Supplemental hospital insurance in Switzerland: is it worth it?
Free choice of hospital and more comfort? Supplemental hospital insurance makes it possible – and covers the additional costs. Comparis explains.
04.12.2024
iStock / gorodenkoff
1. Which hospital stays are covered by basic insurance?
As part of compulsory basic insurance you generally have free choice of hospital in Switzerland. Prerequisite for unconditional assumption of costs: the hospital must be on the hospital list of the canton of residence.
The treatment costs are divided between your health insurance company and your canton of residence: taking into account the cost sharing maximum of 45 percent, the canton pays the rest.
What applies to hospital stays in another canton?
In many cases, the canton and the basic insurance also over the hospital costs in another canton:
The hospital is found on the hospital list of the canton of residence.
There is an emergency.
Treatment in the canton of residence is not possible. A permit from the canton is required.
There is a contract between the hospital and your health insurance company. Important: in the case of contract hospitals, the cantonal share is waived..
Do you seek treatment for personal reasons in a hospital that is not on the hospital list in your canton of residence? Then you will usually only be reimbursed for the costs that would have been incurred if you had been treated in a list hospital in your canton of residence. Any additional costs are borne by you or your supplemental hospital insurance general department throughout Switzerland.
Hospital supplementary insurance closes gaps in coverage
Do you want to ensure that you have free choice of hospital at no additional cost? Supplemental hospital insurance throughout Switzerland closes the gaps in coverage – with a comfort upgrade on request.
What hospital costs are not insured?
In addition to deductible and copay , you pay a hospital contribution. This is 15 francs per day. The costs are not covered by hospital insurance. If you do not have supplementary insurance, you will also have to pay the costs not covered by the canton and health insurance.
2. What are the different types of hospital insurance?
With a supplementary insurance for the hospital, you extend the coverage for hospital stays. There are various types of hospital insurance.
The hospital insurance “general department throughout Switzerland” pays the cost difference for extra-cantonal treatments. This means if the treatment costs more than in the canton of residence, the supplemental insurance pays. However, it is only valid for the general ward in the hospital – usually in the multi-bed room.
The addition of "general department" is particularly worthwhile in rural cantons with few hospitals. In cantons with a well-developed infrastructure, it is usually not worth taking out additional insurance. In Zurich, for example, most treatments are offered.
In the best case, there is the hospital insurance "general ward" for adults from two francs per month. The price varies depending on where you live and your gender. In some cases, this insurance is only included as part of a supplemental insurance package and therefore costs more.
The supplementary insurance semi-private ward is an extension of the coverage "general department". You can get extra-cantonal treatment at no extra cost – sometimes even abroad. As a rule, it also covers the following services:
Two-bed room
Free choice of doctor. This includes, for example, treatment by a senior physician.
Part additional services such as more flexibility in the choice of appointments for non-urgent treatments, contributions to cures and household help.
The exact benefits depend on the health insurer. Important: Some health insurers limit coverage to hospitals on their own hospital list.
In the best case, there is the hospital insurance "semi-private department" for adults, sometimes for under 15 francs per month. However, the premium varies depending on the benefit, gender, age, place of residence and the chosen deductible. Age and gender also determine the price: women sometimes pay significantly more than men, older insured people more than young people.
The supplementary insurance private ward is the most comprehensive hospital coverage. You can get extra-cantonal treatment at no extra cost – sometimes even abroad. As a rule, it also covers the following services:
One-bed room.
Free choice of doctor. This includes, for example, treatment by a senior physician or attending physician.
You are often treated by the Chief Physician.
Partial entitlement to a medical second opinion before operations and serious medical treatments.
Some additional hospitality services. This includes, for example, à la carte meals and home pickups.
Part additional services such as more flexibility in the choice of appointments for non-urgent treatments, contributions to cures and household help.
The exact benefits depend on the health insurer. Important: Some health insurers limit coverage to hospitals on their own hospital list.
In the best case, there is "private department" hospital insurance for adults from around 30 francs per month. However, the premium varies depending on the benefit, place of residence and the chosen deductible. Age and gender also determine the price: Women usually pay significantly more than men, older insured persons pay more than younger ones.
Flex-Models are cheaper than semi-private and private hospital insurance products. Policyholders only choose a ward upon admission.
Here’s how it works: For the general department, the full costs are usually covered throughout Switzerland. If you want to go to the semi-private or private department, you have to pay a deductible. This varies from insurer to insurer and from insurer to insurer.
In the best case, there is Flex hospital insurance for adults for less than 10 francs per month. However, the premium varies depending on the benefit, place of residence and deductible. Age and gender also determine the price of supplementary hospital insurance: women usually pay significantly more than men, older insured persons more than young ones.
Will I be covered by supplemental insurance?
With supplemental insurance, health insurance companies set the premiums according to risk. Criteria include age, gender and health condition. Unlike basic insurance, health insurers may also make reservations or refuse admission.
3. Is supplemental hospital insurance a good idea?
Supplemental hospital insurance mainly provides more flexibility and comfort during hospital stays.
Coverage "general department throughout Switzerland" is worthwhile if you want to go to a more expensive extra-cantonal hospital without medical necessity.
The "semi-private department" and "private department" coverages are worthwhile if you want additional comfort in addition to the free choice of hospital.
Surgeries are increasingly performed on an outpatient rather than inpatient basis. This means that in case of treatment, you will not spend the night in hospital. Some health insurers offer supplementary hospital insurance for inpatient and outpatient interventions.
In addition, the differences in comfort between the wards have become smaller. There are hospitals that only have single rooms or single and twin rooms. As a result, the price-performance ratio for semi-private and private hospital insurance is no longer so clear.
You can tailor your supplemental insurance products to suit your requirements.
Different people have different needs for supplemental insurance. Since premiums and benefits vary, it's worth comparing.
4. What are the pros and cons of supplemental hospital insurance?
| Pros | Cons | |
|---|---|---|
| General ward throughout Switzerland |
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| Semi-private |
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| Private |
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| Flex |
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5. How can I save money on supplemental hospital insurance?
When taking out hospital insurance in Switzerland, you have the following savings options:
Insurance companies offer different benefits and premiums. Calculating and comparing supplemental insurance is worthwhile.
Some employers or associations have a collective agreement with a health insurance company. Find out more. If you're a member, you can get discounts on your premiums and even join without a health check.
Supplemental insurances sometimes offer discounts, such as for families. Find out what the different insurance providers are offering.
Women with completed family planning can save premiums. Exclude maternity cover from the policy.
If you take out a supplemental insurance with a high coinsurance it’s cheaper. For Flex models, upgrading to semi-private or private is always associated with a higher deductible.
Are you planning a hospital stay in the near future? Then you should calculate, which is more worthwhile: more expensive premiums or the higher deductible.
Think early about cancellation deadlines for supplemental insurance. In the worst case, this will help you avoid double insurance. However, do not cancel your current insurance policy until you have been approved by the new insurer. This will prevent you from no longer having supplemental insurance.
Most insurers require three months’ notice prior to the end of the contract. The termination letter must then be received by the insurance company by 30 September. Check the cancellation deadline in your policy.
Good to know: If the health insurance company changes the premiums or contractual conditions, you can terminate the contract extraordinarily with one month's notice from receipt of the notification.
This article was first published on 19.08.2022
