Supplemental health insurance

A close look at 13 supplemental health insurance products – which are really worth buying?

INFORMATION
|
Source: iStock / urbazon

Some 80% of the population take out supplemental health insurance to fill any gaps in compulsory basic insurance. This is often precisely where money can be saved.

To complement the basic health insurance cover that is compulsory for anyone resident in Switzerland, you can also take out outpatient and hospital insurance if you wish. But are these supplementary policies really worth it? And if so, which ones? Our table provides an initial overview – detailed explanations are available further down the page.

Supplemental insurance Recommendation
Visual aids Check your requirements
Medicines not covered by basic insurance 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 treatments and convalescent care Check your requirements
Home nursing care and domestic help Check your requirements
Dental insurance Useful for children
Treatment 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

How does supplemental insurance differ from basic 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. They can reject applicants completely or impose exclusions. 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 do not wish to replace it. You can fill in the online questionnaire (in German only) at comparis.ch to get an initial idea of your chances of being accepted for supplemental insurance.

Supplemental outpatient insurance 

There is a range of supplemental outpatient insurance packages available at different prices. This means that cover can vary enormously. It often includes: 

Visual aids

Good to know:

  • Adults must pay for glasses and contact lenses themselves.
  • Supplemental insurance will pay a contribution of between 150 and 300 francs per year towards necessary visual aids, but there is no product that solely covers glasses and contact lenses.

Is it worth it?

Glasses and contact lens insurance can only be taken out as part of a package including other cover (from approx. 10 francs per month). It’s therefore not really worth taking out a supplemental insurance product if you are only doing so for the contribution to visual aids. Check whether you really need your current package and whether a cheaper deal is available from a different insurance company.

Medicines not covered by basic insurance 

Good to know:

  • Supplemental insurance policies differ here – not all insurers cover the same medicines excluded from basic insurance. The amount reimbursed also varies.
  • With a supplemental insurance policy, you are entitled to cover for all contractually agreed drugs that are not on the list of pharmaceutical specialities reimbursable under basic insurance. 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 a coinsurance amount of 10%. Check whether you really need your current package and whether a cheaper deal is available from a different insurance company.

Psychotherapy by a psychologist (non-medical psychotherapy) 

Good to know:

  • Basic insurance only covers the cost of medical and “delegated” psychotherapy. “Delegated” psychotherapy is when the therapist is employed by a doctor and works in the same practice. From a legal perspective therefore, it is the doctor (psychiatrist or child psychiatrist) who provides the service and bills the insurance company for it.
  • Supplemental insurance covers a proportion of the cost of psychotherapy by independently practising “non-medical” psychotherapists – but the therapist must usually be included on the health insurer's list.

Is it worth it?

Many insurers only cover between 50% and 90% of the 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.

Gym memberships

Good to know:

  • Some supplemental insurance products make a contribution 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 500 francs per year.
  • Not all gyms and fitness centres are accepted.

Is it worth it?

If you train regularly in a gym, supplemental insurance may be an attractive option. Just find out which fitness centres are covered by which insurers and whether they offer the services you need. Rewards are now also available to customers who measure their fitness activities using an app and send the data to their health insurer.

Compare fitness centres now

Travel and prophylactic vaccinations

Good to know:

  • Basic insurance 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 the coinsurance of 10%.

Is it worth it?

Vaccinations are not mandatory in Switzerland. Check whether you really need your current package and whether a cheaper deal is available from a different insurance company. 

Spa treatments and convalescent care

Good to know:

  • Supplemental insurance covers some of the residential costs of such treatments if they were prescribed by a doctor.
  • As a rule, there is a limit on the cost per day and the number of days per year.
  • Note: any inpatient rehabilitation stays prescribed directly after an operation are covered by basic insurance.

Is it worth it?

Once again, services and premiums for spa treatments and convalescent care vary considerably. Check whether you really need your current insurance cover and whether a cheaper deal is available from a different insurance company.

Home nursing care and domestic help

Good to know:

  • Acute and transitional care prescribed by a doctor directly after a stay in hospital is covered by basic insurance.
  • It also covers home nursing/care services (Spitex) prescribed by a doctor.
  • Excluded from basic insurance are any care services that go beyond the care requirements ascertained by the Spitex organization (e.g. more frequent showering), domestic help, meal services and hospitality costs in a care home – although the local authority may cover such costs. Supplemental insurance may also cover these services. 

Is it worth it?

Some supplemental hospital and 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 your current insurance cover and whether a cheaper deal is available from a different insurance company.

Dental insurance

Good to know:

  • You should take this out as early as possible and not wait for problems to arise, as ongoing treatment costs will not be reimbursed.
  • Supplemental insurance may cover the cost of services such as cavity fillings and orthodontic treatment for children.

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. One thing to bear in mind: 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.

Treatment abroad (including single-trip cover for holidays)

Good to know:

  • Basic insurance only pays out in a medical emergency – in other words, if medical treatment is required and it is unreasonable to expect the patient to return home for it. The cost may not be more than twice that charged in Switzerland.
  • A good supplemental insurance policy, on the other hand, provides full cover including repatriation.
  • In addition, it will pay a larger contribution than basic insurance in the event of emergency or transfer transportation.

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. It does, however, reimburse 50% of the cost of emergency transportation to the nearest hospital, up to a maximum of 500 francs per year. If you have an accident abroad, your compulsory accident insurance covers the costs incurred. Treatment costs in EU and EFTA countries are usually processed by a local insurance company and then paid by basic health insurance. Note: if you have used up your deductible, you must pay the coinsurance payment applicable in the host country out of pocket – in France, this is really high for hospital stays.

Supplemental hospital insurance

There are four types of supplemental hospital insurance:

1) General ward throughout Switzerland

Good to know:

  • This is the cheapest supplemental insurance of all and can be taken out for as little as 2.40 francs per month if not already part of a package.
  • 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 the hospital.

Is it worth it?

This insurance may be useful for people living in rural regions with a less sophisticated infrastructure. Consider whether this would be of benefit to you.

2) Semi-private ward throughout Switzerland:

Good to know:

  • The option of a semi-private ward throughout Switzerland covers the cost of a two-bed room. As a rule, “throughout Switzerland” refers to 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 degree of comfort during their hospital stay. However, public hospitals nowadays offer a range of 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 cheaper. Over the years, the lower premium prices offset the coinsurance payment required on an upgrade. 

3) Private ward throughout Switzerland

Good to know:

  • The option of a private ward throughout Switzerland covers the cost of a one-bed room. As a rule, “throughout Switzerland” refers to 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 spa treatments, emergency and transfer transportation, domestic help and home nursing care. Examine and compare the costs and benefits carefully. Flex models are significantly cheaper. Over the years, the lower premium prices offset the coinsurance payment required on an upgrade.

4) Flex model (flexible choice of hospital ward)

Good to know:

  • With the Flex model, you decide shortly before you go into hospital in which type of ward you wish to be treated.
  • 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, general or semi-private cover will apply, depending on which you choose.
  • As a rule, no coinsurance applies to a stay in a general ward, whereas 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, requiring 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, although the premiums are lower overall, 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.

Summary

As you can see, there is an enormous range of supplemental insurance products to choose from. The disadvantage is that you cannot always adapt the cover to suit your individual needs, so you may end up buying a package that includes benefits you will never use. For this reason, it is 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.