How does the health insurance system in Switzerland work?
An overview of the Swiss health insurance system: who determines the benefits of basic insurance? What do I need to know when switching health insurers? Who supervises health insurers?
Health insurance made simple
Basic health insurance is mandatory in Switzerland. However, you can change it every year. Supplemental insurance is optional. Health insurers may refuse to take you on or exclude treatments.
Switching health insurers for basic and supplemental insurance
You can switch basic insurance every year without any restrictions. This is because health insurers are obliged to accept you.
As a rule, the cancellation must be received by the old health insurer by the last working day of November. You can also switch basic insurance during ongoing treatment.
The freedom to choose your health insurer means that you can switch to the health insurance that you wish to take out without any restrictions. Full freedom only exists for your basic insurance. Health insurers must accept your application for basic insurance without any exclusions.
You should only terminate your supplemental insurance if you have received confirmation of acceptance from a new insurer. Otherwise, you may be left without supplemental insurance. This is because health insurers are permitted to refuse to provide supplemental insurance based on any health issues.
Good to know: you can take out basic and supplemental insurance with different health insurers. If you change your basic insurance, the health insurer is not allowed to cancel your supplemental insurance.
Finding a cancellation template and new health insurance
Use our templates for cancelling your health insurance. To find a new health insurer, it is best to compare the premiums on offer. When it comes to supplemental insurance, you should also pay attention to the benefits offered – they differ depending on the insurance package.
Information about health insurers for switching
Double health insurance: what to do and how to avoid it?
Waiting periods in Swiss insurance policies: what are they?
Cancel and switch health insurance: deadlines and process
Basic and supplemental insurance with different health insurers: is it possible?
Delayed admission to health insurance: what can I do?
Cancelling health insurance: cancellation letter template
Changing health insurance while undergoing treatment: is it possible?
How to cancel and switch supplemental insurance
Health insurance policy, law and associations
The general conditions of insurance are an important part of insurance contracts. They specify the cover provided by the insurance product in question. They also govern the rights and obligations of both contracting parties.
Health insurers cannot freely determine the content of the general conditions of insurance. The Federal Office of Public Health (FOPH) reviews the conditions for the basic insurance. The Swiss Financial Market Supervisory Authority (FINMA) is responsible for supplemental insurance. This ensures that the interests of the insured are protected.
The Health Insurance Act (HIA) is the basis for compulsory basic insurance and voluntary daily sickness benefits insurance in accordance with HIA. It is formulated in such a way that the benefits of basic insurance are the same at all health insurers.
According to the HIA, all persons resident in Switzerland must be insured by a health insurer. The canton of residence is responsible for ensuring this obligation is met. This ensures that the Swiss population is insured in the event of illness.
The Insurance Policies Act (IPA) forms the legal basis for private insurance contracts. In the case of health insurance, this includes supplementary insurance and daily sickness benefits insurance in accordance with the Insurance Policies Act.
In accordance with the IPA, health insurers can:
refuse to accept persons on the basis of freedom of contract.
set the premiums based on age, gender, health condition and other criteria.
collective agreements with premium discounts.
The cancellation options may vary depending on the health insurer.
The Health Insurance Ordinance (HIO) contains, among other things, information on
Compulsory insurance
Duration of the insurance
Service providers
The Health Insurance Benefits Ordinance (KLV) governs the benefits covered by compulsory health insurance. This means that all basic insurance policies offer the same cover, irrespective of the health insurer.
Federal Office of Public Health (FOPH)
The Federal Office of Public Health (FOPH) oversees health insurers and their provision of basic insurance cover.
Health insurance associations: Prio Swiss, RVK, Santésuisse and SVV
There are two industry associations for health insurance in Switzerland:
There is also the service organisation Santésuisse, which offers services to health insurers. The two industry associations also represent the interests of health insurers vis-à-vis
the public
politics
the authorities
other players in the healthcare sector
Some large health insurance companies are also members of the Swiss Insurance Association (SIA). This association acts in the interests of the entire private insurance industry.
Swiss Financial Market Supervisory Authority
The Swiss Financial Market Supervisory Authority (FINMA) oversees companies based in Switzerland in the field of finance and insurance. These include:
Insurance companies
Banks
Stock exchanges
Financial institutions
Collective investment schemes and their portfolio managers, fund management companies
Insurance intermediaries
It protects creditors, investors and insureds. It also ensures the proper functioning of the financial markets. In the area of health insurance, FINMA is supplemental insurance companies
In principle, basic health insurance is compulsory in Switzerland. In certain cases, you can be exempted from compulsory insurance:
During military service: are you doing military service for more than 60 consecutive days? If so, you can suspend your basic insurance cover for the period of your service. You should notify your health insurance company in good time.
Persons in training or further education from abroad: Persons in training or further education from abroad can be exempted from compulsory health insurance. The exemption is valid for a maximum of three years, but can be extended by three years if necessary. To be eligible for the exemption, you must have equivalent insurance cover from your country of origin. However, as soon as you receive a salary, you must take out insurance in Switzerland.
Cross-border commuters from Germany, France, Italy and Austria. You must take out insurance in your country of residence.
You must apply for the exemption from your cantonal office. This list is not exhaustive. Further information is available from SVA Zurich.
The right insurance for every situation
Your health insurance needs change depending on your age, place of residence and life plans. Comparis shares tips on insurance for different situations in your life.
Health insurance explained for all insured groups
Health insurance and age categories: will your premiums get more expensive?
Cross-border commuters and health insurance in Switzerland
Health insurance for pensioners in Switzerland
Health insurance for adolescents and young adults
Health insurance for students from abroad
Health insurance when moving abroad: what you need to keep in mind
Sabbaticals in Switzerland: planning your insurance
Guest insurance
Our health insurance guide
Further information about health insurance is available here.
