What’s the difference between basic and supplemental insurance?
Switzerland’s compulsory basic health insurance (KVG / LaMal) covers a wide variety of treatments.
Among them are doctor’s care and hospital stay, medical tests, physiotherapy, occupational therapy, nutritional counselling, speech therapy, mental health therapy, chiropractic therapy, rehabilitation therapy, and prescribed medications.
Basically, anything your doctor orders, the insurance will pay for, with the exception of experimental drugs or treatments which have not been approved in Switzerland.
Additionally, if you get sick or have an accident abroad, KVG / LaMal will pay the costs of emergency treatment in a foreign hospital, up to twice the amount that the same treatment would cost in your canton of residence.
There are some out-of-pocket expenses you are expected to pay. Only after your chosen deductible amount (“franchise”) has been reached does the insurance company start to pay out.
But after the deductible is reached, you will still have to pay 10 percent of treatment and medication costs, up to 700 francs for adults and 350 for children per year.
There is also a 15-franc per day charge for hospital stays.
READ MORE: Five tips for getting cheaper health insurance in Switzerland
What about the supplemental insurance?
This type of insurance offers certain benefits that KVG / LaMal covers only partly, or not at all. This includes complementary treatments such as:
- Memberships or passes for gyms and swimming pools.
- Home nursing services and domestic help
- Glasses and contact lenses
- Medical accessories and devices
- Emergency transport and transfer transport as well as rescue and salvage costs
- Cost of dental treatment, corrective dentistry and maxillofacial surgery
- Wellness services such as massage therapy
Additionally, it may cover alternative medicine treatments and psychotherapy performed by therapists without medical training.
The cost of the supplementary insurance may vary from one company to another and is likely to be limited to a maximum amount you can spend per calendar year.
You can take out this policy from any of the dozens of insurance carriers in Switzerland — not necessarily the one where you have your basic coverage.
And unlike the compulsory coverage, there are no deductibles for supplementary insurance.
Can anyone in Switzerland buy supplemental insurance?
Depending on your medical history and current health, it may be difficult or expensive.
While insurance companies must offer the same obligatory KVG / LaMal coverage to everyone, regardless of health status, carriers can deny supplemental benefits to people deemed ‘at risk’.
This includes those with pre-existing medical conditions or history of repeated treatments.
So if you are relatively healthy and have no chronic illnesses necessitating frequent treatments, you will not have a problem getting supplemental coverage.
But if you have a record of illnesses, your pre-existing conditions may be excluded from coverage, or else the premium might be very high.
To see what your chances are of getting these additional perks, and how much they would cost, you can go on some insurance sites and fill out the questionnaires, such as here and here.
EXPLAINED: How to change your health insurance carrier in Switzerland and save money
Comments (1)