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InsuranceHealth insuranceGlossary

Basic insurance

Since 1 January 1996, basic health insurance has been mandatory for all persons residing in Switzerland. Basic insurance benefits are precisely determined by the Health Insurance Act (KVG). These are uniform across all insurance providers. Health insurance providers are required to accept every applicant for basic health insurance (full freedom to choose one's insurer). Basic health insurance covers "illness" and "accidents". If already insured for accidents by an employer, accident coverage can be excluded.

Premiums for basic health insurance vary depending on the policyholder's place of residence, deductible, insurance model and age. Art. 61 of the Health Insurance Act defines three age levels:

  • Children (up to age 18)
  • Young adults (ages 19 to 25)
  • Adults (age 26 and over)

Insurers must define lower premiums for children by law. For young adults, the insurance companies may offer reduced premiums, but they do not have to. The change from one age category to the next happens after the policyholder's 18th or 25th birthday, respectively, with effect from 1 January of the following year.

Out of the covered expenses, the policyholder is responsible for his own out-of-pocket expenses, namely a deductible and a coinsurance of 10 percent.

Note: Maternity services are exempt from the deductible and coinsurance.

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