Denial of Coverage for Foreign-Performed Phalloplasty Under Mandatory Health Insurance
Schweiz · Kanton Schwyz (CH-SZ)
Legislator-Zusammenfassung
KI-generiertThe appeal concerned the denial of coverage for a phalloplasty performed abroad under a mandatory health insurance plan, where the appellant sought reimbursement for costs incurred following a gender affirmation procedure. The court reasoned that the treatment, even if medically necessary for the appellant's condition, was elective surgery primarily for aesthetic or non-essential reasons in the context of mandatory basic health insurance coverage, and therefore, the insurer was not obligated to cover the expenses for the procedure performed in a foreign country.
Legislator-Regeste
KI-generiertDenial of Coverage for Foreign-Performed Phalloplasty Under Mandatory Health Insurance: The court reasoned that the treatment, even if medically necessary for the appellant's condition, was elective surgery primarily for aesthetic or non-essential reasons in the context of mandatory basic health insurance coverage, and therefore, the insurer was not obligated to cover the expenses for the procedure performed in a foreign country.
Schlagwörter
KI-generiertVerwandte Entscheide
KI-generiertVolltext
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\n\n| | | |\n II 2017 76 |\n |\n \n\n
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\n\n| | | |\n |\n Entscheid vom 20. Februar 2018 |\n \n\n
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\n\n| | | |\n Besetzung |\n Dr.iur. Vital Zehnder, Vizepräsident |\n \n|\n |\n Dr.oec. Andreas Risi, Richter Dr.iur. Frank Lampert, Richter |\n \n|\n |\n lic.iur. Josef Mathis, Gerichtsschreiber |\n \n\n
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\n\n| | | |\n Parteien |\n A.________, \n Beschwerdeführer, \n vertreten durch Rechtsanwalt MLaw Z.________, |\n \n|\n |\n gegen |\n \n|\n |\n B.________ AG, \n Vorinstanz, |\n \n\n
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|\n Gegenstand |\n Krankenpflegeversicherung (Kostenübernahme für im Ausland erbrachte Leistung [Phalloplastik]) |\n
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Sachverhalt: