Health Insurance

Health insurance in a few words

Health Insurance is compulsory in Switzerland.

According to the Federal Health Insurance Act, health insurance coverage is compulsory for all persons domiciled in Switzerland within three months of taking up residence or being born in the country.

What is covered by compulsory insurance in Switzerland ?

The compulsory insurance covers a range of treatments which are set out in detail in the Federal Act. It is therefore the same throughout the country and avoids double standards in healthcare. It provides for treatment in case of illness or accident (to the extent that no other accident insurance provides the cover) and pregnancy. The health insurance covers the costs of medical treatment and hospitalization of the insured. However, the insured person pays part of the cost of treatment. This is done:

– by means of an annual minimum contribution “franchise”. This payment may start from minimum of around Sfr. 300.- to around Sfr. 2’500.- as chosen by the insured person;

– by a charge of 10% of the costs over and above the franchise.

In case of pregnancy, there is no charge. For hospitalization, one pays a contribution to room and service costs.

Is there cover for supplementary benefits ?

The compulsory insurance can be supplemented by complementary insurance policies which allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalization. For example, dental treatment and private ward hospitalization which are not covered by the compulsory insurance can be covered by complementary policies. As the insurance is compulsory, the insurance companies cannot set any conditions relating to age, sex or state of health for coverage in that area. Although the level of premium can vary from one company to another, they must be identical within the same company for all insured persons or whatever age, sex or state of health.

What are premiums ?

Insurance premiums vary according to the insurance companies (caisses-maladie), the level of franchise chosen, the place of residence of the insured person and the degree of supplementary benefit coverage chosen (dental care, private ward hospitalization etc).

Is the system public or private ?

The Swiss healthcare system is a combination of public, subsidized private and totally private :

– public : the university hospital (CHUV) ;

– subsidized private : the home help and care services to which you may have recourse in case of pregnancy (difficult pregnancy or after childbirth), illness, accident, handicap of age ;

– totally private : doctors in private practice and in private clinics.

The insured person has full freedom of choice among the recognized treatment providers competent to treat their condition on the understanding that the costs are covered by the insurance up to the level of the official tariff.

How to select your health insurance company ?

There is freedom of choice to select an insurance company (an officially registered caisse-maladie or a private insurance company authorized by the Federal Act) to which one pays a premium, usually on a monthly basis. The list of caisses-maladies can be obtained from the Cantonal authority. However, the following addresses can be of help : (what will be the amount of my premium ? – French, German, English, and Italian)
Priminfo (Swiss Confederation website)