Medical Expenses

You are entitled to receive a reimbursement for the cost of medical treatment, medication, or medical aid, depending on your health insurance, insurance status, or other conditions that may apply. All medical reimbursement requests are subject to approval or denial by the SZV’s control doctor.

Who

ZV, FZOG, OZR insured.

Procedure

  1. You pay 100% of the invoice for a medical treatment, medication, or medical aid.
  2. You submit a request for medical reimbursement at SZV by filling out the medical reimbursement form.
  3. Your request is processed for approval or denial by the SZV physicians.
  4. The reimbursement process and payment can take up to six weeks.
  5. The calculated and approved funds of your reimbursement request are paid to you via a bank transfer and you will receive a decision from SZV indicating what amount has been reimbursed and why

Please note:

  • The amount you will be reimbursed depends on your health insurance coverage and the by law established medical tariffs.
  • Retired Government workers (FZOG) and civil servants receive 90% or 100% of the approved tariffs and amount.
  • Most reimbursements payments will not cover 100% of your costs.

What to bring

  • ZV, FZOG and/or OZR Insurance Card
  • If applicable: insurance Letter (can be obtained at the Employee’s Desk)
  • Original and detailed receipts/bills related to the medical expenses made
    Please make sure that:
    a) The bills are completely paid
    b) That proof of payment of the bill is present/visible
    c) That the patient’s name is mentioned on the receipt/bills
    d) ZV insured can submit receipts/bills not older than 6 months
    e) OZR and FZOG insured can submit receipts/bills not older than 1 year and 3 months
  • A valid medical referral (not older than 6 months)
    Please make sure that:
    a) The referral is from a GP to a specialist or from a specialist to a specialist
    b) Laboratory and radiology treatments/visits have referrals
    c) That the referral that is prior (up to 6 months) or equal to the treatment date
  • Detailed medical report
    The medical report needs to mention:
    a) Who underwent the procedure
    b) What was done (in detail)
    c) When it was done
    d) How it was done
  • The medical reimbursement form, properly filled out and signed
    Please make sure that:
    a) An email address has been provided
    b) That the form is signed and dated
    c) Each adult and each child is filled out on a separate form
    Keep in mind that the more information the patient provides the better for the evaluation process.

FAQ’s

How will I know what I was reimbursed?

You are required to fill in your email address on the medical reimbursement request form. SZV will use this to email you the official decision which will have a detailed specification of what has been reimbursed.

I don’t agree with the reimbursement.

If you do not agree with what has been reimbursed, you have six weeks (after receipt of the original decision with the specification) to write an appeal letter, addressed to the Director of SZV, explaining why you are not in agreement with your reimbursement payment.

Can someone else request my reimbursement?

Yes, they can, however, they must have in their possession a power of attorney (authorization letter) to receive any funds on your behalf.

How do I get my prescription glasses covered?

FZOG insured, PP-card holders and OZR insured qualify for coverage of their prescription eyeglasses.

  • FZOG insured can submit their eyeglasses prescription to SZV, where they will receive a blank check with the calculated amount (based on the by law established tariffs) that is in accordance with the strength of their lens. They can also pay for the glasses first and then submit a claim through a medical reimbursement request.
  • PP-card holders and OZR insured can submit their eyeglasses prescription (or contact lenses prescription if you are OZR insured) for a stamped approval before collecting their eyeglasses. They can also pay for the glasses first and then submit a claim through a medical reimbursement request.

How do I get my dental treatments covered?

FZOG insured, PP-card holders and OZR insured qualify to receive dental treatment coverage. All amounts will be paid and/or reimbursed based on the by law established tariffs. They can:

  • Pay for their dental treatments and then submit a request for a medical reimbursement.
  • Or submit a pro-forma invoice of the total cost and a check will be issued in the name of the dentist.

How do I get my orthodontic treatments covered?

OZR insured qualify to receive orthodontic treatment coverage. All amounts will be paid and/or reimbursed based on the by law established tariffs. They can:

  • Pay for their dental treatments and then submit a request for a medical reimbursement.

Or submit a pro-forma invoice of the total cost and a check will be issued in the name of the dentist.

Social & Health Insurances SZV © 2018