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HEALTH INSURANCE

Reader question: Will my Swiss insurance cover me if I catch coronavirus abroad?

Being ill is bad enough while you are at home, but getting infected with Covid-19 while in a foreign country makes the situation much worse. This is what you can expect from your insurance provider in Switzerland.

Reader question: Will my Swiss insurance cover me if I catch coronavirus abroad?
If you hospitalised abroad due to Covid, your care should be paid for. Photo by Anna Shvets / Pexels

Everyone living in Switzerland is required to take out at least the basic health insurance coverage, the so-called KVG in German, and LaMal in French and Italian.

This insurance will pay for medical emergencies abroad, whether you have an accident, need urgent surgery, or —  as in the case of coronavirus — become ill and require immediate treatment.

If you do need urgent care while out of the country, you will have to notify your carrier by calling the number indicated on the back of your insurance card.

Keep in mind, however, that when it comes to insurance coverage, not all countries are created equal.

If you get sick in one of the EU or EFTA (Norway, Iceland, and Liechtenstein) nations, the European Health Insurance Card (EHIC) — that is, your regular Swiss insurance card — entitles you to receive the same paid services as someone who is insured in that country.

But if you are unfortunate enough to contract Covid and require hospitalisation while in the United States, where the cost of medical care is notoriously high, your LaMal coverage will not suffice to cover whatever costs you incur.

READ MORE: Should you buy supplemental health insurance in Switzerland?

That’s because the insurance will reimburse up to a maximum of twice what the same treatment would have cost in Switzerland.

If, however, you have a supplemental private insurance, your carrier will cover more costs. And if you took out additional health insurance to cover the cost of treatment abroad, it would pay for most (if not all) of the costs which are unrefunded by your main insurance.

Typically, you will have to pay for your medical care immediately. Then, when you return to Switzerland, send the documents you received from a foreign doctor or hospital to your insurance for a refund.

In order to be reimbursed, you will have to fill out a form (which is available either online or which your carrier will mail you), detailing the history of your illness or accident — how and where it happened, and what medical care you received.

Then send it back to the insurance company along with the invoice from the hospital, proof of payment, and medical records showing what tests, treatment, and medication you were given, and how much you were charged for each.

Make sure you have all this paperwork before you ask for a refund. If your documents are incomplete or an important piece is missing, the insurance may refuse to pay.

Relating specifically to coronavirus, you will also need a written certificate from a foreign health authority stating that you are fully recovered and able to travel.

And, at least for the time being, you must have a negative Covid test to come back to Switzerland.

Reader question: What documents do I need to enter Switzerland?

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For members

HEALTH INSURANCE

How to save money by changing your Swiss health policy

Switzerland’s compulsory health insurance is notoriously expensive, but you can lower the cost of premiums substantially by changing your company or coverage.

How to save money by changing your Swiss health policy

The cost of health insurance premiums usually represents at least 7 percent of a typical household budget.

An adult spends nearly 4,600 francs a year on average on the mandatory basic coverage (KVG / LaMal) alone – covering only medical care, not dental. If any extra policies are taken out, the cost is even higher.

Not only that, but premiums have been rising practically each year, and look set to go up again in 2023, possibly by as much as 10 percent — the sharpest hike in 20 years.

READ MORE: Why Swiss health premiums are set to rise — and what you can do about it

Even though these costs are high and climbing, many people keep the same health insurance for years.

However, significant savings — to the tune of thousands of francs a year — could be made simply by switching carriers or plans, from the more expensive to the cheapest ones, according to a new study by the cost comparison site Comparis.

How much and where

The amount of the savings varies depending on policyholder’s place of residence, because rates are determined by cantons.

However, Comparis calculated that over a 10-year period, people living in Zurich could have saved 33,396 francs in premium costs and for those living in Bern this amount is 30,064.

Lausanne residents could cut their costs by 36,494 francs over 10 years, 31, 032 in Geneva, and 33,490 in Basel-City.

“With the strong premium increases expected this fall, the savings potential is even greater,” said Felix Schneuwly, health insurance expert at Comparis.

So how can you save money? Here are some of the ways:

Increase your deductible

In Switzerland, the deductible (franchise) ranges from 300 to 2,500 francs – this represents the medical costs that you have to pay out of your own pocket before your health insurance kicks in.

As with most types of insurance, the lower your deductible, the higher your premiums, and vice-versa.

If you are young, healthy, and are not on any long-term medication then you can save substantially with the highest franchise.

Keep in mind, however, that if you choose the highest deductible and end up having an accident or falling sick and needing medical care, you will have to pay a greater proportion of the costs.

Switch to a less expensive plan.

The standard model for healthcare in Switzerland is that you can consult any medic that you want, and you do not need a referral to see a specialist.

However, there are some types of health insurance plans that have cheaper premiums, but impose certain limits on your access to non-emergency medical care.

For instance:

Health maintenance organisation (HMO)

Under this model, policyholders are required to consult a particular HMO practice. Two disadvantages of this alternative is a limited choice of doctors and you also need a referral to see a specialist.

However, the benefit is a premium reduction of up to 25 percent compared to the conventional insurance.

Family doctor model

Your family doctor, a general practitioner, will be designated by your insurance company and will be in charge of all your non-emergency medical treatment.

He or she will refer you to a specialist if necessary. 

If you opt for this option, you could save 20 percent on your insurance.

READ MORE: Five tips for getting cheaper health insurance in Switzerland

The Telmed alternative

If you choose this option, you have to call a telephone service and get a referral to a doctor or hospital.

This does not apply to medical emergencies and there are other exceptions, such as eye exams and annual gynaecological check-ups.

Total savings could range between 15 and 20 percent. 

Cancelling or changing your policy

If you want to cancel your current insurance policy and take up a cheaper one , you have to do so by registered letter before November 30th.

By then, you will know what your premiums will be in 2023 because your carrier must notify you of the new rates by October 31st.

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