Supplemental health insurance

When is it worth taking out supplemental insurance?

When it's worth considering supplemental insurance. Source: iStock
Framed, unobtrusive or something more striking – the display at the optician's offers a great selection of the latest eyewear styles to choose from. Until you look at the price tag. This is the moment when you start wondering whether your health insurance might make a contribution. On average, Swiss customers pay out 600 francs every three years for some kind of visual aid, which is required by one in two people. 

Glasses from your health insurer

According to the Federal Office of Public Health (FOPH), the average Swiss premium has worked out at 447.26 francs per month in 2017. An amount you would think could be used to cover at least part of the cost of a new pair of glasses. But in 2011, health insurance companies withdrew the allowance of 180 francs every five years that had previously been guaranteed to spectacle wearers. 

Basic insurance offers 180 francs per eye once a year but only if the condition has a medical cause, such as diabetes, opacity of lens, eye muscle disorders, lazy eye, medication use or eye operations (e.g. for glaucoma). 

Will supplemental insurance contribute? 

If you do not fall into any of the above categories and are over 18 years old, you have to pay for your glasses or contact lenses out of your own pocket. Unless you have taken out supplemental insurance. Depending on the insurer, you can expect a contribution of 150 to 300 francs per year for necessary visual aids. However, there is no such thing as a supplemental insurance plan exclusively for visual aids, so you have to take out this cover as a package containing other benefits such as gym membership, alternative medicine and antenatal classes. As a rule, it is not worth taking out this kind of comprehensive package simply to get a contribution for your glasses or contact lenses. But you can also consider this from another angle: If you prefer more extensive cover, you may well appreciate the generous slew of benefits that comes with these supplemental insurance packages – and automatically includes a new pair of specs. 

When supplemental insurance makes sense

Supplemental insurance complements compulsory basic insurance by covering those areas where there are otherwise insufficient or no benefits. If you want an insurance package that covers glasses and contact lenses along with other benefits, you can find this for as little as 10 francs per month. 

Comparis tip: Choose a cheap insurer for your basic insurance and take out supplemental insurance to cover additional needs.

Basic and supplemental insurance with different providers

You do not necessarily have to take out basic insurance and supplemental insurance with the same insurance provider. 

If you already have supplemental insurance and the premiums go up, you can switch providers. Depending on the insurer, you can do this within 25 to 30 days of notification of the premium increase. Others require you to wait until the insurance agreement expires at the end of the year.

If you have supplemental insurance with the same provider as your basic insurance and you would like to cancel the latter, you do not need to worry about your supplemental insurance. Insurance providers cannot cancel supplemental insurance plans simply because a policyholder has cancelled their basic insurance and switched to another provider. However, they are permitted to add a surcharge to the supplemental insurance to cover the extra administration costs. It is also possible that the provider of the supplemental insurance policy may withdraw a discount (family discount, collective discount) that had previously been applied. Only a few health insurers do this though.

Acceptance for supplemental insurance

You should only switch providers when you have been unconditionally accepted by your new insurer. This is because, unlike basic insurance, health insurance companies are within their rights to turn down your application for supplemental insurance. The decision depends mainly on the health declaration (questionnaire on illnesses and treatments in recent years), which the supplemental insurance applicant must fill out truthfully. 

The best time to apply

In addition, most supplemental insurance companies apply age limits to their offers, which may vary according to product and insurer. These limits typically lie between 50 and 70 years. From this age, you may no longer be able to take out supplemental insurance or only do so with certain provisos

Too healthy for supplemental insurance

Why spend money when you have no health issues? But this is precisely the best time to take out supplemental insurance. Because you are less likely to be rejected following your health check. In addition, you could consider supplemental insurance as a kind of life insurance that you can also finance when you are older. The rule is therefore “the sooner, the better”. Anyone who is healthy and would like to stay that way can also benefit from the health-promoting measures available under supplemental insurance.

You might also want to consider taking out insurance for children and adolescents, because short-sightedness is increasing dramatically worldwide. In Asia, 80 per cent of adolescents are now affected. Although there are no figures for Switzerland, the number is on the rise here too. While basic insurance does provide cover for children and adolescents up to age 18, the ceiling is 180 francs per year and you must have a prescription from an ophthalmologist. Also remember that visual aid contributions function in the same way as other insurance benefits. You are legally required to pay a co-insurance amount of 10 per cent as well as your chosen deductible. Example: If the child or adolescent has a deductible that is higher than zero francs, then the family will have to pay for the glasses up to the amount of the chosen deductible, say 300 francs.

Comparis recommendation: For children and adolescents, it is worth selecting a deductible of zero francs since the discount for higher deductibles is low and children usually visit the doctor quite often. 

So if you're wandering past an optician’s and are eyeing up the glasses on display, the prices might look a lot more tempting if you have supplemental insurance up your sleeve.