Swiss healthcare system | Sanitas health insurance

Anyone living in Switzerland benefits from one of the best healthcare systems in the world. But what are the pros and cons of the healthcare system? What do you need to know when moving to Switzerland? And how does the Swiss healthcare system differ from the system in your home country? We provide an overview.

How is the Swiss healthcare system structured?

The Swiss healthcare system is based on a federalist structure, which means that the federal government, cantons and local municipalities assume different tasks in the healthcare system. For example, the government specifies the rate of deductibles and accepts or rejects changes to premiums, while the cantons specify which benefits are provided by which hospitals. They also set the wages and working hours of hospital doctors and nurses. In addition, the state and private sector have to work together. Private health insurance companies provide both basic and supplementary insurance, but they must strictly observe the regulatory requirements of the Federal Office of Public Health (FOPH/BAG) and the Financial Market Supervisory Authority (FINMA). In accordance with the Swiss Federal Health Insurance Act (KVG/HIA), basic insurance is compulsory for anyone who lives in Switzerland. To supplement the benefits available under basic insurance, you can take out supplementary insurance plans that cover, for example, dental treatment or single-room accommodation during hospitalisation.

What are the pros and cons of the Swiss healthcare system?

The biggest advantage of the Swiss system is that everyone has access to high-quality medical care. For example, every person living in Switzerland is entitled to basic insurance and must be admitted without a medical exam. What’s more, Switzerland has a very high density of hospitals and doctors. In 2018, Switzerland ranked first in the annual Health Consumer Powerhouse survey which focused on criteria such as patient rights, access to healthcare, therapy results, preventive care, medicines and range of benefits.

The biggest problem is that, due to the fact that numerous stakeholders (government, cantons, municipalities, health insurers, healthcare providers) assume different tasks, the Swiss healthcare system is very complicated. It’s also one of the most expensive healthcare systems in the world alongside the USA, Sweden and Germany.

Healthcare system in comparison with other countries

Find out how the Swiss healthcare system compares to other countries and how they differ.

The English healthcare system is organised by the National Health Service (NHS) and financed by taxes. The principle of solidarity applies in Switzerland. Put simply, everyone pays health insurance contributions regardless of their state of health. Another difference: Switzerland has a choice of basic insurance models: free choice of doctors, telemedicine consultation or family doctor model. In England, you always have to go to your family doctor first. Only those who take out private supplementary insurance can choose which doctor to go to.

UK	Switzerland
England, Northern Ireland, Scotland and Wales each have their own publicly-funded national health service (NHS)	No public health system as such, but people must have mandatory basic health insurance covering fixed catalogue of benefits defined by law
Private medicine (provided by private healthcare establishments), paid for by the patient, their private insurer or employer, is a niche market	Optional private supplementary insurance covering additional benefits (e.g. superior hospital accommodation or complementary therapies)
No separate premium for healthcare; NHS is funded by taxpayers	Premiums paid by insureds themselves. Premium depends on region, age, and alternative basic insurance model chosen (discounts possible)
Inpatient care (including accommodation, meals, drugs, etc.) in state-run hospitals is free; most state-run hospitals also offer superior facilities for which patients can pay a supplementary charge	Inpatient care (including accommodation, meals, drugs, etc.) is covered by basic insurance; superior facilities in hospital, e.g. a single room, are available with supplementary insurance.
The NHS is funded mainly from general taxation supplemented by National Insurance contributions (NICs).	Per-capita premium
NHS patients (with certain exceptions) in England pay a fixed prescription charge of GBP 9.15 for each item of medication from community pharmacies; no such charges in NI, Wales or Scotland	Medication paid for subject to chosen annual deductible and 10% copayment (max CHF 700 per year)
Visits to the doctor, hospital and (basically) the dentist free of charge, unless the patient chooses to go private	Medical care (but not dentistry) paid for subject to chosen annual deductible and 10% copayment (max CHF 700 per year)
Medical care provided by state-run health centres and hospitals, in minority of cases by private doctors or hospitals	Depending on choice of model, either free choice of doctor or certain limitations

The Swiss and U.S. healthcare systems have one thing in common: they are among the most expensive systems in the world. Otherwise, they are worlds apart. In the USA, citizens can choose whether to take out state or private insurance. However, the costs are so high that many people don’t have any health insurance. In contrast, everyone in Switzerland has to take out basic insurance by law. In the USA there are several public health insurance schemes, including Medicare for senior citizens over 65 and people with disabilities, Medicaid for people with low incomes, and Tricare for military personnel and veterans.Although there are around 60 different health insurers in Switzerland, they all offer the same benefits under basic insurance. In addition, all health insurers in Switzerland are legally obliged to admit all applicants to basic insurance, thus ensuring that everyone has access to high-quality medical care.

United States	Switzerland
Affordable Care Act provides a mandate that everyone needs to be insured. If you don’t take out health insurance, you have to pay a fee. Subject to extensive legal debate.	Universal mandatory healthcare provided by private companies
Private health insurance is predominant. Government options at federal level, such as Medicare and Medicaid, exist. Private plans vary.	Private health insurance available, e.g. travel insurance or greater luxury in hospital (e.g. single room instead of multi-bed room)
Insurance often comes through employer, but employees are ultimately paying it through their paycheck.	Paid by insured, not by employer
Can be paid by an individual. However, an individual can get insurance that covers family by adding dependents. Children and spouse covered.	Paid by person, not by family
Insurance premiums are decided by private companies and rates vary due to a number of factors. However, insurance cannot be denied to those with pre-existing conditions.	Premium depends on region where insured lives, age and insurance model chosen
Dental insurance is completely separate. Does not have to be covered.	Dental care not included; covered by private insurance
Depends on plan. But generally, if you pay more per month, you get more benefits, i.e. lower deductible (general trend).	Adult deductible can be chosen between CHF 300 and 2,500 per year -> the higher it is, the lower the monthly premium
Depends on plan	Copayment of 10%, but not more than CHF 700 per year for adults or CHF 350 for children
If below a certain income, you may qualify for Medicaid. You can have both Medicare + private insurance.	Low income situations: government subsidises regular healthcare plans (no separate health insurance). Insurance premiums not dependent on income (billionaires pay same price as everyone else)
Separate plan (Medicare) exists for retired individuals, but is not mandatory (you can still use private insurance).	No separate healthcare plan for retired people

Germany	Switzerland
Statutory and private health insurance	Statutory basic insurance (KVG/HIA)
Private supplementary insurance	Private supplementary insurance plans (e.g. alternative medicine)
Costs of health insurance covered 50% by employer and 50% by employee	Costs of health insurance covered by insured; usually no employer contribution
Family premium	Per capita premium
Same premium for everyone	Premium dependent on premium region, age, alternative insurance model (discounts available)
Exemption from statutory health insurance possible	Exemption from mandatory basic health insurance only possible in exceptional cases
Dental insurance included with health insurance	Dental insurance must be taken out separately

What is the principle of solidarity?

This principle has a long tradition in Switzerland and it is based on the idea that all insureds form a group.Each person makes a contribution so that in an emergency there are enough resources available to give someone the help they need when they need it. This means that even those who are in perfect health and never need to see a doctor pay their monthly premium and thus indirectly provide for those who are ill and need more medical support. It is the task of the federal government, cantons, municipalities and health insurance companies to keep this group balanced. That’s why decisions in the Swiss healthcare system are always taken in the interest of the group as a whole.

Premium regions

In Switzerland there are different premium regions for the health insurance company. These are specified by the federal government. This means that your premium is based not only on your age and sex but also where you live. Generally speaking, premiums tend to be higher in cities than in rural areas. This is because health costs are higher in cities as the density of doctors, hospitals and nursing homes is higher. There are currently 42 premium regions in Switzerland. Each canton has at least one region, for example the cantons of Aargau, Appenzell Innerrhoden, Basel and Geneva, and a maximum of three, for example Bern, St. Gallen and Zurich. Find out here how you can save money on your premiums.

Any questions?

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.

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