Swiss health insurance

A guide to Swiss health insurance

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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 claim reimbursements for Swiss healthcare services once they are registered for Swiss health insurance.

Healthcare in Switzerland isn’t charged via Swiss 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 continue 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 who needs Swiss health insurance, exemptions and how to take out Swiss health insurance, plus how to claim your medical reimbursements. It includes:

 

Health insurance in Switzerland

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.

Some of the exceptions for residents in Switzerland include:

  • pensioners who draw a pension exclusively in an EU or EFTA state;
  • cross-border workers who are employed in an EU or EFTA state;
  • students who are temporarily resident in Switzerland and have comparable insurance;
  • staff of international organisations, embassies and consulates.


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.

Other exemptions apply in certain circumstances. After you register your address with your local commune, they will typically send you a letter to prove your health insurance coverage. You can ask your local authority if you qualify for an exemption, or find more information on the government website.

Children up to the age of 18 do not need to be with the same company as their parents, and are granted price reductions. Once 18, young adults are responsible for their own health insurance and will typically receive a reminder before their birthday. If they fail to sign up, the local commune will enrol them automatically and they will be sent their first bill. If a parent has failed to pay any past insurance payments for their child, at 18 years a young adult can become liable for the total bill of backpayments. However, with some children being presented with bills of more than CHF 10,000–20,000, there have been calls to reform the law to put responsibility on the parent.

Babies must be insured within three months of giving birth in Switzerland, if you want coverage to date retrospectively to the birth. If you take out insurance after three months, coverage will start from the date of your policy, which can mean fees relating to the birth aren't covered. While all companies must accept any applicant for mandatory Swiss health insurance, supplementary insurances can be refused based on medical conditions from birth. In such cases it is advised to take out supplementary insurance before giving birth in Switzerland, if your Swiss health insurer allows this.

How to apply for Swiss health insurance

In Switzerland, it is your responsibility to arrange your own state Swiss health insurance. Foreigners can’t sign up for Swiss healthcare until they have arrived in Switzerland and applied for their Swiss residence permit or registered their residence with the local commune (ie. EU citizens moving to Switzerland). The commune will chase you to provide proof of sufficient health insurance, depending on your circumstances.

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.

Once you have registered with a Swiss heath insurance company, 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 Swiss health 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 your Swiss health insurer at the end of each calendar year, typically giving one month’s notice (ie. by 30 November). This also gives applicants one month to decide after seeing the annual publication of health insurance prices for the following year, which all Swiss health insurance companies must publish by 31 October.

This period is sufficient for applicants to change Swiss health insurance company if they disagree with the new policies or fees, although it is still advised to start the process early to ensure you don't miss the deadline on 30 November. When you send a cancellation letter, the date your letter arrives at the insurance company will count, not the date you sent it. You can find examples of letters in French, German and Italian.

Compare Swiss health insurance companies

There are a number of sites where you can compare Swiss health insurance companies, including:

Swiss health insurance costs

How much does Swiss insurance 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 between Swiss health insurance companies.

Each year Swiss health insurance fees are reviewed according to a number of factors, such as healthcare costs and company debt. This can mean premium costs can vary widely year-on-year when companies fail to cover costs, as was recently seen when some low-cost health insurance providers raised premiums 15–20 percent year-on-year to make up for insufficient reserves.

In 2017, substantial price hikes to Swiss health insurance premiums were adopted, averaging 4.5 percent across all cantons and insurance companies, ranging 3.5–7.3 percent depending on the canton. Health insurance fees for children saw the biggest rise, averaging 5–10 percent, which the Federal Public Health Office (OFSP) reported was because previous premiums were insufficient to cover child healthcare expenses. With the increases, the average Swiss health insurance premium in 2017 is estimated at CHF 447 per month.

The cantons with the highest average monthly health insurance costs in 2017 include Basel-City (CHF 567), Geneva (CHF 554), Vaud (CHF 495), Jura (CHF 488), and Basel-Landschaft (CHF 488). In comparison, the cheapest five cantons were Appenzell-Innerrhoden (CHF 348), Nidwalden (CHF 361), Ury (CHF 369), Zug (CHF 376) and Obwalden (CHF 376). The most expensive, Basel-City, is more than 60 percent higher than the lowest. The government provides a complete list of fees for 2017 here, plus details on premiums by canton.

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.

Health insurance is available from so many different providers and 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.

Read more in our complete guide to getting healthcare in Switzerland.

How to get cheaper Swiss health insurance

Aside from shopping around for the best deal, there are other ways you can cut the cost of your health insurance in Switzerland.

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.
  • Most Swiss health insurer's offer a discount for paying in advance, typically around 2 percent off of one year upfront.
  • 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.

The government provides a guide on ways to reduce your premiums and how to apply for a 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.

Swiss health insurance for students

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.

Swiss health insurance companies

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 Swiss health insurance company you choose is required to accept your application regardless of age or health risks and without stipulating any conditions or a waiting period.

Some health insurers include mountain rescue, but you should check your policy.

Swiss dental care

With the exception of dental care 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 Swiss 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 Swiss 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).

You can find a doctor using www.doktor.ch or www.doctorfmh.ch. Alternatively, the health section of the Swiss Yellow Pages lists a range of healthcare professionals from doctors to dentists.

Swiss hospitals

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. 

Emergencies

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. See our list of Swiss emergency numbers.

Pharmacies in Switzerland

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 for cheaper costs.

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.

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. Accident insurance covers both occupational and non-occupational accidents, ie. accidents that happen during leisure time.

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.

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. Read more about social security in Switzerland and benefits.

Useful links



Click to top of our guide to Swiss health insurance.


Expatica
Updated 2017.
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