Federal Supreme Court, Decision 9C_264/2018 of 8 May 2019

23 mai 2019 – The Federal Supreme Court had to examine whether healthcare insurance companies must cover the costs of gender reassignments (phalloplasty) carried out abroad, because, in Switzerland, they cannot be provided (in a safe manner). The Court held that mandatory healthcare insurance must also cover the costs if the treatment in Switzerland represents a considerably higher risk than the treatment abroad, i.e. if an appropriate treatment is not guaranteed in Switzerland. The mere fact that a specialized clinic abroad has more experience is not sufficient. However, the Court concluded that an average number of 5.5 phalloplasty surgeries per year in Switzerland is, indeed, extremely low. Under these circumstances, the question arises whether the Swiss surgical teams could acquire the minimum amount of routine which is required. In order to answer this question and to reassess the coverage of costs, the Court referred the case back to the healthcare insurance company.