Supplemental hospital insurance in Switzerland – is it worth it?
Hospital insurance is one of the most popular supplemental insurance policies. Since there are various models of supplemental hospital insurance, it’s worth taking a close look at the pros and cons.
28.06.2023
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1. Which hospital stays are covered by basic insurance?
As part of mandatory basic insurance, hospital treatment is generally only possible within your canton of residence. Treatment in other cantons is covered in the following exceptional cases:
Emergencies.
Treatment within the canton of residence is not possible (e.g. in the case of transplants).
The hospital is found on the hospital list of the canton of residence.
The hospital has a contract with your health insurance company. This allows for reimbursement of benefits under compulsory health insurance.
The costs (flat-rate payment) may not be higher than in your canton of residence. Is the flat-rate payment higher and is treatment in another canton not considered medically necessary? Then the difference is borne by the policyholder or supplemental insurance.
2. What hospital insurance products are available?
You can extend your cover by taking out supplemental hospital insurance. The following options are available:
General ward throughout Switzerland
The “General ward throughout Switzerland” add-on is particularly worthwhile for residents of cantons with low hospital costs. This gives you free choice of hospital throughout Switzerland without incurring the costs of a higher flat-rate payment.
Semi-private ward throughout Switzerland
“Semi-private ward” means you are entitled to a two-bed room, greater flexibility in the choice of operation appointments and free choice of doctor (senior or attending physician).
Private ward throughout Switzerland
The addition of “Private ward throughout Switzerland” insurance entitles you to cover for a single room and greater flexibility in the choice of operation appointments. As a general rule, you can choose the chief or attending physician.
Flex models
These models are cheaper than semi-private and private hospital insurance products. Policyholders only choose a ward upon admission. All costs of treatment in any general ward throughout Switzerland are covered. Pre-agreed out-of-pocket expenses apply for the semi-private or private ward.
Will I be covered by supplemental insurance?
With supplemental insurance, health insurance companies set the premiums according to risk. The criteria include, for example, age, gender and state of health. Insurers may also impose exclusions or turn down applicants.
3. Is it worth taking out supplemental hospital insurance?
Supplemental hospital insurance makes sense if the answer to the following questions is yes:
Would you like more flexibility or comfort?
Would you like to go to a more expensive hospital outside your canton of residence without a medical reason to do so?
Important: you can tailor your supplemental insurance to suit your needs. The needs of an athlete, for example, are different to those of a pregnant woman. With supplemental insurance for maternity in particular, there are a few things to watch out for, such as the qualifying period. Since premiums vary, it’s worth comparing hospital insurance.
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.
In addition, the differences in comfort between the wards have become smaller. As a result, the price-performance ratio for semi-private and private hospital insurance is no longer so clear. Flex models perform better in terms of value for money.
4. What are the pros and cons of supplemental hospital insurance?
Pros | Cons | |
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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 do 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 in any case.
Find out whether your employer or the association of which you are a member has a collective agreement with a health insurance. If you’re a member, you can get discounts on your premiums.
Supplemental insurances sometimes offer discounts, such as for families. Find out what the different insurance providers are offering.
Women who will not have any more children can reduce premiums by excluding maternity cover from their policy.
If you take out a supplemental insurance with a high coinsurance, you will save on premiums. However, if you are planning a hospital stay in the foreseeable future – for example, because of a birth – you should calculate carefully: in many cases, the coinsurance for a single or twin room is higher than the premium savings.
Supplemental hospital insurance can be taken out either with or without out-of-pocket expenses. If you contribute to medical, drug or hospital costs, the health insurance company will reward you with premium reductions.
Many insurance products limit the choice of hospitals to a list defined by the insurance company, which leads to lower premiums. This means the insurer can avoid entering into a contract with every (expensive) hospital.
Take out hospital insurance when you are young, because you are always required to complete a health questionnaire. Unlike with basic insurance, health insurers are not obliged to accept applications for supplemental insurance.
Pay attention to cancellation deadlines
Think early about cancellation deadlines for supplemental insurance. Usually, the notice period is three months before the end of the year. In most cases, the insurer must receive the cancellation letter by 30 September.. The cancellation notice period is stated in the conditions of your supplemental insurance policy.
Good to know: you do not have to observe the standard notice period if the insurer changes the premiums or other conditions of insurance.
This article was first published on 19.08.2022