Contraception: what does health insurance cover?
More women are choosing natural methods over hormonal contraception. But who pays for contraception in Switzerland? Comparis explains.
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Condoms are the most commonly used method of contraception. Hormonal contraception can lead to side effects. This is especially true for the emergency contraceptive pill, known colloquially as the “morning after pill”. Either way: contraception is considered a private matter. Health insurers only cover the cost in exceptional cases.
Roughly one in three women in Switzerland take birth control pills. However, their image as a safe and comfortable contraceptive has been tarnished. Mood swings, low libido and thrombosis: even if some of these risks are rare, many women now think twice about using hormonal contraception.
1. Costs and usage of contraception in Switzerland
Statistics from the FSO (2017) on sexual activity of women and men between the ages of 15 and 49 show: not only is the condom the only reliable method of contraception for men (apart from sterilization), it’s also a clear frontrunner in terms of usage.
| Contraception methods | Usage (in %) | Cost in CHF |
|---|---|---|
| Condom | 33.9% | Approx. CHF 10–15 for 10 |
| Pill/mini pill | 27% | Approx. 15–25 per month |
| IUD/coil | 11.7% | Copper coil approx. 200 (incl. device, insertion and follow-up) per 5 years; hormonal IUD: approx. 500–700 (incl. device, insertion and follow-up) every 5 years |
| Sterilization | 8.5% | For women: approx. 1,000-2,000; for men: approx. CHF 700 to 1,000 |
| Other hormonal contraceptive methods | 5.1% | Three-month injection approx. 65–85; hormone patches approx. 26 per month; contraceptive implant approx. 420 per 3 years; contraceptive ring approx. 24 per month |
| Natural methods of contraception | 3.4% | No costs |
2. Overview of the most common contraception methods
Hormonal contraceptive methods
Pill
IUD
Implant
Injection
Vaginal ring
Mini pill
Hormone patch
Mechanical/chemical contraceptive methods
Condom
Copper coil
Diaphragm
Vaginal cups, gels, foams, etc.
Natural contraceptive methods
Symptothermal method
Temperature method
Fertility monitor
Calendar method (Knaus-Ogino method)
3. Pros and cons of different types of contraception
Condoms (also the female condom) are the only method of contraception that also reliably protect against sexually transmitted diseases. The disadvantages: wearing a condom can negatively affect sensation. If used improperly, condoms can slip or tear.
Hormonal contraceptives such as the pill/mini pill, the patch and the injection reliably protect against pregnancy. However, there can be side effects such as weight gain, mood swings and bleeding disorders in relation to the use of hormones. You also have to remember to take the pill and mini pill every day.
Mechanical contraceptive methods (such as the coil) can also have side effects such as bleeding, pain and inflammation of the fallopian tubes. However, they are also very reliable when they are fitted and used correctly. Chemical contraceptives alone are very unreliable. They are therefore recommended in combination with mechanical contraceptives. They can also cause inflammation and irritation.
Natural methods of contraception have no side effects. Depending on the method, however, the reliability varies enormously. For example, according to Sensiplan, the symptothermal method is almost as safe as the pill when used correctly. The calendar method, on the other hand, is very unreliable.
The reliability of contraceptives is indicated by the Pearl Index (named after the American scientist Raymond Pearl). The lower the value, the safer the contraception method. A Pearl index of 0.1 means: one woman becomes pregnant in one year for every 1000 women who use a particular method of contraception.
| Method | Pearl Index |
|---|---|
| Condom or female condom | 2.12% |
| Pill (all except mini pill) | 0.5% |
| Mini pill | 1.2% |
| Injection (three months) | 1% |
| Implanon® contraceptive implant | < 0.1% |
| Hormonal IUD | ~ 0.2% |
| Copper IUD | ~ 1% |
| Symptothermal method | ~ 0.6–1.8% |
| Knaus-Ogino method (calendar method) | ~ 20% |
4. Do health insurers cover the cost of the IUD or pill?
As a rule, you bear the costs yourself, regardless of which method of contraception you choose. Neither basic nor supplemental insurance pays for contraception. Only the consultation with the gynaecologist to clarify which method of contraception is right for you is covered by basic insurance, as is contraception prescribed for medical reasons. This could be the case, for example, with hormonal acne or with cycle disorders.
The same is true of sterilization. Basic insurance only covers the procedure if you are seeking to prevent pregnancy for health reasons. However, various supplemental insurances pay contributions to the cost of tubal ligation (sterilization in women) or vasectomy (sterilization in men).
In contrast, basic insurance covers the costs of a medically prescribed abortion. However, the morning-after pill does not fall under this category. Women must pay for emergency contraception out of their own pocket.
Tip: If your health insurance won’t cover the cost of your contraception, it’s all the more important that you don’t pay too much.
5. Emergency contraception: the morning-after pill
Contraception can fail (e.g. a condom breaks, or you forget to take the pill), or maybe you didn’t use any form of contraception at all. In such cases, women can still prevent pregnancy after sexual intercourse. To do so, you must take emergency contraception, also known as the morning-after pill, as soon as possible after sexual intercourse.
This drug inhibits fertilization and implantation of the egg. It is not an abortion drug. If the egg has already implanted in the uterus, the morning-after pill is ineffective.
Among the best-known in Switzerland are NorLevo and ellaOne. Neither require a prescription. They are available in pharmacies, but require a mandatory consultation. The efficacy of NorLevo and ellaOne is 95% and 98%, respectively. This is guaranteed if they are taken within 12 to 24 hours after sexual intercourse.
The morning-after pill is an emergency medication and is not suitable for regular use due to the high hormone content. It is not an alternative to other contraceptives, also because the effectiveness decreases with frequent use. Taking the morning-after pill is only permitted as a one-time emergency solution. In Switzerland, it is illegal to order the morning after pill online to stock up.
6. Contraception is (still) women’s concern
Apart from condoms or vasectomy (sterilization), there is currently no method of contraception for men. However, the development of a contraceptive gel that is intended to inhibit sperm production after an injection is in the advanced stages of development. Whether and when it will be launched on the market, however, is still uncertain.
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