What types of supplemental insurance make sense?
In addition to compulsory basic health insurance, you can also take out supplemental insurance. This is often precisely where money can be saved. Comparis explains which supplemental health insurance is worthwhile.
25.07.2023
iStock/urbazon
1. What should I bear in mind when taking out supplemental insurance?
Unlike basic insurance, the cover offered by supplemental insurance differs according to the health insurer.
In addition, insurers are not obliged to accept customers. You are usually required to complete a health check first. You should therefore only cancel an existing supplemental insurance policy when you already have your new policy in place, or if you don’t want to replace it.
If you’ve found supplemental insurance that you’re interested in, pay attention to the duration of the contract. Some insurance companies have a term of up to three years. Without a cancellation notice the contract is automatically renewed for the specified duration.
Good to know
Basic insurance with one company, supplemental insurance with another – this is no problem at all. Learn more about having separate basic and supplemental insurance.
2. Which outpatient supplemental insurance products are worthwhile?
Supplemental outpatient insurance covers personal health needs that are beyond the scope of basic compulsory insurance. These might include alternative treatment methods, medicines not covered by basic insurance or even dental care. The insured benefits vary from one provider to another. The most popular packages are:
What you need to know:
Adults must generally pay for glasses and contact lenses themselves.
Supplemental insurance will pay a contribution of between 150 and 300 francs per year towards necessary corrective lenses, but there is often no product that solely covers glasses and contact lenses.
Is it worth it?
Supplemental insurance for glasses and contact lenses is only available as part of a package including other services. Therefore, it is hardly worth taking out this supplemental insurance if you are only doing so for the contribution to your glasses or contact lenses. Check whether you really need this package, or whether a cheaper offer is available from a different insurance company.
What you need to know:
Not all insurers cover the same non-compulsory medications. The amount reimbursed also varies.
With supplemental insurance, you are entitled to cover for all contractually agreed drugs that are not on the basic insurance list of pharmaceutical specialities. They include products such as alternative and new medicines.
Vitamins and dietary supplements are not covered.
Is it worth it?
Even supplemental insurance does not cover certain products, and you may have to pay coinsurance of 10%. Check whether you really need this package, or whether a cheaper offer is available from a different insurance company.
What you need to know:
A new system was introduced in the summer of 2022. As long as the required therapy is prescribed by a doctor, psychotherapists are permitted to independently invoice their services under basic insurance.
Supplemental insurance covers a proportion of the cost of psychotherapy by independent “non-medical” psychotherapists – but the therapist must be included on the health insurer’s list. The therapy must also be prescribed by a doctor.
Is it worth it?
Many insurers only cover between 50% and 90% of therapy costs. The number of sessions may be limited. Check the details and consider whether the supplemental insurance policy is a worthwhile investment for you.
What you need to know:
Basic insurance only pays for convalescent care if it is medically necessary and prescribed by a doctor.
Supplemental insurance covers some of the residential costs of such treatments if they are prescribed by a doctor.
As a rule, there is a limit on the cost per day and the number of days per year.
Is it worth it?
The services and premiums for balneotherapy and convalescent care also vary considerably. It’s worth comparing: some cantons in border areas also cover treatment in Germany.
What you need to know:
Some supplemental insurance products contribute towards the cost of health-promoting activities, such as gym memberships or fitness activities measured by an app.
You can expect a contribution of up to 800 francs per year.
Not all gyms and fitness centres are accepted.
Don’t forget to compare the rates offered.
Is it worth it?
If you train regularly at a gym, supplemental insurance may be an attractive option. Just find out which gyms are covered by which insurers and whether they meet your requirements. Rewards are now also available to customers who measure their fitness activities using an app and send the data to their health insurer.
What you need to know:
Acute and transitional care prescribed by a doctor directly after a stay in hospital is covered by basic insurance.
Medically prescribed care at home (Spitex) is covered by basic insurance.
Excluded from basic insurance: any care services that go beyond the care requirements prescribed by the Spitex organization (e.g. more frequent showering), domestic help, meal services and hospitality costs in a care home – although the municipality may cover such costs. Supplemental insurance may also cover these services.
Is it worth it?
Some supplemental hospital or outpatient insurance policies also cover the costs of domestic help following a stay in hospital. Insurance cover varies by insurer and product. Check whether you really need this insurance.
What you need to know:
Basic health insurance only covers certain vaccinations. It does not cover travel vaccinations (e.g. against yellow fever or rabies) or flu vaccines for healthy individuals.
If you have supplemental insurance, you usually only have to pay coinsurance of 10%.
Is it worth it?
Vaccinations are not mandatory in Switzerland. Check whether you really need this package and whether a better deal is available from a different insurance company.
What you need to know:
Supplemental dental insurance may cover the cost of services such as dental hygiene, cavity fillings and orthodontic treatment for children.
You should take this out as early as possible and not wait for problems to arise, as ongoing treatment costs will not be reimbursed.
Is it worth it?
Basic insurance only covers dental treatment that is medically required following an illness. If you cannot afford the cost of crowns or a full set of dentures, for example, you should take out the relevant supplemental insurance in good time. Before taking out supplemental dental insurance, you will usually need a certificate from a dentist confirming that your teeth are in good condition.
However, supplemental insurance is highly recommended for children as they often require orthodontic treatment, which can cost up to 10,000 francs or more. When registering for supplemental insurance before the birth of a child, there is usually no need for a health check.
What you need to know:
Basic insurance only pays for treatment abroad in the event of a medical emergency.
A good supplemental insurance policy, on the other hand, provides full cover including repatriation.
In addition, it will pay a larger contribution towards the cost of emergency transportation or transfers than basic insurance.
Is it worth it?
For travel in countries with high healthcare costs (e.g. Australia, Japan, Canada and the USA), it’s a good idea to take out single-trip supplemental insurance providing international cover. Basic health insurance does not usually cover the cost of repatriation back to Switzerland. Note that even if you have used up your deductible, you must pay the coinsurance payment applicable in the host country out of pocket – for example in France, where this is very high for hospital stays.
3. Which hospital supplemental insurance products are worthwhile?
Compulsory basic insurance only covers hospital stays in a general ward. If you are treated in a hospital in a different canton than your own, the maximum your insurance will pay is the rate applicable for your place of residence. If you take out supplemental hospital insurance, you are free to choose your hospital, benefits and type of room.
There are basically four types of supplemental hospital insurance:
What you need to know:
This type of supplemental insurance is particularly affordable. If it’s not already part of a package, you can take it out for as little as 2.40 francs per month.
It covers the cost of hospital stays outside the canton of residence that are higher than those in the canton of residence and applies to all hospitals on a cantonal hospital list. If you need to go to a hospital in another canton because the treatment you need is not available in your own, basic insurance will cover the cost.
You do not usually have free choice of doctor in hospital.
Is it worth it?
This general supplemental hospital insurance may be useful for people living in rural regions with less sophisticated infrastructure. Consider whether this would be of benefit to you.
What you need to know:
With the Flex model, you decide shortly before you go into hospital which type of ward you wish to be treated on.
For serious operations, you are entitled to a two-bed or one-bed room and treatment by the senior or chief physician if you choose “private ward throughout Switzerland”. Otherwise, the scope of services is the general or semi-private ward.
As a rule, no coinsurance applies to a stay in a general ward. You will make a contribution to the additional cost if you choose a semi-private or private ward.
Is it worth it?
The Flex model provides an attractive alternative to semi-private and private insurance policies that require policyholders to pay a predefined amount or share of any additional costs out of pocket. The main benefit of this model is the flexibility it offers to policyholders. In addition, the premiums are lower overall, but you can still access private treatment if you wish to do so. However, prices vary considerably from insurer to insurer. Some insurers also charge different premiums depending on gender.
What you need to know:
The option of a semi-private ward throughout Switzerland covers the cost of a two-bed room. As a rule, “throughout Switzerland” means all hospitals on the hospital list of your health insurer.
The senior physician is normally responsible for your treatment.
Is it worth it?
The semi-private ward option for the whole of Switzerland is of interest to patients seeking a certain degree of comfort during their hospital stay. However, public hospitals nowadays offer many two-bed rooms that are covered by basic health insurance. This means that the benefit of this insurance lies mainly in the free choice of doctor. However, Flex models are significantly less expensive. Over the years, the lower premium prices often offset the coinsurance payment required for an upgrade.
What you need to know:
The option of a private ward throughout Switzerland covers the cost of a one-bed room. As a rule, “throughout Switzerland” means all hospitals on the hospital list of your health insurer.
The chief physician is normally responsible for your treatment.
Is it worth it?
This insurance is the most expensive, but offers you the comfort and privacy of your own room (if available) as well as treatment by an experienced chief physician. Some packages also include additional benefits such as convalescent care, emergency transportation and transfers, domestic help and at-home nursing care. Compare the prices and benefits carefully. Flex models are significantly less expensive. Over the years, the lower premium prices often offset the coinsurance payment required for an upgrade.
4. Is an accident supplement a good idea?
Both outpatient insurance and hospital insurance offer accident cover. This means that accident-related treatment costs that exceed the statutory benefits (accident cover under basic insurance) are also covered.
If accident cover is included, supplemental insurance pays for the same benefits in the event of an accident as it would for illness. So if you are likely to want home care, domestic help and spa treatments and don’t want to pay transportation and rescue costs, you should consider supplementary accident insurance.
5. Which supplemental insurance products are worthwhile?
There is an enormous range of supplemental insurance products to choose from. This means you may end up buying a package that includes benefits you will never use.
For this reason, it’s important to check and compare the different packages offered by each insurer carefully and to seek advice. The premiums also differ from insurer to insurer, and you may end up paying more than the actual cost of the service.
| Supplemental insurance | Recommendation |
|---|---|
| Corrective eyewear | Check your requirements |
| Non-compulsory medication | Check your requirements |
| Psychotherapy by a psychologist | Check your requirements |
| Gym membership | Useful if you train regularly |
| Travel and prophylactic vaccinations | Check your requirements |
| Spa and convalescent therapies | Check your requirements |
| At-home nursing care and domestic help | Check your requirements |
| Dental insurance | Useful for children |
| Treatments abroad | Also consider single-trip cover for holidays abroad |
| General ward throughout Switzerland | Check your requirements |
| Semi-private ward throughout Switzerland | Consider switching to the Flex model |
| Private ward throughout Switzerland | Consider switching to the Flex model |
| Flex model | Check your requirements |
| Accident supplement | Check your requirements |
This article was first published on 12.07.2021
This might also interest you
Supplemental insurance: why was my application rejected?
Health questionnaire for supplemental insurance: what should I be aware of?
Basic and supplemental insurance with different health insurers: is it possible?
