Health insurance for pensioners in Switzerland
After retirement, your income tends to go down. Meanwhile, medical expenses are likely to rise. Comparis explains what to watch out for when it comes to health insurance for seniors.
05.10.2023
iStock/gradyreese
1. Changing health insurance as a pensioner: is it possible?
You can easily switch basic health insurance even in old age. You can therefore compare a range of providers and models to find the right insurance deal for you.
Good to know: unlike for basic health insurance, providers are not obliged to accept new applicants for supplemental insurance. When applying, you have to fill out a health questionnaire.
It is very difficult for older people to switch supplemental insurance. This is especially true if you have pre-existing conditions.
2. Least expensive health insurance for pensioners
For basic insurance, pensioners pay the same premiums as working adults over the age of 25. All basic insurance policies offer the same cover, irrespective of insurer.
Would you like to save on basic insurance? Then compare different health insurance companies’ prices. It’s usually possible to switch health insurance in the new year.
3. Health insurance matters to consider as you get older
Look closely at your healthcare costs. If your annual medical expenses are more than 2,000 francs, you should choose the lowest deductible of 300 francs. If your costs remain below 2,000 francs per year, the highest deductible of 2,500 francs is worthwhile.
When you are employed, your employer provides your accident insurance cover. Once you retire, you must include accident cover in your personal basic insurance policy.
Special health insurance conditions apply to Swiss citizens permanently residing abroad. Find out what your options are.
Supplemental insurance premiums usually increase with age. Switching is usually difficult. It is possible to save money on supplemental insurance without switching providers.
Many employers and associations enter into group contracts with health insurers. If you’re a member, you can get discounts on your premiums. Check whether you can claim a discount.
Increase the deductible on any supplemental insurance polices that you seldom use. Sometimes the basic insurance deductible is applied if you have both policies with the same insurer.
4. Health insurance benefits for seniors
As you get older, your healthcare needs change. Basic insurance essentially covers all services that are medically necessary.
When is supplemental insurance a good idea?
You can choose supplemental insurance products to cover benefits that are not included in basic insurance, such as aids, appliances and treatments that are not medically necessary and not prescribed by a doctor.
Depending on the supplemental insurance, it may pay for:
Glasses
Dental treatment
Preventive check-ups
Transport to the doctor
Supplemental insurance may also cover an additional portion of the cost of nursing services in your own home or in a care home.
5. Basic insurance benefits: examples
Basic insurance covers most of the care and nursing services provided by Spitex organizations. Patients pay:
Annual deductible
Coinsurance of 10% for nursing/care services up to a maximum of 700 francs per year
Depending on the canton, the patient contribution varies up to a maximum of 15.35 francs per day
In order for these costs to be covered, Spitex services must be prescribed by a doctor.
Preventive check-ups are not considered medically necessary and are therefore not usually covered by basic insurance.
There are however exceptions:
Gynaecological check-ups including a cervical smear test every three years
Mammograms for those at increased risk of breast cancer
Early detection of colorectal cancer in people aged between 50 and 69 years
Basic insurance also covers the cost of any prescribed rehabilitation services following a hospital stay for a period of up to two weeks.
Basic insurance covers chiropody services prescribed by a doctor, for example for diabetics.
Medical aids such as compression stockings, walking aids and hearing aids are covered by basic insurance when they are prescribed by a doctor.
Basic insurance pays for all medications prescribed by a doctor that appear on the list of pharmaceutical specialities or on the list of birth defects. Some health insurers also offer discounts on medicine orders or pay a contribution towards fall prevention courses.
6. Financial support for people on low incomes
Do you have trouble paying for your health insurance after retirement? Then you may be entitled to an individual premium reduction (IPR). Your entitlement depends on your level of income and the number of dependent children you have. These limits vary from canton to canton.
Applying for an individual premium reduction
In some cantons, the authorities will notify you of your entitlement directly on the basis of your tax assessment. In other cantons, you need to apply. This means that you must apply for the discount each year.
People with physical or mental impairments receive what is known as a helplessness allowance. The amount of allowance given depends on the level of the impairment. It is independent of financial circumstances.
Can’t cover the costs required to achieve a minimum standard of living? You are entitled to supplementary benefits.
7. Health insurance for pensioners abroad
Are you a pensioner and planning to go abroad? Then you must take out health insurance in the country from which you receive your pension. There are exceptions to this rule, however.
Compulsory health insurance in Switzerland
Are you moving to an EU/EFTA country or the UK? If the following three points apply to you, you are still obliged to take out insurance in Switzerland:
You are drawing your pension from Switzerland.
You will not receive a pension in your new country of residence
Your pension insurance ran longer in Switzerland than in an EU/EFTA country
In Switzerland, the statutory benefits of the pension fund count as a pension:
Old age and survivors’ insurance (OASI)
Disability insurance (DI)
Military insurance (MV)
Accident insurance (UV)
Occupational pension (BV, also known as the second pillar)
You can find more information on the website of the KVG Joint Institution.
Pension from another country
Do you receive your pension from several countries, none of which is your country of residence? Then you must take out insurance in the country in which you have paid pension contributions for the longest time.
Choice of the place of health insurance
In some countries, something known as an insurance option law applies. This means that you can decide for yourself whether you want to take out insurance in Switzerland or in your country of residence. Countries where you have this choice include:
Germany
France
Italy
Austria
If you want to be exempted from compulsory health insurance in Switzerland, you must submit an application to the KVG.
This article was first published on 01.04.2021
