Medical Devices & Aids (MiGeL)

What is the MiGeL?

The MiGeL (Mittel- und Gegenstandeliste / Liste des moyens et appareils / Elenco dei mezzi e degli apparecchi) is a comprehensive list maintained by the Federal Office of Public Health (FOPH/BAG). It specifies:

• Which medical devices and aids are covered by KVG basic insurance
• The maximum reimbursement amount for each item
• Whether a prescription is required
• Whether the device is purchased or rented
• The replacement interval (how often you can get a new one)

The MiGeL covers a wide range of items from simple bandages to complex motorized wheelchairs. It is organized into product groups with specific position numbers that pharmacies, medical supply stores (Sanitatshaus), and other providers use for billing.

Major categories of covered devices

The MiGeL covers devices and aids across many categories. Here are the most commonly used:

• Mobility aids: Wheelchairs (manual and electric), walkers (Rollator), crutches, canes. Electric wheelchairs require pre-approval (Kostengutsprache). Manual wheelchairs are covered up to a defined maximum -- typically CHF 2,500--4,500 depending on the type.
• Hearing aids: Covered with a maximum contribution of CHF 840 per ear every 6 years for adults. Children receive higher contributions. The actual cost of modern hearing aids often exceeds CHF 2,000--4,000 per ear, so supplementary insurance or out-of-pocket payment is common for the difference.
• Respiratory devices: CPAP machines for sleep apnea (usually rented, not purchased), oxygen concentrators, nebulizers. CPAP rental is covered by KVG after a diagnostic sleep study confirms the diagnosis.
• Prosthetics and orthotics: Artificial limbs (arm and leg prosthetics), orthopedic shoes, custom orthotics (shoe inserts), knee braces, back braces. Coverage varies significantly by type and complexity.
• Compression therapy: Compression stockings (Kompressionsstrumpfe) for venous insufficiency, lymphedema, and post-surgical use. Typically 2 pairs per year are covered.
• Diabetes management: Blood glucose monitors, test strips, insulin pumps (with pre-approval), continuous glucose monitoring systems (CGM) for specific patient groups. Insulin pens and needles are covered under the pharmaceutical benefits (SL list), not MiGeL.
• Incontinence products: Absorbent products, catheters, and related supplies up to defined monthly maximums.
• Wound care: Specialized wound dressings, vacuum-assisted wound closure systems (for complex wounds).
• Vision aids: Contact lenses and glasses are NOT on the MiGeL for adults. Children under 18 receive a contribution of CHF 180/year toward corrective lenses.

Rental vs. purchase

The MiGeL distinguishes between devices that are purchased and those that are rented:

• Purchased items: You own the device. Examples include compression stockings, orthotics, blood glucose monitors, and basic wheelchairs. The insurer pays the MiGeL maximum amount (minus your franchise and Selbstbehalt).
• Rented items: The device remains the property of the rental company or insurer. Examples include CPAP machines, electric wheelchairs (in some cases), and specialized hospital beds. Monthly rental fees are covered by KVG. When you no longer need the device, you return it.

Rental is more common for expensive devices that may need to be adjusted, upgraded, or returned if the medical situation changes. It is also used for devices needed temporarily (e.g., crutches after surgery).

How to obtain a covered device

The process for getting a MiGeL-covered device typically follows these steps:

1. Doctor's prescription: Your treating physician writes a prescription (Verordnung) specifying the device needed and the medical indication. Some devices require a specialist prescription (e.g., hearing aids need an audiologist or ENT specialist).
2. Pre-approval for expensive items: For costly devices (electric wheelchairs, insulin pumps, certain prosthetics), you need advance approval from your insurer (Kostengutsprache). Your doctor submits the request with medical documentation. The insurer decides within a few weeks.
3. Fitting and purchase/rental: Take your prescription to a certified medical supply store (Sanitatshaus), pharmacy, or specialized provider. They will fit the device, ensure it meets your needs, and bill your insurer directly (tiers payant) or give you an invoice to submit.
4. Cost sharing: You pay your franchise (if not yet reached) and 10% Selbstbehalt on the covered amount, just like any other KVG benefit.

Supplementary insurance for upgrades

Many people use VVG supplementary insurance to cover the gap between MiGeL maximums and actual costs:

• Hearing aids: Supplementary plans often add CHF 500--2,000 per ear on top of the KVG contribution, making modern hearing aids affordable.
• Glasses and contact lenses: Since adult vision correction is not covered by KVG, supplementary insurance is the primary source of coverage. Many plans offer CHF 150--300 every 2--3 years.
• Premium wheelchairs: Lightweight carbon fiber or advanced electric wheelchairs that exceed MiGeL maximums can be partially covered by supplementary insurance.
• Orthotics and shoe inserts: If you need custom orthotics that exceed the MiGeL maximum, supplementary insurance may cover part of the difference.

When choosing supplementary insurance, check the specific benefits for medical aids (Hilfsmittel) if you anticipate needing devices that exceed MiGeL limits.

Replacement and maintenance

The MiGeL defines replacement intervals for each device category:

• Hearing aids: Every 6 years (adults).
• Compression stockings: 2 pairs per year.
• Blood glucose monitors: Every 3--5 years depending on the model.
• Wheelchair: When the existing one is no longer functional or suitable (no fixed interval for manual wheelchairs).
• Orthotics/shoe inserts: Annually or as medically needed.

Repairs and maintenance for purchased devices are generally your responsibility unless the device is under warranty. For rented devices, the rental company handles maintenance.