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What you need to know before you take out Swiss health insurance

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What you need to know before you take out Swiss health insurance
There is no such thing as "free" health care in Switzerland. File photo: Depositphotos
09:25 CET+01:00
From choosing a provider to options for supplementary private cover, The Local outlines the basics of health insurance in Switzerland.

Who needs compulsory health insurance in Switzerland?

If you move to Switzerland, chances are you will need to take out compulsory basic health insurance within three months. There is no 'free' public healthcare in Switzerland and you will have to pay your compulsory premiums out of your own pocket.

The only people who are exempt are cross-border workers, retirees with pensions from European Union or EFTA states, students living temporary in Switzerland with their own equivalent health insurance and certain international officials and diplomats.

What does this compulsory health insurance cover?

Basic health insurance (Grundversicherung/assurance de base/assicurazione di base) in Switzerland is very comprehensive and includes coverage for illness, maternity and accidents – although with accidents, basic insurance only kicks in when people do not have accident insurance through their workplace. You are also covered for emergency treatment overseas, although conditions apply here.

Can I choose my which health insurance provider I want?

Yes. You can choose from your own provider from an authorised list: there are around 60 companies to select from. These insurers are legally obliged to take on any people seeking compulsory health insurance cover.

How much does compulsory basic health insurance cost?

Costs depend on where you live, which insurance provider you select and what options you go for. If you are a low-income earner, you may be eligible for a deduction depending on where you live, while children under 18 pay less. People aged under 25 also enjoy cheaper premiums.

Another important factor when it comes to your monthly premium is your excess or ‘deductible’ (Franchise/franchigia).

Read also: Switzerland moves to make people pay greater share of health costs

The deductible (which people under 18 do not have to pay) refers to how much you will have to pay before your health insurance starts chipping in for costs of your treatment.

The minimum deductible in Switzerland is 300 Swiss francs (around €260). The maximum amount is 2,500 francs. The higher your deductible (in other words, the more you pay out of your own pocket) the lower your monthly premium is.

To give one example, a 30 year old living in downtown Zurich with a 300-franc deductible would pay a monthly premium ranging from around 400–500 francs a month (depending on which insurer they go with). But if that deductible were 2,500 francs, the premium would range from around 265–410 francs.

The Swiss government has an online calculator (only available in German, French and Italian) which can help give you an idea of how much you can expect to pay.

The comparison site Comparis offers a similar service in English as does the moneyland website.

Are there any other costs?

Yes. Apart from the monthly premiums and the deductible, you may also have to pay a retention fee (Selbstbehalt/quote-part/aliquota percentuale) and a contribution to the cost of hospital stays.

The retention fee means you still have to pay 10 percent of medical costs over and above your deductible but this amount is capped at 700 francs for adults and 350 francs for children.

To give you an example, let’s say you have medical costs of 1,500 francs in a given year. If your deductible is 1,000 francs, you will pay 1,000 francs plus ten percent of the remaining 500 francs, so you will pay 1,050 francs and your insurer will pay 450 francs.

If you require a hospital stay, you will also have to pay an extra 15 francs a day, although children, young adults in training and education and women with full maternity cover do not have to pay this amount.

How can I save money on compulsory health insurance?

There are a number of 'low-cost' options for basic insurance, including the HMO, telmed and bonus insurance programs.

With the HMO (Health Maintenance Organization) model, you are not free to choose your doctor or hospital. Instead, your first point of contact will be with a doctor from an HMO, or group practice, who will coordinate your treatment. In exchange, you get a cheaper premium.

You can also take out a Telmed policy, where (in most cases) you receive medical advice in a first consultation over the phone before a referral to a doctor or hospital.

Some providers also offer a bonus insurance program where you start with a higher premium which then drops for every year that you do not submit an invoice to your provider. This can see premiums falling as much as 50 percent in five years.

What about private supplementary insurance?

Beyond the basic compulsory insurance that everyone has to have in Switzerland, you can also take out private supplementary insurance (Zustatzversicherungen/assurances complémentaires/assicurazioni complementari).

This supplementary insurance covers items like orthodontic treatment for children, a free choice of doctor or hospital anywhere in Switzerland, alternative medicine options or partial refunds on health-promoting activities such as gym memberships.

Note that you do not have to take out your supplementary insurance with your basic health insurance provider, so it pays to shop around.

However, in contrast to basic health insurance, insurer providers are not required to take you on as a customer for supplementary insurance and may reject your application if you have a pre-existing condition.

What is the best insurance provider?

There is no perfect solution for everybody. It depends on your own personal needs. But it is definitely worth looking at your options rather than just signing on with the cheapest provider.

What do our readers recommend?

Readers of The Local recently completed an online form on health insurance in Switzerland and the range of answers we received reveals the different priorities of people when looking for a Swiss health insurance provider.

Laurentiu Tanase told us it was important to lower your deductible in the case of one-off or rare events, whereas Don Golding recommended using the maximum available deductible of 2,500 francs.

Meanwhile, Tiago Ferreira, advised: "Go for the lowest [cost] compulsory insurance. If you need additional insurance, you can have it separately from another company."

Another reader drew on personal experience to tell us: "Be sure to get private coverage if you don’t want to share a hospital room. I came to Switzerland young and perfectly healthy, I registered for the most basic health insurance from Assura. Then I got cancer. I wish I had paid more attention to what insurance I was getting."

In terms of what other general advice, one reader said it was important to take out dental insurance while another recommended orthodontics treatment for people with children.

"The earlier you get coverage, the cheaper it will be, especially before seven years old," Josie Bourbon told us.

Do you have health insurance tip you want to share with other readers? Send us an email here.

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