Adjustment of the benefits catalog for basic insurance as of January 1
Published: Monday, Dec 2nd 2024, 13:20
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From January 1, 2025, various changes to the Health Care Benefits Ordinance (KLV) will come into force. Compulsory health insurance (OKP) will now cover the costs of head prosthesis therapy, which is used to guide the growth of infants with head deformities.
However, reimbursement by the OKP is limited, as the Federal Office of Public Health (FOPH) announced on Monday. The therapy is reimbursed for the treatment of premature cranial suture closure in infants under six months of age. Costs are not covered in the case of positional head deformity, where the skull is deformed due to external influences, such as one-sided positioning of the infant while the cranial sutures are still open.
Premature cranial suture occlusion is considered a recognized congenital defect, which is why disability insurance (IV) covers the medical measures required for treatment, according to the statement. Health insurance companies only reimburse if the insurance requirements for cost coverage by the IV are not met, for example in the case of a child with asylum status.
The costs of examinations for the early detection of bowel cancer between the ages of 50 and 69 have been covered by OKP since 2013. According to the FOPH, this involves the detection of blood in the stool every two years or a colonoscopy every ten years. According to the Federal Health Insurance Act (KVG), the benefits of prevention programs can be exempted from the deductible upon request. This is possible in 14 cantons and, from January 1, 2025, also in the canton of Solothurn.
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