Health insurers reimburse preventive breast and ovary removal

From next year, compulsory health insurance will cover preventive breast and ovary removal for women with certain risk genes. The service catalog will be expanded accordingly.

This serves to prevent breast and ovarian cancer in people with a greatly increased risk of these diseases, The Federal Ministry of the Interior (EDI) announced this on Friday. Surgical removal of breast and/or ovaries and fallopian tubes are measures to prevent cancer.

At the same time, “genetic counseling is now an explicit condition for remuneration,” the EDI continued in its statement.

Previously, both interventions were only reimbursed if two specific gene mutations were present. However, according to EDI, the need for expansion with additional risk genes has been reported in recent years. Therefore, from January 1, 2024, the indications will be expanded and the associated genes will be included in a reference document.

In addition, from July 1, 2024, HIV prophylaxis (HIV-PrEP) services for people at significantly increased risk will also be covered by compulsory health insurance as part of the ‘SwissPrEPared’ study. However, this acquisition is limited to the end of 2026.

According to the EDI, HIV prophylaxis effectively prevents the risk of HIV infection through unprotected sexual intercourse. This includes medical advice, the necessary laboratory tests and medication.

This is a measure of the new national program “Stop HIV, hepatitis B, hepatitis C virus and sexually transmitted infections,” the EDI continued. It is also intended to help answer open questions about the effects of HIV prophylaxis on infection rates.

Further adjustments to the service catalog are taking place, for example in the field of cardiology. From April 1, 2024, healthcare costs will be reimbursed through telemedicine programs for patients with advanced chronic heart failure (heart failure). (saw/sda)