You’re planning on moving to Switzerland or just moved here recently? Switzerland has one of the best healthcare systems in the world – and you can benefit. Here you’ll find everything you need to know about being properly insured in Switzerland.
Health insurance is mandatory in most European countries – and Switzerland is no exception. If you move to Switzerland and work here or receive a pension from Switzerland, you have to take out basic health insurance in accordance with the Swiss Health Insurance Act (KVG/HIA).
Who is subject to compulsory health insurance?
The insurance obligation applies to all persons who settle permanently in Switzerland. The Swiss system is based on a per capita premium. This means that each individual family member must take out basic insurance and pay premiums (monthly contributions) to the health insurance company. You are exempt from the compulsory insurance requirement when:
Special conditions apply for people who live in Europe but who work or study in Switzerland.
When does the compulsory insurance requirement take effect?
Once you move to Switzerland, you have three months to take out basic insurance. However, this doesn’t mean that you don’t have to pay contributions for the first three months. This is because the insurance starts retroactively from the date on you entered Switzerland. As the health insurance will cover any costs retroactively, you must also pay contributions retroactively. Therefore, it’s a good idea to take out health insurance as soon as possible despite the three-month deadline, because otherwise you may have to pay three monthly premiums at once.
What is basic insurance?
There are around 60 health insurance companies in Switzerland. You are free to choose a provider. The Swiss Federal Health Insurance Act (KVG/HIA) stipulates that all health insurance providers must offer the same benefits under basic health insurance. This ensures that everyone has access to high-quality medical care. Under mandatory basic insurance, you can choose between different care models and thereby save up to 20% on
What costs are covered under basic insurance?
The general rule is that mandatory basic health insurance covers benefits in case of illness, accident and maternity.
A detailed list of benefits can be found here.
In the event of accidents, however, basic insurance will only cover the costs if you have included it in your basic insurance and have no other insurance cover under a separate accident insurance policy.
Who provides cover against accidents in Switzerland?
If you work for more than eight hours a week for the same employer, you’re automatically covered for accidents by your employer. Your employer’s contract stipulates which ward you will be treated on in hospital in the event of an accident. If you would like to upgrade your insurance cover and receive treatment, for example, on the semiprivate or private ward, you may want to include accident in a supplementary insurance plan.
How much does basic insurance cost?
If you use medical services, you must contribute to the costs. The amount of cost share owed is calculated on the basis of your deductible, copayment, and hospital copayment if you have to go to hospital. The hospital copayment for an inpatient stay is CHF 15 per day.
You choose your annual
Put together an individual offer for you or your whole family. Important: To take out health insurance, you must be resident in Switzerland. To calculate your monthly premiums, we need a Swiss postcode as premiums vary depending on your place of residence. Please also let us know your date of entry. You will be insured with us from this date.
What is the deductible?
The deductible is the amount you pay each year before the health insurance covers a share of the costs for medical benefits (visits to the doctor, medicines, laboratory tests, hospitalisation, etc.) For example, if you choose a deductible of CHF 500, your health insurer pays the difference (minus your
You can choose from the following deductibles:
Child and adult deductibles
Which deductible is right for me?
You can save money by choosing a high deductible, but bear in mind that you have to be able to pay the deductible in full if you go to the doctor and receive a high bill. The deductible is therefore a risk amount. Think carefully in advance about the amount you can raise in an emergency. To determine which deductible is right for you, answer the following two questions: Am I generally healthy? How many times a year do I usually go to the doctor? If you’re healthy and don’t go to the doctor very often, you can choose a higher deductible. However, if you go to the doctor several times a year and don’t want to take a risk, we recommend that you choose the lowest deductible. If the deductible you choose doesn’t suit your requirements after all, you can adjust it up or down at the end of a calendar year.
What is the copayment?
Once you’ve reached your chosen deductible, you only pay a part of the costs for all further treatments. This is known as the copayment. You reach the deductible by submitting the invoices you receive for medical benefits (visits to the doctor, medicines, etc.) to your health insurer. The copayment is governed by the Swiss Federal Health Insurance Act. It is usually 10%, up to a maximum of CHF 700 per calendar year. If this amount has also been paid in full, all other costs will be covered by your health insurance.
What is the premium?
The premium is your insurance premium – i.e. the amount you pay to the health insurance company each month. The monthly amount depends on your place of residence, insurance model and the deductible you’ve chosen. Generally speaking, the higher the deductible, the lower your monthly health insurance premium will be.
Your health insurance premium depends on the premium region you live in. The Federal Department of Home Affairs (EDI) decides which municipality belongs to which premium region.
If you choose an alternative insurance model for your basic insurance, you benefit from discounts and a central point of contact for health queries. The discount varies depending on the model you choose.
By choosing a higher deductible than the standard one, you can save money on premiums, but you also bear a greater financial risk in case of illness. For children up to age 18 the minimum deductible is CHF 0.
Do I need supplementary insurance?
Supplementary insurance plans are governed by the Swiss Federal Act on Insurance Policies (VVG/IPA). Health insurers are free to define the benefits they provide under supplementary insurance plans. You decide whether you want to take out supplementary insurance.
However, it’s a good idea to take out supplementary insurance cover, because it fills any gaps left by the benefits of basic insurance. For example, supplementary insurance may cover dental treatment or alternative medical treatment. Or offer you the comfort of a two-bed/single room if you need to stay in hospital.
If you want to take out a supplementary insurance plan, you first have to answer a few health-related questions truthfully. Health insurers are free to accept or reject your application or accept it with restrictions. Your application may be rejected if there is a risk of very high treatment costs due to a past illness. Acceptance with restriction means that certain benefits will be excluded from your cover.
Hospital Top Liberty
Freie Arzt- und Spitalwahl weltweit: With the Hospital Top Liberty supplementary insurance plan, you have a free choice of doctors and hospitals worldwide and benefit from the highest level of comfort in case of hospitalisation. This private supplementary hospital insurance plan also covers the full cost of planned treatment and emergencies abroad.
Do you feel ill, but don’t dare to see a doctor because you’re afraid of a high bill? The following two examples give you an overview of approximately how much a visit to the doctor or an inpatient stay in hospital will cost. The following figures are based on experience and may differ from the actual calculation.
In Switzerland there are two different types of reimbursement for care services. Under the Tiers Garant (third-party guarantor) system, you pay the bill yourself and send the reclaim voucher to your health insurer. The health insurer settles the bill and reimburses you the amount you’re entitled to according to your insurance cover. The Tiers Garant system is mainly used for outpatient treatments. Many independent doctors bill using this system. Under the Tiers Payant (third-party payer) system, your doctor sends the bill directly to your health insurer. The health insurer pays the bill and sends you a claims settlement. You then pay your share (deductible and copayment) directly to your health insurer. The Tiers Payant system is mainly used in hospitals, nursing homes and for outpatient care. However, pharmacies are also increasingly using the Tiers Payant system for the dispensing of medicines.
Our “Welcome to Switzerland” team will be happy to help – by phone, email or chat. We’ll help you find the right health insurance solution for you. Our experts speak German, English, French and Italian.
Recommend Sanitas for a reward
Are you satisfied with Sanitas? Then put in a good word for us with your friends. We’ll make it worth your while by giving you a CHF 50 Digitec/Galaxus voucher for every person you recommend who takes out supplementary insurance with us. And your friends benefit too – they also get a CHF 50 voucher.