A guide to Swiss health insurance
Foreigners can access subsidised Swiss healthcare once they become official residents and join a Swiss health insurance scheme.
The Swiss healthcare system is renowned for being one of the best in Europe, although it may seem complicated at first with a range of public, subsidised private and fully private health insurance options to consider. Foreigners living in Switzerland can access subsidised Swiss healthcare once they have Swiss health insurance.
Healthcare in Switzerland isn’t charged via social security but is administered by local health authorities in each canton. Everyone living in Switzerland needs to take out a health insurance policy within three months of moving to the country, although exemptions apply. To access Swiss healthcare, you’ll need to pay monthly health insurance premiums and pay part of the cost of your medical treatment in Switzerland. This guide explains how to take out Swiss health insurance and access Swiss healthcare, as well as how to claim your medical reimbursements.
Who needs Swiss health insurance?
Any foreigner who is living or working in Switzerland will typically need to take out Swiss health insurance once they are an official resident and have received their permit, although some exemptions exist.
If you’re an European Union (EU) citizen visiting for less than three months, you’ll be eligible for state Swiss healthcare at a reduced cost through your European Health Insurance Card. Once you become an official resident or get a job, however, you’ll need to join a Swiss health insurance scheme.
If you’re a cross-border commuter (for example, you reside in Germany, France, Italy or Austria but work in Switzerland), you have the option of being insured in either country.
How to apply for Swiss health insurance
In Switzerland, it is your responsibility to arrange your own state health insurance. Foreigners can’t sign up for Swiss healthcare until they have arrived in Switzerland and applied for their residence permit.
After arriving in Switzerland, you have 90 days to join a Swiss health insurance plan or apply for an exemption. If you don’t join a plan within three months you’ll be assigned one by your local authority. It’s advisable to shop around and choose a provider yourself as you won’t necessarily be assigned the best insurer for your circumstances, for example, English-language information. Additionally, unless you have a good reason for delaying your registration, you can be subject to pay a premium supplement.
There are a number of sites where you can compare health insurance premiums, including:
Once you have registered with a Swiss heath insurance provider, your coverage will backdate to the day you were liable for compulsory Swiss health insurance, for example, when you took up residency or gave birth in Switzerland. As expenses can also be claimed retrospectively, you will also be obliged to pay the premiums from the beginning of your compulsory insurance period.
If you wish to change insurance companies, you can do so with three-months notice before the end of June or end of December, providing you’re on a package where you pay the standard CHF 300 excess. Otherwise, you can only change providers at the end of each calendar year, typically giving one month’s notice (ie. by 30 November).
How much does Swiss insurance and healthcare cost?
Swiss schemes cover individuals rather than families, so you need separate insurance for each household member. You will be typically charged a monthly premium fee, which varies from provider-to-provider.
On top of that, state healthcare works on an excess system so you’ll need to pay a minimum of the first CHF 300 of your medical expenses each year (no excess applies to children under 18), and 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 10 percent of healthcare charges up to a maximum of CHF 700 per year, or CHF 350 per year for children. If you're admitted into 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.
With healthcare being available from so many different providers, monthly premiums vary based on your individual circumstances, though they do tend to be cheaper if you’re under 25 years old. You can find information about costs and calculate your premiums here (for you and your family) or find your canton’s health insurance premiums and information on ways to save money on your monthly fee.
You can read more about getting healthcare in Switzerland.
How to get cheaper Swiss health insurance fees
Aside from shopping around for the best deal, there are other ways you can cut the cost of your health insurance.
Most Swiss health insurers typically offer these alternate deals to reduce your monthly payments:
- You can choose a policy with a restricted choice of doctor and health maintenance organisation (HMO).
- You can take out a Telmed policy, under which you’ll need to call a telephone service before being referred to a doctor or hospital.
- You might be able to increase your excess above CHF 300, with some packages offering excess options up to CHF 2,500. This means you’ll be subject to lower premiums when you’re well, but you’ll have to pay more if you get ill.
- Low-income earners can be eligible for a premium reduction. If this applies to you, after filing a tax return you will typically be contacted by your cantonal authority, although in some cantons you must request your own reduction.
Private Swiss health insurance
Many Swiss residents choose to top-up their insurance to give themselves access to a wider range of treatments or better accommodation should they be admitted to hospital.
Private healthcare can usually be taken out with either the same insurer or a different one, and your premium will be decided by a number of factors, including your risk profile (based on your medical history), the range of benefits you’re choosing and your location.
If you’re an EU/EFTA student with a European Health Insurance Card (EHIC) then you can be exempt from paying for Swiss health insurance while you’re studying, and in some cases, your family members as well.
When you receive a letter asking you to provide proof of insurance you can apply for an exemption, which includes handing in a copy of your EHIC along with an application form (these forms vary slightly depending on where in Switzerland you’re based).
Additionally, both EU and non-EU students can be exempt if they have a private insurance policy in their own country that offers the same coverage as state Swiss health insurance. Your insurer must provide a stamped disclosure known as ‘form A’, showing that your health insurance package meets Swiss requirements.
If you do not have health insurance that is accepted in Switzerland, you will need to take out a plan with a Swiss health insurance company. Some offer special packages for students.
What does Swiss health insurance cover?
The basic state health insurance coverage is set by law and identical across all providers, including:
- Outpatient treatment
- Inpatient treatment from hospitals on the official list
- Emergency services including transport contributions and treatment
- Medicines prescribed by a doctor
- Pregnancy services such as antenatal classes, childbirth expenses and abortion
- General healthcare (such as vaccinations and gynaecological check ups)
- Rehabilitation services after an operation or serious illness
- Illness when travelling abroad, although conditions apply.
By law state health insurance can not be reliant on any personal factors, and any fund you choose is required to accept your application regardless of age or health risks and without stipulating any conditions or a waiting period.
Sick pay and accident insurance
All workers in Switzerland are required by law to be covered by accident insurance, including those who work from home, cleaning staff, volunteers and trainees. Those who are employed for more than eight hours with one employer will be covered under their employer’s scheme, while other categories such as self-employed workers, students, pensioners and other unemployed persons should consider taking out accident insurance alongside their health insurance plan. Accident insurance covers both occupational and non-occupational accidents, ie. accidents that happen during leisure time.
If you are unable to work due to illness, employers in Switzerland usually require a doctor’s note as of the third day you’re away from work, and they must pay your salary for a limited period. If you’re caring for a sick child, your employer must give you up to three days off work, provided you have a doctor’s note. If you are sick while taking holiday leave, your sick days can be discounted if you can provide a doctor’s certificate.
Swiss dental care
With the exception of care required due to an accident or serious illness, dental check ups and treatment aren’t covered by standard Swiss health insurance. School children in Switzerland generally have their teeth checked by the school dentist once a year. In most areas, this service is provided free of charge.
To cover the cost of dental treatment, many people take out complementary private dental insurance on top of their health insurance package.
Visiting the doctor in Switzerland
When you visit the doctor, you’ll need to take your health insurance card. If fees are incurred, you must typically pay the doctor’s bill first and later claim a reimbursement from your insurer. Your insurer may have an agreement for direct payment with certain medical specialists, where you won't need to pay the full amount upfront.
You are usually free to choose any doctor, provided your insurance policy doesn’t place a restriction on which doctors you can use (this may be the case if you chose a cheaper policy).
Hospitals in Switzerland have three types of wards: general (rooms for several patients), semi-private (rooms for two patients) and private (rooms for one patient). Your Swiss health insurance will usually cover admission to a general ward only, so if you want to upgrade to a semi-private or private room, you may have to pay the expense yourself or use private insurance.
After being treated either by your doctor or at the hospital, you’ll usually need to settle the bill within a specified period and send a copy to your insurance company for reimbursement. In some cases, the hospital will bill your insurance company directly, and your insurer will send you a bill instead for your outstanding share.
If you call an ambulance you’ll need to pay some of the ambulance costs yourself – it is not fully covered by Swiss health insurance – so you might consider another form of transport if the patient is fit enough. If you require an ambulance, you can dial 144 free of charge from any public phone.
In any case, you can attend your nearest accident and emergency unit (Notaufnahme), and you should take along your Swiss health insurance card. Most hospitals will have an A&E department open 24 hours a day.
Pharmacies (Apotheke) are usually open from 8am–12pm and 2pm–6pm, although they tend to close early (5pm) on Saturdays and don’t usually open at all on Sundays.
If you’re picking up a prescription, you’ll need to pay a deductible of 20 percent if it’s a branded medicine or 10 percent if it’s a generic medicine. You can always ask if the pharmacist has a generic version.
If you need medication outside of normal opening hours, you can go to your nearest emergency pharmacy (Apotheken-Notfalldienste), which can be found using the SOS pharmacie website.
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