Foreigners can access subsidized Swiss healthcare once they become official residents and join a scheme for health insurance in Switzerland.
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, subsidized 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 health insurance in Switzerland.
This guide explains who needs health insurance in Switzerland, health insurance costs in Switzerland and how to take out Swiss health insurance, plus how to claim your medical reimbursements. It includes:
- The healthcare system and health insurance in Switzerland
- Who needs Swiss health insurance?
- Public health insurance in Switzerland
- Applying for health insurance in Switzerland
- Private Swiss health insurance
- Swiss health insurance costs and reimbursements
- Health insurance for the unemployed and low earners
- Useful resources
The healthcare system and health insurance in Switzerland
Switzerland has the best healthcare system in Europe, currently ranked number one according to the 2018 Euro Health Consumer Index. However, the Swiss health system is one of the costliest in the world and, unlike many other European countries, healthcare in Switzerland isn’t charged via social security payments 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 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.
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 insured in another 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 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.
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.
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. 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 reminded before their birthday.
What happens if I am not covered by health insurance in Switzerland?
Failure to purchase health insurance in Switzerland by the three month deadline means that your local authority will sign you up to a plan, which might 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 which they will be billed for.
Public health insurance in Switzerland
Swiss health insurance is provided by private companies but the government stipulates a minimum basic health insurance package to be purchased by all residents, with private top-ups available. Unless you qualify for an exemption, you will need to purchase at least the basic insurance level.
What is covered by Swiss public health insurance?
The basic state health insurance package covers between 80-90% of medical costs (excluding the first CHF 300 of treatment costs each year and a daily fee for hospital stays). Coverage is set by law and identical across all providers, including:
- Doctors and medical specialists – general check-ups and treatment is covered, including physiotherapy, but some specialist treatment is excluded and premiums are higher for those with high-risk profiles;
- Hospital visits – inpatient, outpatient and emergency treatment is covered;
- Medication – doctor’s prescriptions are covered at either 80% or 90%;
- Mental healthcare – some services are covered, such as some psychotherapy, but other alternative or rehabilitative programs might not be;
- Maternity care – pregnancy services such as antenatal classes, childbirth expenses and abortion are covered;
- Dental care – only emergency treatment relating to a serious mouth or jaw disorder or disease is covered;
- Eye care – children aged up to 18 are covered for prescriptions of glasses and contact lenses up to the value of CHF 180 a year. Adults with certain serious visual illnesses or conditions are also covered;
- Sexual health – gynaecological screening examinations are covered;
- Vaccinations – various vaccinations are covered, in accordance with the Swiss Vaccination Plan guidelines;
- Alternative/complementary therapies – some treatments, such as acupuncture, pharmacotherapy and homeopathy, are covered if done by an accredited specialist trained in complementary medicine. Check with your insurer before receiving treatment to see if it is covered;
- Cancer screenings – mammograms and colon cancer screenings are covered for those aged over 50;
- Medical aids and devices – a certain amount can be claimed towards things such as bandages, inhalers or incontinence devices;
- Accidents – if you work for 8 hours a week or more, you will be covered by your employer against all accidents. If you are not covered through an employer, you will need to take out accident coverage through your Swiss health insurance, which will increase your premiums slightly;
- Rehabilitation services – care provided after an operation or serious illness is covered;
- Medical transport and rescue – 50% of costs are covered if you need specialist emergency transport or rescue;
- Treatment abroad – costs are covered in EU/EFTA countries through the European Health Insurance Card. Some costs are covered for treatment in non-EU countries during short trips, although you may need to purchase additional travel insurance. Check which 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.
Applying for health insurance in Switzerland
In Switzerland, it is your responsibility to arrange your own 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 (i.e. EU citizens moving to Switzerland).
After arriving in Switzerland, you have 90 days to join a Swiss health insurance plan or apply for an exemption. It’s advisable to shop around and choose a provider that best suits your circumstances and preferences. You will usually have to provide proof of residence and details of your address to take out a policy.
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. Policies are usually offered to individuals with no additional family member coverage, so spouses and children need to have separate coverage.
Choosing a Swiss health insurance provider
You can find details of authorized health insurance providers in Switzerland from your local cantonal authority. When choosing a provider, look at costs as well as what is covered and the claims process. You can check for things to consider in this short guide here.
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. Full information, including sample cancellation letters, can be found on the Swiss government website.
Some of the largest health insurance companies in Switzerland include:
There are a number of sites where you can compare Swiss health insurance companies, including:
Private Swiss health insurance
Many Swiss residents choose to top-up their insurance with private supplementary health insurance to give themselves access to a wider range of treatments or better accommodation should they be admitted to hospital.
Who should get private health insurance in Switzerland?
Private health expenditure accounts for 32.6% of all health expenditure in Switzerland according to 2014 statistics, which is high compared to other OECD countries. Although the basic Swiss health insurance package is good, many people choose a supplementary package to access a wider and better range of services and treatments. 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 think they may need or want to access specialist treatments not available through basic packages.
The advantages of getting private health insurance coverage in Switzerland
Private insurance coverage will enable you to access additional treatments (e.g. dental treatment, specialist treatments and complementary treatment such as osteopathy), private healthcare services and benefits during hospital stays (private room, free choice of doctor, etc.). However, premiums are determined by risk factors such as age, lifestyle and health condition so can be costly for some. Also, whereas companies cannot refuse coverage for basic insurance, they are not obliged to offer a supplementary package to someone they view to be too high risk.
How does private health insurance work?
Private health insurance in Switzerland can usually be taken out with either the same provider of your basic package or a different one. You can choose the level of extra coverage you want and the costs will be determined by your risk profile, the range of benefits you’re choosing and your location (the most expensive cantons are around 60% dearer than the cheapest). You will typically have to pay medical fees upfront and then claim reimbursements from the insurer by sending them copies of invoices and receipts.
How to choose a private health insurance provider
It’s advisable to shop around the different companies and see who is offering the best supplementary deals that suit your individual circumstances. See this guide on expat health insurance quotes for things to take into consideration, and this guide on choosing expat health insurance for further information. Expat-friendly insurance brokers such as HP Swiss Insurance can help you compare different health insurance packages and choose the best fit for your situation.
Private health insurance companies in Switzerland
Companies providing good supplementary expat health insurance in Switzerland include:
Swiss health insurance costs and reimbursements
How much does Swiss health insurance cost?
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 seen in 2017 when premiums were raised by an average of 4.5% across all cantons, with some low-cost providers raising their premiums by as much as 15-20%.
According to the Swiss Federal Office for Public Health (FOPH), Swiss health insurance premiums will rise by an average of 1.2% in 2019, with the average monthly payment for an adult over 26 being CHF 372.3 per month. The cantons with the highest monthly insurance costs include Basel-City, Geneva, Vaud, Jura, and Basel-Landschaft. The cheapest five cantons are Appenzell-Innerrhoden, Nidwalden, Ury, Zug and Obwalden. You can find details of prices for all cantons for 2019 here.
Annual health insurance excess and deductible in Switzerland
State healthcare in Switzerland 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 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 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 claims and reimbursements in Switzerland
Most health insurance firms in Switzerland will expect you to pay fees upfront and then claim reimbursements afterwards. You will need to submit a claim form (available through your insurer) along with necessary invoices or receipts. Reimbursements usually take a few weeks to come through. Check with your insurer for exact details of the process and likely waiting times.
Tips to pay a lower health insurance premium
There are a few ways to reduce your monthly premiums. These include:
- Choosing a policy with a restricted choice of doctor or health maintenance organization (HMO);
- Taking out a Telmed policy, where you have to call a telephone service before being referred to a doctor or hospital;
- Increasing your excess above CHF 300 a year;
- Paying a lump amount of fees upfront (discounts of around 2% are offered for annual upfront payments).
Health insurance for the unemployed and low earners in Switzerland
Those unemployed or on a low income may be eligible for a premium reduction in the form of a government subsidy. This is administered at local level and both eligibility and amount reduced varies across the cantons. If you are entitled to a subsidy, you will normally be contacted by your cantonal authority after filing your annual tax return. You can also contact your local canton to make enquiries if you think you qualify for a reduction.
- Swiss Federal Office for Public Health – contains information on health insurance in Switzerland as well as a range of other subjects.
- Swiss government website – information on different health insurance topics.
- Guide to healthcare in Switzerland.