Points limit for medication
Definition of points limit
The points limit is the maximum quantity of a medicine that may be reimbursed under basic insurance for a person within a defined period. Once the points limit has been reached, basic insurance covers no further costs.
What does it mean if a medicine on the FOPH’s specialities list has a limit?
Basic insurance covers the costs of original drugs or generics when they are included on the specialities list of the Federal Office of Public Health (FOPH). However, the FOPH may impose additional restrictions and clarifications, known as limits. These limits influence whether and to what extent basic insurance will ultimately cover the costs. This list can be adjusted at any time by the Federal Office of Public Health.
How can I find out the points limit for a specific medicine?
The points limit set for a medicine can be found in the specialities list. The list shows the maximum number of points permitted for 90 days for a medicine.
