We are committed to keeping claims settlements as clear and simple as possible and, of course, settling your claims correctly.
When you or your doctor send an invoice to Sanitas, we send you a claims settlement.
The claims settlement shows which costs Sanitas pays and your share of the costs. We therefore welcome customer feedback on claims settlement documents.
If you have any questions, for example on a charged item, copayment or itemised amounts, please contact your service centre.
There are different ways to reimburse invoices issued for medical treatment. Please see below for important information and explanations.
Under the law (KVG/LAMal), people with health insurance have to pay a share of the costs when they claim for treatment provided by a doctor or hospital or for drugs. The cost share comprises an annual deductible, copayment and hospital contribution. Please see below for important information on these definitions.
If we have not contractually agreed direct payment with a healthcare provider (hospital, doctor, therapist, etc.), the Swiss Federal Health Insurance Act states that the patient is liable to pay, not the health insurer. This is why the invoice is sent to you personally after your appointment.
You pay the invoice issued by the billing party and send us the reclaim voucher. We check the invoice and refund you the insured costs minus your cost share.