Health insurance in Switzerland

How to avoid excessive health care costs


What does the basic insurance cover? When do I need supplemental insurance? What is a deductible? Are you still confused when it comes to health insurance in Switzerland? Below you can find the most important information, explained in a comprehensible way.

The Swiss health insurance system


 

After moving to Switzerland, you have three months to take out the mandatory (basic) health insurance.

 

The key facts in a nutshell:

  • The health insurance provider can be freely chosen.
  • You can change your health insurance at the end of each year.
  • The benefits are identical with all providers.
  • The individual premium depends on one's place of residence, age, insurance model and deductible ("franchise").

 

The benefits cover the areas of:

  • Illness
  • Accident
  • Maternity

As an employee you are usually insured for accidents by your employer and can therefore exclude accident coverage.

 

It pays off to compare premiums before deciding on a provider as there are considerable differences between the health insurance companies.

As with taxes, it is your place of residence that determines how much you have to pay for your basic insurance. Thrifty people might therefore want to consider moving to a canton or region with low premiums.

 

Good to know:

Health insurance providers are required to accept every applicant for basic insurance.

Basic health insurance


 

When you live in Switzerland, taking out health insurance is mandatory.

 

The benefits are the same with all providers and cover all necessary medical services. Comparing premiums still pays off, though, because the premiums vary strongly from one health insurance company to another. In part, these differences are due to the fact that the level of service provided by the insurance companies varies as well.

The amount of the premium itself is determined by the policyholder's place of residence, age, insurance model and deductible.

Normal case: health insurance without accident coverage


 

In Switzerland, you are automatically insured against accidents (Accident Insurance Act – UVG) by your employer if you are employed for more than eight hours per week with the same employer. Employees can therefore exclude accident coverage from health insurance without worry. Accident insurance covers the cost of treatment following occupational and non-occupational accidents.

All inactive policyholders, children and self-employed individuals must take out accident coverage with a health insurance provider or a private accident insurance provider.

 

Good to know:

Employees quitting their job voluntarily are covered for 30 days after their entitlement to salary ceases. If you happen to become redundant, you are covered against accidents by SUVA (Swiss Accident Insurance Fund) through the regional placement office (RAV in German).

Out-of-pocket expenses in the event of illness


 

When you use medical services such as visiting a doctor, staying in hospital or taking medication, you are required to bear a certain share of the cost yourself. The mandatory health insurance does not cover the full cost.

These out-of-pocket expenses are made up of the deductible and the coinsurance


Deductible ("franchise")

You are free to choose the amount of your deductible. For adults, the minimum is 300 francs and for children it is 0 francs. This means that, with the minimum deductible, you will have to pay up to 300 francs per calendar year out of your pocket. By choosing a higher deductible, you receive a greater premium reduction.


Coinsurance

Once your annual health care costs exceed the amount of your deductible, you must pay a coinsurance of 10 percent of the amount exceeding the deductible up to a maximum of 700 francs per year (the maximum amount for children is 350 francs). This means that the coinsurance comes into play when the deductible has been used up.

Does this sound a little complicated? Then maybe you will find this sample calculation here helpful.

Supplemental insurance


 

Health insurance supplements provide added comfort and close potential gaps in the coverage of your basic insurance. The benefits of supplemental insurance products vary from one provider to another. The insurance companies may set the premiums according to risk, i.e. with varying levels depending on age and gender, and make reservations in respect of new applicants.

 

There are two categories, "supplemental insurance for outpatient care" and "hospital insurance", which address different needs. The "supplemental outpatient insurance" covers alternative medicine, glasses and dental treatment, among other things.

"Hospital insurance" includes the following benefits, for example:

 

"General"

The supplemental insurance for "general ward throughout Switzerland" covers the additional costs if you go to a hospital outside your canton of residence that is more expensive than the ones in your canton. This supplement is worth considering if you live in a canton where the hospital costs are low, but wish to undergo treatment elsewhere. However, if you are obliged to undergo treatment in another canton because it is not available where you live, this is paid by your basic insurance.

 

"Private/Semi-private"

The insurance supplements for "private ward throughout Switzerland" or "semi-private ward throughout Switzerland" are designed especially for patients who do not want to give up a certain level of comfort while they are in hospital or who generally dislike sharing a room with other people. These two supplements entitle you to payment of a single or double bedroom, respectively. In addition, the chief physician (private) or senior physician (semi-private) are in charge of your treatment.

 

Good to know:

Basic insurance and supplemental insurance do not have to be taken out with the same provider. Frequently, providers require that basic insurance also be taken out with them when supplemental insurance is purchased or they may grant a discount on the supplement if that is the case. However, you can easily switch to a different provider for basic insurance later on if you are offered better terms there.

How do I buy insurance for my children?


 

In Switzerland, there are no family insurance policies as in other countries. Technically, mother, father and children could all be insured with a different provider.

 

The premiums for children are lower and young adults (from 19 to 25 years of age) often also benefit from reduced premiums. We therefore recommend that you compare premiums for your children, as well.

 

If you are expecting a child – congratulations if that is the case! – you need to register your baby for health insurance within three months of its birth. However, you will certainly have better things to do then. So, to be able to focus all your attention on your newborn, and for many other reasons, taking out health insurance before birth is worth it. Another advantage of buying insurance while you are still pregnant is that you can usually choose insurance supplements without a prior assessment of your child's health.

A particularly recommendable supplement is dental insurance. Only few children are blessed with a naturally healthy and straight set of teeth and orthodontic treatment is expensive.

 

Good to know:

Children benefit from a reduced premium for the basic insurance. Do you have more than two kids? Wonderful! In that case, your second or third child plus every additional child benefit from a supplementary discount with some companies. Many health insurance companies also offer family discounts on supplemental insurance.

Changing health insurance


 

Would you like to change your health insurance? For the basic insurance, the following rules apply:

  • In most cases, health insurance can only be cancelled with effect from the end of the year (31 December).
  • The cancellation letter must be sent by registered mail and reach your health insurance provider by the last working day of November.
  • Your cancellation may be denied if you have not fully paid your monthly premiums and out-of-pocket expenses.

 

For supplemental insurance, the following rules apply:

  • Do you wish to switch providers because your premiums have risen? You can find the applicable cancellation period in the terms and conditions of insurance of your provider.
  • Do you wish to switch for other reasons? The health insurance companies apply various cancellation periods in this case. We have listed the cancellation periods for you here.
  • Cancel your supplemental insurance only after having received confirmation of acceptance from your new provider.