Answers to your questions

Here you will find ways to reduce your premium:

• Increase your deductible for basic insurance: This automatically lowers your monthly premiums, enabling you to save up to CHF 1,540 a year. Find out in the video what the terms deductible and copayment actually mean.
• Choose an alternative insurance model (AIM) for an attractive discount. Sanitas offers a range of alternative insurance models for basic insurance.
  

Find more money-saving tips here. Do you have any questions? Or would you like us to help you optimise your insurance? Then book a personal consultation in just a few clicks or contact your service centre directly – you can find the contact details on your policy document. We’ll be glad to help.

Switzerland has one of the best healthcare systems in the world. This first-class care comes at a cost, which is reflected in the health insurance premiums. This is because premiums are based on the cost of claims of all insureds. It is therefore possible that your premium will increase even though you practically never had to go to the doctor or hospital yourself and have needed neither medication nor treatment. However, it’s worth bearing in mind that you will be protected against high costs under basic insurance if you happen to fall ill at some time in the future and need medical care. This principle of solidarity is an integral part of the Swiss health insurance act. There are many other factors that drive up health costs in general – and therefore also the premiums:

• Advances in medicine and technology (e.g. new, expensive gene therapies to treat cancer)
• The increasing proportion of older people in the population and their need for medical care
• Increase in the number of chronically ill people
• Expansion of benefits covered by basic insurance (e.g. non-medical psychotherapy)

Please note: The following video explains the key facts clearly and concisely:

The average values for basic insurance communicated in the media rarely have a bearing on your individual premium. One reason for this is that insurance companies have to calculate premiums independently of each other. This is prescribed by law and monitored by the supervisory authority, the Federal Office of Public Health.

The FOPH requires that premiums cover the costs in each canton. That is why premiums primarily reflect a health insurer’s cost of claims, which is the costs they pay out for doctors, therapists, hospital stays and drugs. The cost of claims can vary considerably as it depends on a number of factors, including the structure of a health insurer’s customer base and the insureds’ place of residence. That’s why the premium of 44-year-old Mr M. living in canton X differs from the premium of 44-year-old Mr B. living in canton Y.

Important: The figures published by the FOPH refer only to the premiums for basic insurance. When comparing this figure with your policy, remember that it applies only to your basic insurance premium and not the premium for supplementary insurance.

The Swiss healthcare system attaches great importance to the concept of solidarity for basic insurance. This means all adults in a premium region pay the same premium for basic insurance regardless of whether they are sick or healthy, old or young, male or female. You’re one of the lucky ones who are in good health. However, it’s worth bearing in mind that you won’t have to pay a higher premium if you happen to fall ill at some time in the future.

This principle of solidarity is an integral part of the Swiss health insurance act. It gives you the security that you won’t face financial difficulties as a result of illness-related costs in the event of an emergency.

Our advertising activities are designed primarily to communicate information about innovative products and services and thus attract new customers to Sanitas. Winning new customers each year is a crucial factor in maintaining the stability and security of a health insurance company. Ultimately, this benefits all Sanitas customers.

Advertising can also play an important role in encouraging our customers to save costs: Since the launch of our Sanitas portal and associated communication measures, over 330,000 customers have switched to electronic – and therefore paper-free – correspondence with Sanitas. This saves paper, postage costs and is environmentally friendly.

And finally, our figures show that foregoing advertising has a negligible impact on costs, because Sanitas’ advertising expenditure makes up only a fraction of a monthly premium at less than 1 Swiss franc per month. In other words, cutting the entire advertising budget would have a negligible effect on premiums.

Did you know that, for every 100 francs you pay in premiums, around 95 are invested directly in medical services, i.e. hospital stays, therapies, lab expenses and medicines?

Sanitas works on a daily basis to keep the growth of healthcare costs as moderate as possible.

• We process up to 750,000 invoices each month and carry out checks in order to identify unjustifiably high invoices or uninsured benefits and thereby reduce costs.
  
• We follow up on information from our customers about questionable invoicing.
  
• We regularly negotiate tariffs with healthcare providers such as hospitals.
  

• Our case management team supports and advises customers experiencing difficult health situations. Proper coordination between doctors, therapists and other involved parties plays a crucial role in optimising the recovery process.
  
• Working together with our independent partner Medgate, we offer our customers free medical advice around the clock. This service is particularly useful at night or at the weekend, because it puts your mind at ease and enables you to postpone any necessary visit to the doctor to regular practice opening hours, thus avoiding expensive emergency costs.
• It has been proven that alternative insurance models help reduce costs. Sanitas offers various alternative insurance models for basic insurance.

In an effort to reduce environmental pollution for the sake of our health and the climate, the Swiss federal government implemented environmental levies on pollutants in 2008. The Federal Office for the Environment (FOEN) is responsible for distributing the levies to members of the public, which it does via the health insurers. In 2024, you will be refunded a total of CHF 64.20 from the revenue generated by the environmental levies (CO2 and VOC levy). Each month, CHF 5.35 will be offset against your premium. This amount is stated in your policy and premium invoices.

You will receive the official information sheet from the FOEN with your policy.

This video published by the FOEN provides further information.

Health insurers are legally obliged to build up reserves. While some insurers pay out any excess to their customers with basic insurance, Sanitas − like the majority of health insurers − prefers to focus on offering its customers premiums that are as stable as possible in the long term. What’s more, the costs of the complex administration process involved in refunding premiums are ultimately borne by the insureds. The possibility of a premium refund is reviewed annually as part of the premium earnings process.

Your chosen basic insurance model dictates who you have to contact first with health-related queries. Here you’ll find an overview:

• Medbase MultiAccess: Medbase network of experts as contact for medical queries
• NetMed: initial consultation with a practice from a medical network
• CareMed: initial consultation with your family doctor
• CallMed: flexible treatment plan after an initial telemedicine consultation
• Compact One: binding treatment plan after an initial telemedicine consultation

As of 1 January 2021, Sanitas offers three discount variants for the NetMed basic insurance model. Sanitas wants its customers to be able to participate more transparently in the cost savings generated by the different networks of physicians. If you choose or have chosen NetMed as your basic insurance model, you benefit from a range of discounts depending on your family doctor or practice.

The handy doctor locator shows you quickly and easily which discount variant your medical contact is assigned to. Or in other words: where you can save the most.

Who decides which discount variant my family doctor is affiliated with?

Your family doctor is affiliated with a network of physicians. The network of physicians and Sanitas have concluded contracts with the aim of encouraging the goal of improving medical quality and reducing costs. This cost savings will be achieved by optimising treatment paths and coordination. Sanitas calculates these discounts annually based on the cost savings achieved by the respective network of physicians each year. In order to share the cost savings of a specific discount variant, each network of physicians will be divided into the corresponding discount variant based on its cost savings.

I don’t agree that I have a lower discount. What can I do?

If you would like a higher discount in your NetMed family doctor model, you have the following option: choose a family doctor in a higher discount. In our family doctor locator, you can check which discount variant is a practice. However, if you want to remain with your current family doctor or your current family doctor, the specified discount is final for 2024.