Who is obliged to have basic insurance cover?
Under the Federal Health Insurance Act (KVG), every person resident in Switzerland must have at least mandatory basic insurance.
Families must take out separate basic insurance for each member of the family, regardless of age.
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When does health insurance have to be purchased?
You have three months from the date on which you register with the residents' registration office to register with a health insurer for mandatory basic insurance. Because insurance cover begins as soon as you register with the residents' registration office, the premiums for basic insurance are owed with effect from the month of registration. This means that you may have to make more than one month’s payment when you pay for the first time.
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Which benefits are provided under basic insurance cover?
The medical benefits covered are regulated by law and are the same with all insurance providers. Insurance companies are obliged to accept all applications for basic insurance.
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Do I have to contribute towards my healthcare costs?
Yes, it is obligatory in Switzerland to contribute towards your own healthcare costs. This contribution is levied through the annual excess and the deductible. The excess is the annual amount which the insured person must contribute towards the services which he/she uses. Individuals can select the level of excess that suits them. The options for excesses are defined in law and are set at CHF 300 to CHF 2,500 for adults. Once the excess has been paid, the insured person is also responsible for paying the deductible, which is 10% of the relevant healthcare costs. However, the deductible never exceeds 700 francs per calendar year. So, with an excess of CHF 300, the maximum cost to the insured person would be CHF 1,000.The excess and deductible are lower for children. The larger the excess, the lower the monthly premium.
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How do I choose the right excess?
The right choice of excess depends on the expected healthcare costs. The larger the excess you choose, the lower your monthly premium will be. Therefore, if you expect your monthly healthcare costs to be low, you would usually choose a large excess and so keep your insurance costs to a minimum. The options for excesses are defined in law and are set at CHF 300 to CHF 2,500 for adults.
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If the benefits provided by all insurers are the same, why do the premiums for basic insurance vary so much?
The basic insurance provides all insured persons with the same scope of cover. The premium to be paid depends on the insured person’s place of residence and age. However, insurance costs can be significantly reduced depending on the basic insurance model chosen.
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Who pays the health insurance premiums?
In Switzerland, unlike in other countries, premiums are paid in full by the insured person. Depending on the insurance company, the insured person can choose the payment frequency.
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What happens if you miss the three-month deadline for registering with an insurance company?
If you miss the registration deadline, you will be assigned to a statutory health insurer by your municipality and a premium surcharge will apply.
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Does the basic insurance cover treatment costs in my home country?
You can only have medical treatment in Switzerland, even if the costs are lower in your home country.
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How are the costs reimbursed to the insured person by the insurance company?
Normally the doctor's bill is sent directly to the health insurer from the doctor’s practice. To take advantage of this facility you must present your insurance card when you register with a doctor. The practice may, however, send the invoice directly to you. In this case you would pay the bill and submit the paid invoice to the health insurer. If you are entitled to reimbursement, the amount in question will be transferred to you by the health insurer.
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Where can I find more detailed information about the benefits that are covered by the mandatory basic insurance?
Every health insurer will be happy to provide you with more detailed information about the benefits available under the mandatory basic insurance. Make an appointment with the health insurer of your choosing.
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How can I reclaim from the insurer the money that I myself have paid for treatment?
As a rule, invoices which you have settled yourself can be submitted to the health insurer either digitally or by post. Submitted invoices are checked and, if you are entitled to reimbursement, the sum in question will be transferred to you. This process generally takes a few days.
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What insurance cover do I have under the law in Switzerland?
In Switzerland there are a number of statutory social insurance providers and schemes. You'll find an overview in our fact sheet on social insurers in Switzerland.
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