One of the most highly rated aspects about Switzerland is the quality of life and one of the reasons for this is the high status of the Swiss healthcare system. Switzerland has an exceptionally high standard of healthcare and is considered one of the best in the world. But, for someone who is new in the country, the whole framework can get overwhelming.
So, if you are looking to move to Switzerland, you may be confused about your choices and obligations when it comes to expatriate health insurance, things like accessing health care, medical insurance providers, premiums and more. To help you out with this, in today’s article, we break down all the useful information you will need to understand the process and your options.
First things first, let’s have a broad look at how the Swiss Healthcare system works – because this one is quite different from a lot of other countries.
A broad look at the Swiss Healthcare System:
Unlike other countries, the Swiss healthcare system works a bit differently. It might come as a shocker to expats that it isn’t tax-based or financed by employers. Healthcare in Switzerland is largely organized by the individual cantons. The health ministers from all cantons form the Swiss Conference of the Cantonal Ministers of Public Health (GDK). This aims to promote cooperation and implement common policies between cantons which is overseen by the Federal Office of Public Health (FOPH).
Back home in India, I could access all the private health care facilities available. And I was covered for everything by my employer – this varies from the kind of job you’re employed in. In mine, I even had my family as well as parents covered in case of surgeries or accidents. Even your apotheke bills had a tax advantage and could be submitted during the tax filing. All in all, a totally different system. I miss it – I grew up this way and I always found it super flexible. But, my situation comes from a place of privilege, this is not true for everyone. However, things in Switzerland are pretty much the same across the board.
Everyone living in Switzerland has to opt for a health insurance policy within three months of moving to the country; of course there are some exemptions. To continue to access Swiss healthcare, one has to pay monthly health insurance premiums and also pay part of the cost of ones medical treatment in Switzerland.
While private health insurance is mandatory, there is a lot of flexibility for residents. You can select from your choice of insurance providers.
Do you need Health Insurance?
If you’re a foreigner who is living or working in Switzerland, you will typically need to take Swiss health insurance once you are an official resident and have received your permit.
You can be exempted if:
- You are a pensioner who draws a pension exclusively in an EU or EFTA state.
- You are a cross-border worker who has insurance coverage in another EU or EFTA states
- You are a student who is a temporary resident in Switzerland and has comparable insurance
- You belong to the staff of international organizations, embassies, and consulates
You can also contact your local authority to find out if you qualify for an exemption, or find more information on the official website.
Additionally, if you are a EU citizen who is visiting for less than three months, health insurance is available at a reduced cost via your European Health Insurance Card. However, you’ll need to take up Swiss health insurance once you become an official resident or get a job.
Things to keep in mind BEFORE you apply for your Swiss Health Insurance
Post arriving in Switzerland, you have 90 days to take up a Swiss health insurance plan or apply for an exemption. It’s recommended to do your research and choose a provider that best suits your circumstances, health conditions and preferences. Just keep your proof of residence and details of your address handy.
In Switzerland, these health insurance schemes are designed to cover individuals, not the entire family, so separate insurance plans can be chosen for each member of the household. You are usually charged a monthly premium fee, and this figure varies. If you’re planning to have a baby, make sure that you take up Health insurance within three months of giving birth in Switzerland. If you take up an insurance plan after three months, coverage will start from the date of your policy; this could mean that fee relating to the birth isn’t covered. Children up to the age of 18 can have coverage with a different company to their parents, and can benefit from cost reduction.
Please note:
If you are unable to get health insurance for yourself and your family in the three-month deadline, then your local authority will sign you up to a plan, which could mean that you pay higher premiums. Anyone in Switzerland without an insurance plan, other than those exempted, will not be able to access Swiss health services other than emergency treatment, for which they will receive a bill.
Picking your plan: Private or Public Health Insurance?
The Swiss government insists that all residents must purchase a minimum basic health insurance package, with the option of private top-ups. Private Swiss health insurance is popular with expats, who can benefit from global plans offered by international companies. It’s also worth considering for those with chronic conditions or who think they may need or want to access specialist treatments not available through basic packages.
State health insurance (Public one) usually covers around 85% of medical bills (excluding the first CHF 300 (also referred to as the lowest possible deductible) of annual treatment costs and daily fees for hospital stays).
The health insurance coverage is similar across all insurance providers and includes:
- Accidents: If you work eight hours or more per week, you’re covered by your employer against accidents. If your employer doesn’t provide coverage, you must get additional accident coverage.
- Alternative therapy: Covers treatments like acupuncture, pharmacotherapy, and homeopathy if done by an accredited specialist. *but not fully, the percentage is decided by your insurance provider*
- Cancer screenings: Covers mammograms and colon cancer screenings for those aged over 50. *Or if like me they are doctor prescribed*
- Dental care: Covers only emergency treatment relating to serious mouth or jaw disorders or diseases. *Fillings, Root Canals, Teeth cleaning, Orthondics etc. is not covered in your insurance unless you have brought a separate dental insurance. When things go wrong with your teeth, be ready to pay through your nose.*
- Doctors and medical specialists: General check-ups and treatments are covered, including physiotherapy. Exclusions include some specialist treatments, and premiums are higher for those with high-risk profiles.
- Eye care: Covers children aged up to 18 for prescriptions of glasses and contact lenses up to CHF 180 a year. Also covers adults with serious visual conditions.
- Hospital visits: Covers inpatient, outpatient, and emergency treatment.
- Maternity care: Antenatal classes, childbirth expenses, and abortions are covered.
- Medical devices: Claims are possible for items such as bandages, inhalers, or incontinence devices.
- Medical transport: Covers half of the costs.
- Medication: Covers either 80% or 90% of prescriptions.
- Mental healthcare: Covers some services, including psychotherapy. Alternative or rehabilitative programs might not be.
- Rehabilitation: Covers care provided after an operation or serious illness.
- Sexual health: Covers gynaecological screenings.
- Treatment abroad: Coverage in EU/EFTA countries through the European Health Insurance Card. Covers some costs in non-EU countries during short trips, although you may need additional travel insurance. Check which conditions apply.
- Vaccinations: Covers the Swiss Vaccination Plan guidelines.
Please note: Some emergency services like ambulances aren’t fully covered by the basic Swiss health insurance.
For source and more info, click below:
How do you apply for your Swiss Health Insurance?
Once you’re done with your research on the kind of insurance you’re looking for, it is your responsibility to reach out to the health insurance provider and get yourself registered. You can find details of authorized health insurance providers in Switzerland from your local cantonal authority. When picking a provider, do measure out the costs, services covered and the claiming process.
A lot of people go with agents to understand the process or to understand their medical policy – the agent comes free of cost and earns commision from the providers. So if you’re new, it’s not a bad idea to go with a trusted agent, the kinds that has good reviews. We’ve been with SWICA from the beginning and although a bit expensive, I’ve never had any trouble with them and really like the service I get. #notanannoyingagent
How much does Swiss health insurance cost?
The monthly premium fee varies between Swiss health insurance companies. Each year Swiss health insurance fees undergo a review according to a variety of factors; these include things like healthcare costs and company debt. This can mean premium costs can vary widely year-on-year when companies fail to cover costs.
Public State healthcare in Switzerland works on an excess system; which means, you need to pay a minimum of the first CHF 300 of your medical expenses each year (no excess applies to children under 18). Your Swiss health insurance provider will only cover bills above this excess. You can elect to pay a higher excess or deductible, which will result in lower monthly fees.
Regardless of your deductible, you’ll also need to pay between 10-20% of healthcare charges up to a maximum of CHF 700 per year; or CHF 350 per year for children. If you’re admitted to a hospital, you will also have to pay CHF 15 each day. Pregnancy, birth, and post-natal care in Switzerland are exempt from excess charges and are covered in full by state health insurance.
How to claim your expenses if you’re covered under Swiss Health Insurance?
When you are visiting the hospital, your GP or a specialist, your health insurance details are noted and your bills are sent directly to your insurance provider. After looking at your plan, your deductible and your current situation – the insurance provider will send you your part of the bill in the form of an invoice that you need to settle. To reduce the carbon footprint and make the process straight forward – you can now pay your premiums as well as open invoices through the app. And in cases where you made the payment directly, you can submit the bills also via the providers app.
Reimbursements usually take a few weeks to come through. You can check with your insurer for exact details of the process and likely waiting times.
Tips to reduce your monthly premiums:
- Choose a health insurer based on the condition of your health
- Choose a family doctor or an insurance model with a low premium.
- Choose a high deductible and pay lower premiums in return
- If you are employed for more than eight hours per week you are covered by compulsory accident insurance. You do not need to include accident cover additionally in your compulsory health insurance
Click here for more info.
Canceling or Changing your Health insurance:
You can generally change your health insurer at the end of each year. To do this, you must cancel your basic insurance in writing. Your letter must reach your current health insurer by 30 November.
Your current insurer will notify you by the end of October of your premium for the next year. This is in time for you to cancel if you do not agree with it. This premium calculator (web page available in German, French and Italian) might be useful if you want to compare what different health insurers are offering.
If you have a deductible of CHF 300, you can also cancel your basic insurance with effect from the end of June. A three-month notice period applies.
Check here for more info on changing/cancelling your Health Insurance:
https://www.ch.ch/en/insurance/health-insurance/health-insurance:-taking-out–changing–cancelling/
Some important resources to help you out with your Swiss healthcare journey:
- Federal Office of Public Health (FOPH official website) : https://www.bag.admin.ch/bag/en/home.html
- You will find here all official information regarding administrative formalities of the Swiss Confederation, the cantons and the communes.
Click here: https://www.ch.ch/en/health/health-insurance/ - Full list of authorized health insurers: https://www.bag.admin.ch/bag/de/home/versicherungen/krankenversicherung/krankenversicherung-versicherer-aufsicht/verzeichnisse-krankenundrueckversicherer.html
Hope this article has got you covered for all your Swiss healthcare needs. If you’re looking for more such articles on expat living, do check out our expat living section where we break down the nitty gritties of expat living.
To read posts from May, click here
Get in touch with me: About Us | Be a Part of My Swiss Story