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Updates in the coverage of medical services in Switzerland in 2025
On December 2, 2024, the Swiss Federal Office of Public Health published the changes that will occur to the Healthcare Benefit Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The updates will enter into force on January 1, 2025, and include the following:
- Minor changes in the Healthcare Benefit Ordinance (KLV/OPre), which relate to the prophylactic vaccinations and exemption from the deductible for colorectal cancer screening for individuals aged 50 to 69;
- Changes in Annex 1 of the Healthcare Benefit Ordinance (list of explicitly evaluated services):
- Coverage with Evidence Development was extended for three procedures, including embolization of the prostate arteries in symptomatic benign prostatic hyperplasia.
- Changes in Annex 1a of the Healthcare Benefit Ordinance (outpatient-before-hospital services):
- Changes concern wording and specific criteria favoring inpatient procedure implementation, both general and procedure-specific. No new procedures will be introduced.
- Changes in Annex 2 of the Healthcare Benefit Ordinance (List of Tools and Equipment):
- Introduction of new categories 23.12.01.00.1 for the provision of cranial orthotic devices for craniosynostosis and 35.01.10c for sterile soft-adhesive plasters with wound pads.
- Changes in Annex 3 of the Healthcare Benefit Ordinance (List of Analyses):
- Changes concern wording and combination rules for certain tests;
- No new tests will be introduced.
The full details in German can be found here.
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