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COST OF LIVING

How much does health insurance cost in Switzerland?

From deductions to supplementary insurance - and an official calculator to work out your premiums - how much will healthcare set you back in Switzerland?

Swiss franc notes close up. Photo by Claudio Schwarz | @purzlbaum on Unsplash
Swiss franc notes close up. Photo by Claudio Schwarz | @purzlbaum on Unsplash

Few things are cheap in Switzerland – and that certainly extends to healthcare. 

However, depending on what kind of coverage you need, where you live and how much you earn, the costs may vary. 

Here’s what you need to know about health insurance costs in Switzerland. 

How does the healthcare system in Switzerland work? 

First things first, it’s important to get an idea of how the healthcare system works in Switzerland. 

Unlike in some other countries, healthcare in Switzerland is funded through health insurance premiums. 

Switzerland’s universal health care system is unlike that of other countries like the United Kingdom and Australia in several ways, primarily as it operates under a compulsory obligation to buy health insurance. 

This is known as ‘compulsory insurance’. There is also ‘supplementary insurance’, which covers a range of other areas. 

READ MORE: Everything you need to know about health insurance in Switzerland

You can choose which insurance to buy, but you can’t choose not to – which means that people wanting to cut costs cannot simply decide to go without health insurance for a year or two while they get their rent straight and their head together. 

There are however some options for people with low or no income. These are discussed below. 

How much does health insurance cost in Switzerland? 

Costs depend on where you live, which insurance provider you select and what options you go for.

Children under 18 pay less than adults. 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.

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.

Swiss franc coins close up. Photo by Claudio Schwarz | @purzlbaum on Unsplash

How much am I likely to pay?

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.

What if I don’t have enough money? 

Being unemployed or earning little money does not remove you from the obligation to pay your health insurance premiums – however, you may be eligible for a reduction in your premiums. 

In effect, this involves the government paying part or all of your insurance premiums. 

Of course, because it’s Switzerland, this will differ depending on where you live.

Some cantons will pay part of your health insurance automatically when your tax return drops below a certain amount, while in other cantons you will have to apply yourself. 

To find out the situation in your canton contact your local authorities – or click the following link

Is it possible to 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 Organisation) 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.

READ MORE: How can health insurance in Switzerland be made cheaper?

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.

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For members

OFFBEAT

Is Switzerland’s male-only mandatory military service ‘discriminatory’?

Under Swiss law, all men must serve at least one year in compulsory national service. But is this discriminatory?

Swiss military members walk across a road carrying guns
A new lawsuit seeks to challenge Switzerland's male-only military service requirement. Is this discriminatory? FABRICE COFFRINI / AFP

All men aged between the ages of 18 and 30 are required to complete compulsory military service in Switzerland. 

A lawsuit which worked its way through the Swiss courts has now ended up in the European Court of Human Rights, where the judges will decide if Switzerland’s male-only conscription requirement violates anti-discrimination rules. 

Switzerland’s NZZ newspaper wrote on Monday the case has “explosive potential” and has “what it takes to cause a tremor” to a policy which was first laid out in Switzerland’s 1848 and 1874 Federal Constitutions. 

What is Switzerland’s compulsory military service? 

Article 59 of the Federal Constitution of Switzerland says “Every man with Swiss citizenship is liable for military service. Alternative civilian service shall be provided for by law.”

Recruits must generally do 18 weeks of boot camp (longer in some cases). 

They are then required to spend several weeks in the army every year until they have completed a minimum 245 days of service.

Military service is compulsory for Swiss men aged 18 and over. Women can chose to do military service but this is rare.

What about national rather than military service? 

Introduced in 1996, this is an alternative to the army, originally intended for those who objected to military service on moral grounds. 

READ MORE: The Swiss army’s growing problem with civilian service

Service is longer there than in the army, from the age of 20 to 40. 

This must be for 340 days in total, longer than the military service requirement. 

What about foreigners and dual nationals? 

Once you become a Swiss citizen and are between the ages of 18 and 30, you can expect to be conscripted. 

READ MORE: Do naturalised Swiss citizens have to do military service?

In general, having another citizenship in addition to the Swiss one is not going to exempt you from military service in Switzerland.

However, there is one exception: the obligation to serve will be waved, provided you can show that you have fulfilled your military duties in your other home country.

If you are a Swiss (naturalised or not) who lives abroad, you are not required to serve in the military in Switzerland, though you can voluntarily enlist. 

How do Swiss people feel about military and national service? 

Generally, the obligation is viewed relatively positively, both by the general public and by those who take part in compulsory service. 

While several other European countries have gotten rid of mandatory service, a 2013 referendum which attempted to abolish conscription was rejected by 73 percent of Swiss voters. 

What is the court case and what does it say? 

Martin D. Küng, the lawyer from the Swiss canton of Bern who has driven the case through the courts, has a personal interest in its success. 

He was found unfit for service but is still required to pay an annual bill to the Swiss government, which was 1662CHF for the last year he was required to pay it. 

While the 36-year-old no longer has to pay the amount – the obligation only lasts between the ages of 18 and 30 – Küng is bring the case on principle. 

So far, Küng has had little success in the Swiss courts, with his appeal rejected by the cantonal administrative court and later by the Swiss Federal Supreme Court. 

Previous Supreme Court cases, when hearing objections to men-only military service, said that women are less suitable for conscription due to “physiological and biological differences”.

In Küng’s case, the judges avoided this justification, saying instead that the matter was a constitutional issue. 

‘No objective reason why only men have to do military service’

He has now appealed the decision to the European level. 

While men have previously tried and failed when taking their case to the Supreme Court, no Swiss man has ever brought the matter to the European Court of Human Rights. 

Küng told the NZZ that he considered the rule to be unjust and said the Supreme Court’s decision is based on political considerations. 

“I would have expected the Federal Supreme Court to have the courage to clearly state the obvious in my case and not to decide on political grounds,” Küng said. 

“There is no objective reason why only men have to do military service or pay replacement taxes. On average, women may not be as physically productive as men, but that is not a criterion for excluding them from compulsory military service. 

There are quite a few men who cannot keep up with women in terms of stamina. Gender is simply the wrong demarcation criterion for deciding on compulsory service. If so, then one would have to focus on physical performance.”

Is it likely to pass? 

Küng is optimistic that the Strasbourg court will find in his favour, pointing to a successful appeal by a German man who complained about a fire brigade tax, which was only imposed on men. 

“This question has not yet been conclusively answered by the court” Küng said. 

The impact of a decision in his favour could be considerable, with European law technically taking precedence over Swiss law.

It would set Switzerland on a collision course with the bloc, particularly given the popularity of the conscription provision. 

Küng clarified that political outcomes and repercussions don’t concern him. 

“My only concern is for a court to determine that the current regulation is legally wrong.”

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