresponding to those of the compulsory health insurance system
Persons insured under the insurance program are also insured for private liability.
Persons insured under the insurance program are also insured under Patient’s Legal Protection.
Persons insured under the insurance program are also insured against the risk of accident. Benefits in the event of an accident are the same as for illness.
We are committed to creating sustainable value for our customers, shareholders and employees, while making a contribution to the environment and society.
Having reduced the volume of physical files we publish by almost 65%, we are continuing our commitment to the UN’s Sustainable Development Goals (SDGs).
Having been the first insurance company to introduce the virtual insurance card, we have progressively reduced the use of the printed version, which does not meet current environmental standards.
We are now at the end of this transformation, which allows us to free ourselves from this physical medium, thus further reducing our impact on the environment, with which our customers are greatly associated.
Who pays what ?
Premiums
The Federal Commission for Scholarships (FCS) pays the monthly premiums.
Annual deductible
Scholarship Holder pays the annual deductible (CHF 100 / CHF 300) and contributions (10 % of costs).
Co-payment
It applies to all benefits that exceed the deductible. The Co-payment is 10%.
Normally, Advisor Swiss Insurance will pay the medical bills directly. You will receive an invoice from Advisor Swiss Insurance, corresponding to the annual fixed charge if you use your insurance. You will have to pay that bill or it will be deduced from a medical bill.
However, we cannot guarantee that in particular cases, you will be asked to pay cash the care. In this case, please call or inform Advisor Swiss Insurance as soon as possible.
Provide to Advisor Swiss Insurance the complete bill upon receipt (detailed invoice, payment slip, prescription).
I don’t have a family doctor. How does it work ? Is there a list of providers I can refer to ?
You have free choice and access to all health care providers in Switzerland. For minor diseases, consult a family physician.
If you have none, good medical centers exist in all citys : having the advantage of accepting new patients, grouping several physicians and medical facilities.
In case of severe emergency, you should go to hospital.
Make sur you always have your insurance card available on Advisor Mobile App.
What is covered ?
• Necessary medical, pharmaceutical and hospital expenses in case of illness, accident and maternity, as well as complete coverage of medical repatriation and assistance services.
• Private liability insurance
If you have a medical history, it is strongly recommended to maintain your usual insurance coverage and to read carefully the Policy conditions in order to fully understand the limits of your benefits in relation to pre- existing conditions as well as the obligations incumbent upon you within the framework of the group health insurance program.
What is excluded ?
Although this group health insurance program covers most medically necessary treatment, expenses incurred for the following treatments, medical conditions, procedures, behaviours or accidents mentioned in the “Exclusions” of the Policy conditions should be taken into consideration, unless otherwise indicated on your Care Plan. Please read the insurance policy conditions carefully in conjunction with your Care Plan to ensure that you fully understand your level of cover. Scholarship holders arriving with health problems may have to pay themselves for certain treatments. Any preventive medical check-ups are not covered by this health insurance.
COVID-19
Consult our website on this subject.
All answers are without this space. Our services do not provide answers by phone or email on this subject.
Where is the coverage valid ?
The insurance cover is valid worldwide. Abroad, the cover is only valid in case of emergency.
Insurance card
Each scholar has access to his or her virtual insurance card by downloading the Advisor Mobile App.
How does the dispensation from compulsory health insurance works ?
ADVISOR sends all the necessary documents to the cantonal social insurance office in charge of health insurance.
Some cantons may ask for a signature from scholarship holder. In this case, you must :
• print your exemption form available on Advisor Mobile App
• sign the exemption form
• send the exemption form using the address indicated on the form
If you receive correspondence or e-mail from the cantonal social insurance office, please forward a copy to Advisor upon receipt.