Health insurance
Fragen zu Krankenversicherungen
•Basic cover
Basic healthcare covers basic healthcare and hospitalisation in your canton of residence.
•Complementary insurance cover
Complementary insurance covers a wide range of care not covered by basic insurance, including dentistry, alternative medicine, prenatal care, travel insurance, enhanced hospital care, loss of earnings and lump sum payments if you are unable to work. Complementary insurance is separate from basic insurance even when bought with basic cover.
Vaud parliament – source: Wikipedia
In Switzerland two categories of health insurance exist:
• Basic health insurance according to the "Krankenversicherungsgesetz (KVG)"
• Private supplementary health insurance according to the "Versicherungsvertragsgesetz (VVG)"
Basic health insurance
The basic health insurance covers the costs of treatment and healing costs in case of illness, accident and maternity. The health insurer takes over the costs for ambulant treatments with the family doctor or in hospitals as well as for stationary stays in the general department of a hospital.
The benefits of the basic health insurance are defined in detail by the legislator and are identical with all health insurance schemes in Switzerland.
The health insurance companies are not allowed to reject anybody who wants to get a basic health insurance from them. The health insurer is also not allowed to make any reservations or restrictions concerning the benefits of the health insurance scheme.
Private supplementary health insurance
The private supplementary health insurance offers the possibility to enhance the basic coverage concerning nursing benefits and healing costs. The most important additional covers are:
- The ambulant supplementary insurance for example covers alternative healing methods like homoeopathy and acupuncture, provides contributions to eye lenses or psychotherapeutic treatments and precaution investigations.
- The hospital supplementary insurance allows a treatment in a half-private or private department in a hospital or offers the expansion of the insurance cover to Europe or worldwide.
- Dental assurance covers dental treatments including oral surgery caused by illness.
- Travel assurance covers the ambulant and stationary treatments outside of Switzerland as well as rescue costs and the costs of the home transport.
The daily benefits insurance according to VVG covers any loss of salary as a result of illness beyond the basic insurance.
Unlike with basic insurance, for the private supplement health insurance the insurer can decide on the admission of the insured persons. The offers of the insurers are also extremely different – a detailed comparison of the products is therefore very important.
The insured persons has to take parts of the costs of the medical treatment on his own. This participation exists of an annual fixed amount (Franchise) and 10% of the costs exceeding this franchise (Deductible).
The standard franchise amounts to CHF 300.- per calendar year and the annual maximum of the deductible is CHF 700.- for adults. Therefore a maximum cost participation of CHF 1’000. - per calendar year arises for an insured person with an annual franchise of CHF 300. -.
The health insurance companies offer different franchise heights. For adults they vary typically between CHF 500.- to CHF 2’500.-, and for children between CHF 100.- to CHF 600.-.
The choice of a higher franchise leads to a significant reduction of the annual insurance premium. Nevertheless, this comes with the effect that in case of illness also higher costs have to be carried by the insured person.
Yes, the basic health insurance is mandatory if you are a Swiss resident (regardless of your nationality).
Concerning the private supplementary health insurance every insured person is at liberty to do as he/she pleases.
The following details are important in terms of the mandatory basic health insurance:
- All members of the family must be insured, adults and children (there is no family plan policy).
- If you have a residence permit of three months or longer.
- If you work for less than three months in Switzerland and do not have a comparable health insurance from your country of residence.
- If you, as a Swiss or EU/EFTA citizen, work in Switzerland and live in an EU member state, in Iceland or Norway. This is also valid for your non-employed family members.
- If you, as a Swiss or EU/EFTA citizen, solely receive a pension from Switzerland and live in an EU member state, in Iceland or Norway.
- If you receive an unemployment compensation from Switzerland and you proceed to search for work in an EU/ EFTA member state for up to three months.
- If you temporarily work for a Swiss employer abroad, you are still covered by the Swiss health insurance.
In terms of cancellation periods we need to distinct between the basic health insurance and the supplementary health insurance:
- If you have a basic health insurance with a standard franchise (adults CHF 300.- / children CHF 0.- per calendar year) and the standard health insurance model, you can cancel your health insurance on June 30. That means your present insurer must receive your notice by March 31 the latest.
- In all other cases of the basic health insurance, the cancellation is possible by December 31. Your present insurer must receive your cancellation notice by November 30 the latest.
- Different cancellation terms are valid for the private supplementary health insurance. Certain supplementary insurance policies have a several years’ least term and a cancellation period of three to six months. The terms of notice can be found in the general terms and conditions of the supplementary health insurance.