Does the general rule apply to all benefits?

No. Not all benefits are reimbursed in accordance with the general rule described under the previous question. To check whether the rule applies, please consult the list of benefits that you will find on the site. There you will see that, if you opt for a private hospital that is not approved by the CHIS, your reimbursement will be limited to 80% of your expenditure and the amount at your expense will be unlimited since the general rule does not apply. You may therefore be required to pay large sums of money out of your own pocket.

Am I entitled to the 3 300 CHF ceiling for dental treatment in my first year of CHIS membership?

This depends on when you joined the CHIS, as the annual ceilings are reduced prorata temporis according to your length of membership. The table below explains the ceilings that apply to dental treatment if you joined the CHIS on 1 September of a given year and have a three-year contract ending on 31 August:

 

Am I entitled to the 9 900 CHF ceiling for dental treatment in my first year of CHIS membership?

Am I entitled to the 9 900 CHF ceiling for dental treatment in my first year of CHIS membership?

No. The carry-forward principle is based on an annual expenditure ceiling of 3 300 CHF. Any unused portion of this ceiling can be carried forward to the following year(s) until a maximum cumulated ceiling is reached after three calendar years. This means that the CHF 9 900 expenditure ceiling will apply only in the third year and only if you have not claimed for dental treatment in the previous two years.

Procedure for “travailleurs frontaliers" regarding the right to opt for a health insurance system

Members of personnel are reminded that their spouses who have “travailleur frontalier” (cross-border commuter) status are obliged to formally choose a health insurance system (Swiss or French) within three months of taking up employment in Switzerland. Click on the title for more detail.