FAQ

Do premiums cost the same throughout Switzerland?

No. Premiums vary from canton to canton (sometimes even within the same canton) and between providers. They are not dependent on income but depend on your postcode, age, and deductible (Franchise) selected.

What is a deductible (Franchise)?

Also known as an "excess", a deductible is the amount that you must pay before your health provider will contribute to the costs. The deductible can be chosen by you and can be raised or lowered annually. The higher the deductible, the lower the monthly premium.

What are the different deductible levels?

Adults and young adults can choose a deductible of 300.-, 500.-, 1,000.-, 1,500.-, 2,000.- and 2,500.- Children can choose a deductible of 0.-, 100.-, 200.-, 300.-, 400.-, 500.- and 600.-. The premiums can be quite expensive at the lower end of the scale so adults in good general health generally go for a minimum deductible of 1,000.-, though most go for 1,500.- or even 2,500.-. For children, a CHF 0.- deductible is recommended (especially for younger children) because, although premiums are cheaper with a higher deductible, the saving is not as significant as it is with adults.

Does every member of the same family have to pay the same premium?

No. Children (0-18) and young adults (19-25) pay lower premiums than adults (26+). You will move into the next age category on the 1st of January following your 18th or 25th birthday.

Do health insurers provide the same level of cover?

Yes. Coverage for basic insurance is strictly identical from one company to another according to the law (LAMal/KVG)

Do I need accident insurance?

Yes, accident insurance is compulsory for all residents. However, if you are employed and you work 8 hours or more per week for the same employer, then your employer will cover you for both professional and non-professional accidents. Therefore, if you are self-employed, retired, unemployed, a child or full-time student, then you will need to include accident insurance on your basic cover. Accident insurance can be added to or taken off your policy on a monthly basis. If your employment situation changes, you should inform your insurance company.

When do I have to apply for cover?

If you are taking up residence in Switzerland, you have to show proof of your health insurance policy to your population office within 90 days of your arrival.

Do I need to supply details of my medical history?

No. There is no health questionnaire for basic health insurance, so you cannot be refused on the basis of pre-existing conditions.

I live in Switzerland. Do I need Health Insurance?

Yes. Health insurance is compulsory for anyone living in Switzerland. Health insurance is split into Basic and Supplementary. Basic insurance is compulsory and Supplementary is optional.

What does Basic Insurance cover?

Basic insurance covers you for the following: • General ward (public) hospitalisation within your canton of residence • Treatment by doctors and specialists • Limited cover of costs for emergency services (ambulance, helicopter etc.). • Pregnancy Additional cover may be obtained through Supplementary insurance.

Who is eligible to apply for cover?

Whilst Swiss basic insurance is compulsory for all Swiss residents, it is also only available to Swiss residents. Everyone living in Switzerland, irrespective of whether you are employed, self-employed, studying, retired or not working is eligible as long as they are a resident. Swiss insurance schemes only cover individuals, not families. You will therefore have to insure each household member individually.

How does the deductible work?

All bills covered by the basic insurance will cumulate into your annual deductible. Once you have reached your deductible, you then have to pay an additional 10% of the remaining cost. EXAMPLE : You have a 300.- deductible and you have annual medical bills of 500.-. You have to pay the first 300.- leaving 200.-. From the remaining 200.- you have to pay 10% (i.e. 20.-). Deductibles run from the 1st of January to the 31st of December each year and can be changed for the 1st of January as long as you inform your insurance company by registered letter before the 30th of November.

If I fall ill, can I lower my deductible rate for the following year?

Yes, as long as you inform your insurance company before the 30th of November of the current year.

How can I reduce my monthly premiums?

You can increase your annual deductible. As basic insurance tends to be rather expensive, over the last few years more and more insurance companies are offering “alternative” methods of basic insurance, all of which can save money on monthly premiums: i) Doctor network You can see any doctor you like as long as they are on the list provided to you by your company. ii) Telmed You must ring a special number (24-hour call centre) before going to see a doctor. You’re not obliged to follow the advice given, but you DO have to make the call. iii) HMO systems You choose an HMO or clinic that your insurance company agrees to – there is usually a selection of doctors available (GP, gynaecologist, etc.). You must use the HMO chosen. iv) GP or Primary care physician method You choose a GP or a paediatrician for the children. You name him/her and you always go to see this doctor first before going to see a specialist. You have free choice of doctor as long as this doctor is a general practitioner and not a specialist. This is a system that works quite well (in the UK we have to do this anyway), especially for children as they always tend to see the same paediatrician. You can change your nominated doctor if you need to but you must inform your insurance company before seeing your new doctor. In every case, there are exceptions to the rule (emergency, eyes, teeth, gynaecology, etc.) – basically, in cases where a GP can’t do anything anyway.

I would like semi-private / private hospitalisation. Can I have this under basic cover?

No. Semi-private / private hospitalisation cover is offered under supplementary only.

What are the payment options for my policy?

You can pay your premiums monthly, quarterly, biannually or annually by direct debit or by orange payment slip. Some companies do offer discounts (generally 1 or 2%) if you opt to pay annually.

How long does it take for claims to be reimbursed?

This varies from company to company but in general, you should be reimbursed within 2 to 4 weeks of sending your bills to them. Please note that some insurance companies have a different address for claims. If your bills are sent to the wrong address, you should expect a slight delay on your reimbursements.

What happens when my policy is due for renewal?

You don’t need to do anything to renew your contract. It is automatically renewed each calendar year.

How can I cancel my contract?

You can change providers each year for basic insurance as long as : • You inform your current provider of your intention to cancel by registered letter before the 30th of November. • Your payments for the current year have been paid in full • You have a new insurance company to go to for the 1st of January of the following year. If you have a 300CHF deductible (or 0CHF for children) with no alternative method of insurance, you can cancel for the 30th of June as long as you cancel your current contract for the 30th of March.

I’m leaving Switzerland, how do I cancel my insurance?

When leaving Switzerland, you have to deregister from your commune. Your population office will give you an attestation of definitive departure. Your insurance company will need a copy of this attestation in order to cancel your insurance. Your policy will be cancelled for the end of the month you’re leaving in. You won’t be asked to pay any premiums after this date.

I haven’t received my permit yet, can I apply nonetheless?

Yes. You can ask your population office for an attestation of proof of residence. This will suffice for an insurance application.

Why do I have to provide my bank account details?

Most insurance companies will ask for your bank account details (IBAN and name of bank) for any potential future reimbursements. Reimbursements are then credited directly to your bank account.

What does supplementary insurance cover?

It offers additional cover for things that are covered by basic insurance but perhaps not well enough, e.g. transport costs (ambulance, helicopter), hospitalisation. It offers cover for things which are not covered under basic insurance at all e.g. alternative medicines and massages, contributions towards gyms/sports clubs, contact lenses/glasses, dental care etc.

Does supplementary insurance cover accidents?

As a general rule, yes. With some companies, you can choose to include accident cover on your supplementary cover or not. It is recommended to include accident insurance on your supplementary even if you are covered by your employer. e.g. if you have an accident and then wish to go for an osteopathic massage, you need your supplementary insurance to include cover for accidents.

Does my deductible also apply to my supplementary insurance?

No. Basic and supplementary insurance are treated completely independently. As a general rule, there is no deductible on supplementary cover but please note that some companies do have a deductible on some parts.

Do health insurers provide the same levels of supplementary cover?

No. Unlike basic insurance, each company offers their own individual cover.

Do I need to supply details of my medical history for supplementary insurance?

Yes. You have to fill out a health questionnaire. This means that, as supplementary insurance is not compulsory, the health insurance company isn’t obliged to accept you. Your health insurance company will base your acceptance or not on your health questionnaire.

Are emergency services (ambulance, helicopter) covered?

Yes. Every company offers additional cover for transport costs in their supplementary insurance. The amount covered can vary greatly between companies and products.

How can I cancel my supplementary insurance?

Each company has different cancellation conditions. Your supplementary contract may be over several years so you can only cancel for the end of your contract. Some companies may require 3 or 6 months notice in order to cancel your contract.

Are long-term illnesses/conditions covered?

Yes, you will be covered for any long-term illnesses under the basic insurance. There is no maximum payout for this.

I have a pre-existing condition, can I get cover?

Yes, you can apply for basic insurance no problem but you may be refused for the supplementary insurance depending on your condition. The only way to know if you’ll be accepted or not is to apply and see what the insurance company comes back to you with.

I have received a letter concerning my application with regards to a “reserve”. What is this and how does it affect me?

If you have a pre-existing condition, your insurance company may accept you for supplementary insurance for everything other than this particular condition. You will still be covered under basic insurance for anything relating to this condition. A reserve applies to the supplementary insurance only.

What does semi-private or private hospitalisation cover?

Semi-private and private hospitalisation cover gives you : • Choice of establishment e.g. private hospital or clinic • Choice of surgeon • Semi-private hospitalisation also gives you the right to a room with maximum 2 beds • Private hospitalisation gives you the right to a private individual room

I applied for health insurance last week but still haven’t heard from my insurance company, how long should I expect to wait?

In general, the insurance companies take 3-4 weeks to contact you after your initial application. If you still haven’t heard from them after 4 weeks, you should contact them.

Can I buy a family policy?

No. Health insurance is Switzerland is individual so each member will need his/her own individual insurance.

What kind of dental cover is covered under the basic insurance?

The basic insurance covers any dental work that may be needed following an accident. It also covers dental work due if you can't feed yourself because of the state of your teeth and if you are born with a condition which means you may need dental work. For any ongoing dental treatment - e.g. fillings, bridges, crowns - then a supplement is required

I have health cover from my home country and they've told me they'll cover Switzerland. Can I use this instead?

Maybe. There is no clear cut answer on this. The only thing you can do is to ask at your population office who may ask to see details of what your policy covers. It can be quite a drawn-out bureaucratic process but it does work for some people. If your local authorities do accept your foreign insurance, they will give you an official exemption form. Please note that you have to have the official exemption form. Having a foreign alternative insurance may or may not be ok.

I am moving to Switzerland temporarily to study, do I need Swiss health insurance?

Yes, as a resident in Switzerland, you have to have Swiss basic insurance.

Do I need to take out supplementary insurance as well as basic insurance?

This is not compulsory but it may be something to consider due to the shortcomings of the basic insurance.

Will I be covered for sports accidents (e.g. skiing)?

Yes. You can include accident insurance on your basic cover and this will cover you for all types of accidents.

I’ve heard that as a foreign student, I am eligible for cheaper basic insurance, is this true?

Yes. There are companies that exist which offer very attractive premiums for foreign students as an alternative to standard basic insurance. Please note that these policies are only accepted in certain cantons. This is due to cantonal law and not the insurance companies themselves.

I am a student in my home country but am coming to Switzerland to work for my gap year, am I eligible for cheaper student insurance?

No, as you will be earning money in Switzerland, you do not qualify and will have to take standard Swiss basic health insurance.

I have health cover from my home country and they've told me they'll cover Switzerland. Can I use this instead?

Maybe. There is no clear cut answer on this. The only thing you can do is to ask at your population office who may ask to see details of what your policy covers. It can be quite a drawn-out bureaucratic process but it does work for some people. If your local authorities do accept your foreign insurance, they will give you an official exemption form. Please note that you have to have the official exemption form. Having a foreign alternative insurance may or may not be ok.

I am moving to Switzerland and I am pregnant, will I be covered?

Yes, you will be covered up to the level of basic insurance for anything relating to the pregnancy.

Does my basic cover deductible apply on anything pregnancy related?

No. The deductible on your basic insurance does not apply for anything directly relating to pregnancy – including the birth. Please note that in the case of a miscarriage, the deductible applies.

What does the basic insurance cover during pregnancy?

Your basic insurance covers the cost of seven routine antenatal examinations carried out by a doctor or a midwife and two ultrasound examinations as well as general ward hospitalisation within your canton of residence. In high-risk pregnancies your insurance will cover as many examinations and ultrasound examinations are deemed medically necessary.

Will the basic insurance cover the cost of the birth of my baby?

Yes. Your basic insurance pays for the birth of your baby, as long as it is attended by a doctor or a midwife in a public hospital within your canton of residence, at home or at a birthing centre.

If there are complications during my pregnancy, will they be covered?

Yes.

Is cover provided for caesarean sections?

Yes.

Are post-natal examinations covered?

Your basic insurance covers one post-natal examination and up to three breast-feeding advice sessions provided by midwives or specially trained hospital staff.

Can I switch to another insurance company if I become pregnant?

Yes. As the cover under basic insurance is the same with all companies, there is no problem to change companies. If you have supplementary insurance, it is recommended to keep at least this part of the insurance until after you’ve given birth.

Does supplementary cover pregnancy?

Yes. The majority of companies cover pregnancy in their supplementary products though there are some companies who exclude this completely. Some companies may exclude maternity cover from certain supplementary products. You should double-check before applying for supplementary cover whether maternity is included or not.

I’m pregnant and would like semi-private / private cover for pregnancy. Will I be covered if I apply now?

No. Those companies that do cover maternity as part of their supplementary operate a “wait period” which can range from 9 to 12 months. The wait period runs from the start date of your insurance to the date you give birth.

How soon after giving birth do I have to insure my child?

Within 3 months. If you wait any longer, you will have to pay a supplement, and expenses that you have already incurred will not be reimbursed. A “prenatal” insurance contract is highly recommended. This is generally contracted around the 4th/5th month of pregnancy but can be contracted any time before the birth.

What is “prenatal” insurance and why is it recommended?

Prenatal insurance is basically baby’s health insurance contract but is contracted before baby arrives. It is recommended to do this before the birth as : • It saves time – once baby is here, you’ll have plenty of other things to worry about so at least this is out of the way. • You have to insure baby anyway once he/she arrives. • There is no health questionnaire on the supplementary insurance, therefore baby is automatically accepted for this. • Some companies may have special offers on prenatal insurance (e.g. first month for free ; supplementary for free for the first x months etc.)