The Swiss health insurance system operates two refund principles. The service provider, for example the GP or physiotherapist, can be paid for their services in two ways:

1. Payment from the insured person, who then claims the costs incurred back from his or her insurer (Tiers garant system).
2. Payment from the insurer if the insurer has agreed with the service providers that the insurer will compensate their services directly (Tiers payant system).

The Tiers garant system will be used unless you have agreed something to the contrary with your health insurance provider. This means that you will be sent the bill after you visit a doctor. You will have to pay this yourself. You will be sent a duplicate invoice with the original invoice (reimbursement receipt or copy invoice). Send this copy to the health insurance fund. If the amount exceeds the excess, 90% of the total will be paid into your bank or post office giro account.

Note: To avoid cash-flow problems it is advisable to send the invoice to the health insurance fund immediately. Often the health insurance fund will have paid the money into your account before the payment deadline for the doctor’s invoice has expired.

Hospital invoices are either sent to you at home or to the health insurance fund. Usually the health insurance fund pays the invoice direct. The health insurance fund or the hospital will send you a separate invoice for any costs for which you are responsible (excess, contribution to costs of hospital stay).