Care in old age: who foots the bill?
The cost of care in old age is considerable. Anything not covered by basic insurance must be funded by the person who needs the care.
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Professional care is expensive. It can cost up to 8,000 francs per month. This is shared to differing degrees by health insurers, the patient themselves and the state.
To qualify for financial support for care costs from health insurance and the state, you must have a medical prescription in accordance with the Health Insurance Benefits Ordinance. Non-care services such as shopping, cooking, cleaning, washing, ironing, help going to doctor's appointments, and night duty and meal services must be fully covered by the patients themselves.
Who pays for at-home care?
In the case of at-home care services provided by specialists (e.g. Spitex), those in need of care pay significantly less than they would for residential care. The costs for at-home care prescribed by a doctor are shared as shown below by the health insurer, the Spitex customers and the state.
What at-home care costs does health insurance cover?
| Benefits | Costs covered* (CHF/hr) |
|---|---|
| Basic care (eating and drinking, washing, dressing, moving around, etc.) |
52.60 |
| Examination and treatment (administration of medicines, wound care, blood pressure measurement, etc.) |
63.00 |
| Consultation and advice (care planning, instructions on taking medicines, etc.) |
76.90 |
What do Spitex customers pay?
In addition to the deductible and excess, recipients of care pay a patient contribution of a maximum of CHF 15.35 per day, depending on their canton. The maximum annual costs for at-home care can be calculated using the care cost calculator.
Who covers the remaining costs of at-home care?
The remaining costs, which are not borne by the health insurer or Spitex customers, are covered by the state (cantons or municipalities).
Who finances residential care costs?
The costs of residential care are covered by health insurance, the care home resident, and the state. Patients must dig deeper into their own pockets in such cases, however. As in the at-home sector, the costs of non-care services, i.e. accommodation (rooms, meals, laundry, etc.) are also borne in full by residents.
What does health insurance pay towards residential care costs?
| Care level | Care needs | Costs covered* (CHF/hr) |
|---|---|---|
| 1 |
up to 20 min. |
CHF 9.60 |
| 2 |
from 21 to 40 min. |
CHF 19.20 |
| 3 |
from 41 to 60 min. |
CHF 28.80 |
| 4 |
from 61 to 80 min. |
CHF 38.40 |
| 5 |
from 81 to 100 min. |
CHF 48 |
| 6 |
from 101 to 120 min. |
CHF 57.60 |
| 7 |
from 121 to 140 min. |
CHF 67.20 |
| 8 |
from 141 to 160 min. |
CHF 76.80 |
| 9 |
from 161 to 180 min. |
CHF 86.40 |
| 10 |
from 181 to 200 min. |
CHF 96 |
| 11 |
from 201 to 220 min. |
CHF 105.60 |
| 12 |
more than 220 min. |
CHF 115.20 |
What does the care home resident pay?
In addition to the deductible and excess, care home residents pay a patient contribution of a maximum of CHF 21.60 per day, depending on their canton.
Who covers the remaining costs of residential care?
The remaining costs, which are not borne by the health insurer or the care home resident, are borne by the state (cantons or municipalities).
Help meeting the cost of non-care services
There is support available for those receiving either at-home or residential care to meet the costs of non-care services.
Depending on your personal financial situation, these benefits may be covered by:
1. Personal income and assets
State pension, personal pension payments, 3rd pillar or savings: remember that personal assets above certain allowances are also counted as income.
Supplemental insurance for long-term care: benefits may vary significantly and premiums are high. If you want to keep the premium as low as possible, you must take out the insurance at an early stage.
2. State support
Supplementary benefits (EL): if existing pensions and income cannot cover the subsistence-level cost of living. There are the following categories of benefits:
Annual benefits (difference between recognized expenditure and eligible income)
Illness and disability expenses (e.g. for dental treatment and aids)
Helplessness allowance: irrespective of income and assets and in addition to the state pension. This is for individuals who depend to a varying extent on outside help for day-to-day activities such as getting up, getting dressed, eating, etc.
Attendance allowance: for recipients of a helplessness allowance who depend on regular help but still want to live at home and to employ someone to help.
Social assistance: the social welfare office may be able to help as the last resort. Direct relatives (parents/children) may be required to provide financial support, however.
How are family caregivers compensated?
Anyone who looks after relatives who are in need of care may be entitled to the following benefits:
The care allowance is credited to the later state or disability pension.
Compensation for loss of earnings: as part of the supplementary benefits system, those in need of care can apply for compensation for their family caregivers for the loss of earnings they have suffered.