How does health insurance work in Switzerland?

How does health insurance work in Switzerland?
Basic and supplementary health insurance

Basic health insurance is mandatory. It is commonly referred to as basic insurance and is subject to the Swiss Federal Law on Compulsory Health Care (LAMal/KVG). There is no central system managed by the government. Under the supervision of the Federal Office of Public Health (FOPH), healthcare management is delegated to private insurers who each apply different rates depending on the canton.

In addition, the benefits of compulsory health insurance may be complemented by supplementary insurance subject to the Insurance Contracts Act (ICA).

The health system in Switzerland has a very good reputation, but comes at a relatively high cost. For example, in Lausanne, insurance premiums amount to approximately CHF 1,200 per month for a family of two adults and two children. Unlike in other countries, each family member, including children, must be insured individually.

Basic health insurance (KVG)

3

From the time of your arrival in Switzerland, you will have three months to choose your health insurance provider. After this period has elapsed, the cantonal authorities will automatically choose an insurer for you.

The insured may choose any insurer licensed to practise in the field of social insurance. The list of insurers is available on Priminfo, the official premiums calculator. Insurers cannot refuse an application and no health questionnaire is required for basic insurance.

picto KVG basic cover

Basic cover

KVG covers the basic needs of the insured.

picto hospitalisation

Hospitalisation

It guarantees at least one in-patient stay in a shared room in the hospital of your place of residence.

picto not covered

Not covered

Dental expenses and alternative medicine are not covered by the basic insurance.

Basic insurance premiums are monitored by the government. However, please bear in mind that insurance premiums vary according to the risks and costs, which vary from one canton to another. For example, in Geneva, premiums are higher than in Valais.

Sites such as www.comparis.ch make it easy to compare the offers of insurers.

Cost-sharing

Generally speaking, you will not need to pay your bills yourself. Your health insurance card is enough to guarantee you access to healthcare. Your insurer will pay the fees of health care providers (hospitals, doctors). However, you will incur part of the cost of care not covered by the basic insurance:

10%

The deductible, which represents 10% of the care bill, is always your responsibility

300 to 2,500

You may choose an annual deductible ranging from CHF 300 to CHF 2,500. If you choose a deductible of CHF 2,500, for example, you will have to pay the first CHF 2,500 in the current year before the insurance company starts paying the invoices.

Supplementary insurance - VVG

So-called supplementary insurance is private insurance. Insurers can therefore offer a range of services that will complement the basic insurance benefits (KVG). For example, they will reimburse alternative or natural medical services, dental expenses, hospital stays in double or single rooms, or the possibility of having treatment in the hospital of your choice in Switzerland.

As this is a private contract, the insurer has the right to refuse an application. In addition, it is generally necessary to complete a detailed health questionnaire to sign up for supplementary health insurance.

Finally, the termination terms vary from one contract to another. It is therefore vital to check the termination conditions carefully as they may be restrictive.

How to reduce insurance premiums

  • If you are in good health and do not go to the doctor often, choose a high deductible, for example CHF 2,500.
  • From one year to the next, choose the cheapest health insurer (for basic insurance).
  • Choose a basic insurance model based on access to a family doctor, Telmed or a care network (HMO).
  • Some insurers offer a discount if you pay your premiums all at once.
  • If you work at least eight hours a week, you are automatically covered in the case of an accident. You can remove accident insurance from your health insurance.
  • Finally, depending on your income and family situation, your canton may subsidise a portion of your premiums. Please contact your local cantonal health insurance office for more information.
For your calendar: 30 November - insurance
The insured may change insurer every year before 30 November of the year in question.
This article contains links to third-party websites. They are provided solely as information and their purpose is not to promote subscription to the products offered by Crédit Agricole, which has no commercial links with the owners of these sites. This information should not be considered as advice – financial, fiscal, or otherwise.

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