Do you need to make an appointment or schedule a procedure at Hôpital de La Tour and want to know how much of the cost will be covered by your insurance? Do you want to make sure you are covered if you need emergency care?
What your insurance actually covers depends on a number of factors and we cannot give a definitive answer until we have looked into the specifics of your personal situation. However, the general information below will provide some initial guidance about what your insurance may and may not cover.
General insurance questions?
How do I know if my insurance covers my hospitalization at Hôpital de La Tour?
First of all, let us remember that any care without an overnight stay (e.g., emergency room visit, imaging, chemotherapy, day surgery, etc.) does not require supplementary insurance.
For inpatient hospitalization (one night or more), it is possible to be admitted without supplementary insurance depending on the availability of beds, the availability of the medical team and the pathology.
If you have supplementary hospitalization insurance in a semi-private or private ward , it is recommended to check directly with your insurer or your doctor. Our teams can also help you clarify your situation.
Why don't some supplementary insurance policies cover my hospitalization at La Tour Hospital?
Every year, negotiations take place between insurers and private institutions. Coverage depends on the contract and your insurance product. Negotiations are still ongoing with some insurance companies.
What is the difference between basic insurance (LAMal) and supplementary insurance?
Basic insurance guarantees access to essential healthcare for all, with a strict legal framework imposing the same minimum coverage for each insurer. Supplementary insurance, on the other hand, is subject to the terms and conditions of each insurer, which can set its own terms, accept or reject an insured person based on their health status, and impose reimbursement restrictions.
Why am I receiving a hospital bill and a separate medical bill?
La Tour Hospital is a private facility. Therefore, the hospital bill covers your stay at La Tour Hospital (room, nursing care, medical examinations). Medical fees cover the services of the physician, anesthesiologist, and other specialists. Since physicians are independent, their fees are sent directly to patients.
Can I contest a decision by my insurance company if it refuses to cover me?
Yes. If your insurance company refuses or only partially covers you, you can request a review of your file. You can also consult your doctor to obtain a medical argument in favor of your hospitalization.
What happens if I am admitted as an emergency to La Tour Hospital?
Emergency medical services are available to everyone, adults and children, 24/7, including patients without supplemental insurance. If hospitalization is necessary and can be provided at La Tour Hospital, our teams will inform you of the treatment options.
I live outside the canton of Geneva. Can I be hospitalized at La Tour Hospital?
In case of emergency, yes.
In case of scheduled hospitalization: yes, under certain conditions. Our teams will inform you of the care arrangements.
CSS
Is CSS a partner of La Tour Hospital?
Yes, Hôpital de La Tour and CSS have entered into an agreement to cover your hospitalization costs. Upon receipt of your file, our services will contact your insurer to confirm coverage. Once coverage is validated, Hôpital de La Tour will bill your insurance company directly, with no financial intervention on your part (third-party payment).
What about medical fees?
A pricing agreement has been signed between the CSS, the Hôpital de La Tour and the doctors approved via the Medicalculis system. This guarantees that, if you have supplementary insurance with the CSS, your medical fees are now fully covered , with no remaining costs (excluding any excess or possible co-payment), provided that the medical fees comply with the Medicalculis contractual rates.
What should I do?
No special procedures are required. Our teams handle all administrative formalities directly with the CSS.
Do I have to pay the costs in advance?
Thanks to the care guarantee issued by the CSS, you do not have to pay or advance anything for hospitalization.
The invoices for fees will be sent to you directly (so-called third-party guarantor scheme), and you will then have to send them to your insurance for reimbursement .
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Groupe Mutuel / Assura / SWICA
Is my insurance a partner of La Tour Hospital?
Yes, an agreement has been signed between Groupe Mutuel (along with SWICA and Assura) and Hôpital de La Tour. Your admission will be communicated to your insurer, who will confirm that hospitalization costs will be covered.
What about medical fees?
Groupe Mutuel, Assura, and SWICA recognize the AMGe pricing model. As long as your doctor applies these rates, your fees will be reimbursed.
What should I do?
No action is required on your part. Our services take care of the coverage guarantee.
Do I have to pay the costs in advance?
No, no deposit is required if support is confirmed.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Concordia
Is Concordia a partner of La Tour Hospital?
Yes, Concordia and Hôpital de La Tour have signed an agreement for hospital services. Our services will notify your insurance company and receive confirmation of coverage.
What about medical fees?
Concordia does not recognize the AMGe model and applies a fee cap. Medical fee reimbursement is subject to this cap. Please contact your insurer for more details.
What this means for you:
If your total medical fees are below Concordia's cap, you will be fully reimbursed, subject to your deductible and co-payment.
If your fees exceed this cap, you will be responsible for the excess amount.
If you have any questions about your coverage, we recommend checking directly with your insurance company or asking your doctor for clarification.
What should I do?
Our services will manage the request for support with your insurance.
Do I have to pay the costs in advance?
No, unless your insurance applies a contribution to costs or if the ceiling is exceeded.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Sanitas
Is Sanitas a partner of La Tour Hospital?
No, there is currently no agreement between Sanitas and Hôpital de La Tour. Our teams will handle the administrative procedures related to your hospitalization.
What about medical fees?
A fee estimate is required and submitted to your insurance company. Coverage depends on the options available under your policy and may be limited.
What should I do?
You must forward the quote provided by our services to Sanitas to obtain confirmation of reimbursement.
Do I have to pay the costs in advance?
No deposit will be required upon admission. However, the invoice for the LCA will be sent to you, and it is your responsibility to present it to your insurance company to obtain reimbursement.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Helsana
Is Helsana a partner of La Tour Hospital?
Yes, Hôpital de La Tour and Helsana have entered into an agreement to cover your hospitalization costs. Upon receipt of your file, our services will contact your insurer to confirm coverage. Once coverage is validated, Hôpital de La Tour will invoice your insurance company directly, with no financial intervention on your part (third-party payment).
What about medical fees?
A pricing agreement has been signed between Helsana, Hôpital de La Tour and doctors approved via the Medicalculis system. This guarantees that, if you have supplementary insurance with Helsana, your medical fees are now fully covered , with no remaining costs (excluding any excess or co-payment).
What should I do?
No special procedures are required. Our teams handle all administrative formalities directly with Helsana.
Do I have to pay the costs in advance?
No. Thanks to the coverage guarantee provided by Helsana, you do not have to pay anything upfront, either for hospitalization or medical fees.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Visana
Is Visana a partner of La Tour Hospital?
Yes, Visana and Hôpital de La Tour have signed an agreement for hospital services. Our services will notify your insurance company and receive confirmation of coverage.
What about medical fees?
Visana does not recognize the AMGe model, and fees are capped. Medical fee reimbursement depends on this cap. Don't hesitate to contact your insurer for more details.
What should I do?
Our services will manage the request for support with your insurance.
Do I have to pay the costs in advance?
No, unless your insurance applies a contribution to costs or if the ceiling is exceeded.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
KPT
Is KPT a partner of La Tour Hospital?
No, there is no hospital agreement. Negotiations are underway. Our teams will handle the administrative procedures related to your hospitalization.
What about medical fees?
KPT does not recognize the AMGe model and applies a fee cap.
What should I do?
To find out the amount covered by the KPT, you can contact your insurer or your doctor.
Do I have to pay the costs in advance?
No. No deposit will be required upon admission. However, the invoice for the LCA will be sent to you, and it is your responsibility to present it to your insurance company to obtain reimbursement.
What is the situation with outpatient services at La Tour Hospital?
All outpatient services – which do not involve a night in the hospital* – are accessible without supplementary insurance. Similarly, adult and pediatric emergency services remain accessible to everyone, 24/7, without restriction
(*) such as: consultations with a doctor, imaging tests, chemotherapy or radiotherapy, colonoscopies, surgical procedures not requiring an overnight stay in the hospital, physiotherapy sessions, etc.
Patients from international organizations (UN, CERN, WHO, ILO, etc.)
Is La Tour Hospital a partner of international organizations?
Yes, La Tour Hospital collaborates with all international organizations to provide care for their employees and dependents.
How are medical fees managed?
Patients affiliated with an international organization generally receive full coverage. It is your responsibility to send your doctor's bill to your insurance company for reimbursement.
What should I do before my hospitalization?
It is recommended that you check with your organization's medical department to determine the terms of your coverage. Hôpital de La Tour can also assist you with administrative procedures.
Do I have to pay the hospitalization costs in advance?
No, in most cases, La Tour Hospital sends the invoice for your hospital expenses directly to your organization. However, depending on your contract, you may be charged a remaining amount.
Can I benefit from outpatient services?
Yes, outpatient care (consultations, imaging, specialized treatments) is available to all patients affiliated with an international organization without restriction. Similarly, adult and pediatric emergency departments remain accessible to everyone, 24/7, without restriction.
Patients with international insurance (AXA PPP, Cigna, etc.)
Outpatient coverage under the Swiss insurance scheme
Inpatient coverage according to the Swiss insurance scheme
Outpatient coverage outside the Swiss insurance scheme
Inpatient coverage outside the Swiss insurance scheme
Outpatient Insurance Cover through the Swiss Insurance System
As set by the Swiss Health Insurance Act (Loi sur l’assurance maladie, LAMal) and Accident Insurance Act (Loi sur l’assurance accident, LAA) respectively, the mandatory Swiss health insurance and accident insurance cover the costs related to outpatient care, including medical appointments, diagnostic examinations, treatment sessions, and procedures that do not require you to spend the night in hospital. This applies to both planned and emergency services, whichever Swiss canton (state) you live in.
The co-payment (the portion of the costs that is not covered by your insurance and that you need to pay) depends on your deductible. There is also a percentage contribution paid by patients. These are out of the control of Hôpital de La Tour. You can find more information on this topic on the website of the Swiss Federal Office of Public Health (FOPH).
In some cases, Hôpital de La Tour offers additional private services for outpatient procedures (such as a choice of doctors, a choice of date and rapid access, and hospitality services). These additional private services are not covered by the Swiss social insurance system (LAMal, LAA, etc.) and patients have to pay for them themselves.
Inpatient Insurance Cover through the Swiss Insurance System
Inpatient care at Hôpital de La Tour refers to all admissions to the hospital for at least one night, both in an emergency and for planned procedures. Hôpital de La Tour offers private and semi-private care that give patients access to a wide range of additional services, such as the option to choose your doctor and the date of your procedure, a dedicated medical team, a personalized care pathway, and hospitality services to improve your stay (e.g. a private room or a room with only two beds).
Under the Swiss insurance system, the cost of private or semi-private inpatient admissions is split into two parts. Mandatory healthcare insurance under the Swiss Health Insurance Act (LAMal) and accident insurance under the Swiss Accident Insurance Act (LAA) cover the part of the cost that relates to your basic care3. Any additional medical, hospital, and hospitality services can be covered by supplementary hospital insurance or paid for directly by you.
3 The basic health insurance (LAMal) covers 45% of the cost of your basic care, and your canton or supplemental insurance covers the remaining 55%. Otherwise, accident insurance (LAA) covers 100% of the cost.
Approved Supplemental Insurance
At Hôpital de La Tour, we work with most supplemental hospital insurance providers and have signed agreements with them to simplify the administrative processes involved. It is difficult to provide general information on this topic because of the wide range of products offered by supplemental hospital insurance providers, and because of the general and specific conditions that apply to each individual insurance policy. To reduce the administrative burden on you, we will therefore ask your insurance provider for a payment guarantee before any planned procedure.
For information purposes only, these are the main supplemental hospital admission insurance providers with which we have a full, restricted, or no agreement in place (in alphabetical order):
| The main Swiss health insurance providers we have a full agreement with | Allianz, Atupri, CSS, EGK, Groupe Mutuel, Helsana, ÖKK, Sanitas, Swica, Sympany, Visana |
|---|---|
| The main Swiss accident insurance providers we have a full agreement with | AXA/Winterthur, Bâloise, Generali, Helvetia, La Mobilière, Vaudoise, Zurich |
| Swiss insurance providers with restrictions | Assura (only the ULTRA products), Concordia |
| Main Swiss insurance providers we have no agreement with | CPT/KPT, Innova |
Co-Payment
The co-payment you will have to make (the portion of the costs that is not covered by your insurance) depends on your deductible and your insurance policy. A percentage contribution paid by patients for their basic healthcare is added to this. These are out of the control of Hôpital de La Tour. You can find more information on this topic on the website of the Swiss Federal Office of Public Health (FOPH) and from your supplemental hospital admission insurance provider.
Residence outside of the Canton of Geneva
Apart from in an emergency or on medical grounds, obtaining medical care outside the canton in which you live is considered to be a personal preference under the Swiss social insurance system. Different cantons provide different levels of repayment for inpatient services. As a result, the difference between the fee applicable in your canton of residence and the fee applicable in the Canton of Geneva must either be financed by supplemental hospital insurance, or paid for directly by you.
Outpatient Insurance outside of the Swiss Insurance System
The international organizations (UN, WHO, ILO, and CERN), most foreign postings, and most international insurance providers cover the costs related to outpatient care, including medical appointments, diagnostic examinations, treatment sessions, and procedures that do not require you to spend the night in hospital, both for planned and emergency services. You should always contact your insurance provider for confirmation if in any doubt. For outpatient care, Hôpital de la Tour does not require a payment guarantee from your insurance provider.
The co-payment you will have to make (the portion of the costs that is not covered by your insurance) depends on your insurance provider and your policy. These are out of the control of Hôpital de La Tour and you must seek advice from your insurance provider in advance.
In some cases, Hôpital de La Tour offers additional private services for outpatient procedures (such as a choice of doctors, a choice of date and rapid access, and hospitality services). These additional private services are not always covered by insurance. Make sure to clarify this with your insurance provider in advance.
Inpatient Insurance outside of the Swiss Insurance System
Inpatient care at Hôpital de La Tour refers to all admissions to the hospital for at least one night, both in an emergency and for planned procedures. Hôpital de La Tour offers a wide range of additional services such as the option to choose your doctor and the date of your procedure, a dedicated medical team, a personalized care pathway, and hospitality services to improve your stay (e.g. a private room or a room with only two beds).
Approved International Organizations and Insurance Providers
At Hôpital de La Tour, we work with a wide range of international organizations and international insurance providers and have signed agreements with them to simplify the administrative processes involved. It is difficult to provide general information on this topic because of the large number of products available and the general and specific conditions that apply to each individual insurance policy. To reduce the administrative burden on you, we will therefore ask your insurance provider for a payment guarantee before any planned procedure.
For information purposes only, these are the main international organizations and insurance providers with which we have a full, restricted, or no agreement in place (in alphabetical order):
| Main international organizations | UN, WHO, ILO, CERN (UNIQA) |
|---|---|
| Main international insurance providers | Allianz, April, AXA, BUPA, CIGNA, International SOS, Medigo, VYV |
Co-Payment
The co-payment you will have to make (the portion of the costs that is not covered by your insurance) depends on your insurance provider and your policy. These are out of the control of Hôpital de La Tour and you must seek advice from your insurance provider in advance.