Health insurance in Switzerland: a simple guide to basic and supplementary insurance

Which health insurer is best for you and how can you obtain optimal cover in the event of illness despite high premiums? And how do you obtain a refund of your gym membership? Swiss Life gives you the most important health insurance information easily and conveniently.

Health insurance in Switzerland: this is what you need to know

The health insurance system in Switzerland consists of two parts: basic insurance and various supplementary insurance types.

What do I need to know about basic insurance?

• If you live in Switzerland, you must take out basic insurance.
• Health insurance is freely selectable – you can decide which provider is the right one for you.
• Health insurers cannot refuse basic health insurance cover.
• You can change your health insurance provider every year up to the end of November.
• The premiums vary among providers, however the benefits under basic insurance are standard. The amount of your premium depends on where you live, the insurance model and deductible.
• Illness, accident and maternity are covered by basic insurance. If you work for more than eight hours with the same employer, you are covered for accident insurance through your employer. Additional accident cover via basic insurance is then not necessary.

What's a deductible?

The deductible is the cost sharing that every adult in Switzerland has to pay for his or her treatment costs per calendar year. Insured persons can choose between CHF 300, 500, 1000, 1500, 2000 or 2500. That means insured persons take care of at least the first CHF 300 up to a maximum of the first CHF 2500 of their treatment costs per calendar year.

What is the benefit of a high deductible?

The higher the deductible, the lower the insurance premium. Do you feel as fit as a fiddle and expect not to need much medical care? If so, you should choose a higher deductible and save on premiums.

But be careful: always keep something in reserve just in case. If you unexpectedly find yourself going to the doctor more often, you need to be easily able to cover the deductible.

What is the retention?

The retention becomes due after you reach your deductible limit during a calendar year. From then on, you will only pay 10% of your treatment costs, up to a limit of CHF 700 per calendar year. This retention is the same for everyone – regardless of their deductible.

What is the right insurance model for me?

There are various types of mandatory basic insurance:

Free choice of doctor
As the name says: with a free choice of doctor, you can choose which doctor you would like to go to. For example, if you have regular headaches, you can go straight to a specialist.
The disadvantage: this model is the most expensive variant. The advantage: no other model is more flexible.

HMO models
HMO stands for "Health Maintenance Organization". With this insurance model, you must always first consult a specific HMO practice if you are ill. Exceptions are emergencies, annual gynaecological screening and check-ups by the eye doctor. The disadvantage: your choice of doctor is limited. The advantage: you benefit from a high premium discount.

Family doctor models
You like your family doctor and you always want to visit him first before you go to another specialist? If so, the family doctor model is the right choice for you. Here, too, emergencies, annual gynaecological screening as well as check-ups by the eye doctor are exceptional cases – otherwise you are obliged to always first consult your family doctor if you are ill. The disadvantage: not all family doctors may be eligible – the health insurance company also has a say. The advantage: you benefit from a high premium discount.

Telmed models
Do you like to make regular calls to your friends all the time? If so, this model is definitely right for you. If you have any complaints, the first thing you do is to call a medical hotline. They will give you advice and recommend what to do next.
The disadvantage: remote diagnosis is often difficult. The advantage: this is the cheapest insurance model.

What should I know about supplementary insurance?

• Supplementary insurance adds to your protection for outpatient and inpatient care.
• Supplementary cover is voluntary.
• A medical examination is performed prior to the conclusion of supplementary insurance.
• Take out supplementary insurance when you’re fit and free of ailments – otherwise you may have difficulty being accepted. 
• Supplementary insurance providers are allowed to reject you: if you are already ill, you may be rejected or there may be exclusions for your specific illness.
• You don't have to take out supplementary insurance with your basic insurance provider.
• Supplementary insurance complements basic insurance by insuring benefits that are not paid at all or only partly paid by basic insurance. Attractive supplementary insurance includes, for example, contributions to gym membership, visual aids, travel and protective vaccinations and much more besides.