The Swiss are among the best insured nations in the world. One could also say that the Swiss are overinsured. In Switzerland, you can insure just about anything you care about: your health, your household belongings, your car, your travel, your teeth, your flights, your pet, your smartphone… the list is endless.
Obviously, not all these insurances are needed. One, however, is absolutely necessary and mandatory by law. And that is health insurance. Everything you need to know about this topic can be found here.
Mandatory health insurance – you have to have it
Foreigners residing in Switzerland must take out health insurance in Switzerland. This is compulsory under the Federal Health Insurance Act (KVG). A distinction is made between basic insurance and supplementary insurance. According to the KVG, only the basic insurance is compulsory, the supplementary insurance is taken out voluntarily and according to personal needs.
KGV sets basic insurance benefits
The basic insurance covers all important benefits in the event of illness. What these are is clearly regulated in the Federal Health Insurance Act. Therefore, the basic insurance does not differ in terms of benefits, all providers must comply with the law. It should be noted that the basic insurance does not cover dental treatment, but this can be insured through a voluntary supplementary insurance.
Get complementary insurance according to your personal needs
If you do not feel sufficiently insured with the basic insurance, you can take out supplementary insurance. This does not necessarily have to be taken out with the same basic health insurance company. You can therefore get basic insurance with health insurance company A and supplementary insurance with health insurance company B. Here is an overview of the benefits which are not included in the basic insurance and which are covered by supplementary insurance:
- Alternative medicine
- Glasses and contact lenses
- Protective and travel vaccinations
- Emergency and relocation transports as well as rescue and recovery costs
- Treatment abroad (also temporary for the holiday stay)
- Emergency and relocation transports as well as rescue and recovery costs
- Home nursing and domestic help
- Health care measures such as subscriptions to fitness centres, indoor swimming pools, etc.
In contrast to the basic insurance, the benefits in the supplementary insurances vary from health insurance company to health insurance company. A comparison is worthwhile. In the supplementary insurance, the health insurance companies can arrange the premiums according to the risk, i.e. graded according to age and gender. They may also make reservations or refuse admission without giving reasons. You can find out here how good your chances are of being accepted for a supplementary insurance. Because the health insurance company has the right to turn you down.
Don’t miss the 3-month registration period
After moving to Switzerland, you have three months to insure yourself with a health insurance company. Within the approved health insurance companies, you are free to choose. The competent communal or cantonal authorities monitor the compulsory insurance (they ask you to submit a copy of the policy or insurance card) and approve any exceptions.
There are exceptions to this rule despite residence in Switzerland in the following cases:
- Pensioners if they receive only a pension from an EU/EFTA country.
- Employed persons who work in an EU/EFTA country.
- Students with temporary residence and equivalent insurance.
- Staff of international organisations, embassies and consulates and, under certain conditions, their family members.
- Cross-border commuters, on the other hand – people who live in a neighbouring country and work in Switzerland – have the choice: they can take out insurance in Switzerland or at their place of residence.
How do I choose a health insurance company?
The choice of health insurance is a hotly debated topic in Switzerland. Especially in autumn, when the insurance companies communicate the premiums for the coming year. Premiums have been rising for years and politicians, health insurance companies, doctors and the pharmaceutical industry are blaming each other for this. Unfortunately, there is no solution in sight.
Nevertheless, a comparison of the different health insurance companies is worthwhile. The amount of your health insurance premium depends on a number of factors. Among other things:
- Place of residence
- Insurance model
- Provider of health insurance
Place of residence:
People living in the city usually pay a higher premium than people living in the countryside. The individual health insurance companies must offer identical premiums for each canton and premium region. Up to three premium regions are specified for each canton.
The older you are, the higher the premium. There are three different age groups with corresponding premiums: 0-18 years, 19-25 years and over 26 years.
Women pay higher premiums than men. Because statistically they live longer and give birth to children.
In basic insurance, there are various insurance models, all of which have the aim that the insured can save premiums. These include, for example, the family doctor model. For a premium reduction of approx. 10%, you are obliged to consult your family doctor first when going to see a doctor (except in emergencies). There are also insurance companies where you must first contact the telephone helpline before going to see a doctor. This model is called Telmed. With these models, the insurance companies try to keep people from running to the doctor or into an emergency because of every little thing.
The medical bills are not 100% covered by the health insurance, even if you have a health insurance. Each person has to pay a certain amount per year. This amount is called a franchise. Only when the franchise has been exhausted does the insurance company begin to pay the following doctor’s bills. But even then not to 100%. If the franchise amount is reached, the health insurance company covers 90% of the additional costs (10% is the deductible, up to a maximum of CHF 700).
The amount of the franchise can be chosen yourself. In principle, the higher the franchise, the lower the monthly health insurance premium. Most health insurance companies offer all six possible franchises of CHF 300, 500, 1000, 1500, 2000 and 2500.
Provider of health insurance:
The basic insurance benefits are specified in detail in the Federal Health Insurance Act (KVG). Nevertheless, the premiums of the individual providers differ considerably. It is advisable to obtain an offer from several health insurers and compare them closely.
The Internet portal Comparis is a good place to go to compare health insurance companies. Here you can compare both basic and supplementary insurances.
Income and state of health have no influence on the amount of the health insurance premium. The health insurance companies are obliged to insure every person wishing to join the scheme regardless of their state of health.
These are the top 10 Swiss health insurance companies
Helsana Versicherungen AG, 8081 Zurich, Phone 043 340 11 11
CSS Kranken-Versicherung AG, Tribschenstrasse 21, Postfach 2568, 6002 Lucerne, Phone 058 277 11 11
Swica Krankenversicherung, Römerstrasse 38, 8401 Winterthur, Phone 052 244 22 33
Assura-Basis SA, Avenue C.-F. Ramuz 70, 1009 Pully, Phone 0842 277 872
Concordia Schweiz. Kranken- und Unfallversicherung AG, Bundesplatz 15, 6002 Lucerne, Phone 041 228 01 11
Weltpoststrasse 19/21, Postfach 253, 3000 Bern 15, Phone 031 357 91 11
KPT Krankenkasse AG, Wankdorfallee 3, 3001 Bern, Phone 058 310 91 11
#8: Mutuel Assurance
Mutuel Assurance Maladie SA, Rue de Cèdres 5, 1919 Martigny, Phone 0848 803 111
Sanitas Grundversicherungen AG, Jägergasse 3, Postfach 2010, 8021 Zurich, Phone 044 298 63 00
Atupri Gesundheitsversicherung, Zieglerstrasse 29, 3000 Bern 65, Phone 031 555 09 11
The Swiss German dictionary helps you in every situation
No matter whether you have now telephone contact with your new health insurance or have to go to the doctor (which we do not hope of course). In any case, it is helpful to understand a few words of Swiss German or even to speak it. Have a look at our Swiss German dictionary. There you will find over 20’000 Swiss German terms. Or register directly for our online course.