Who can access healthcare in Switzerland? This guide explains the Swiss healthcare system, Swiss health insurance, visiting a doctor or specialist, going to a hospital, emergency services and more.
The Swiss healthcare system is globally known as an outstanding model, with among the highest amount of healthcare expenditure in the world after the US. Swiss healthcare combines public, subsidised private and totally private healthcare systems to create an extensive network of highly qualified doctors (many of them from elsewhere in the EU) and Swiss hospitals, the best equipped medical facilities and no waiting lists – but it all comes at a price.
Switzerland’s healthcare system derives a significant portion of funding from mandatory Swiss health insurance premiums (averaging around EUR 450 per month) and out-of-pocket payments, meaning there is no free healthcare in Switzerland. In line with the high cost of living in Switzerland, Swiss health insurance equals around 10 percent of the average Swiss salary.
This guide explains everything you need to know about accessing Swiss healthcare:
- Switzerland healthcare system overview
- Swiss healthcare facts
- Basic health insurance in Switzerland
- Supplementary Swiss health insurance
- Swiss healthcare costs
- Paying swiss healthcare bills
- EU and EEA citizens: European Health Insurance Card (EHIC)
- Going to the doctor in Switzerland
- Hospitals and pharmacies in Switzerland
- Visiting the dentist in Switzerland
- Pregnancy and birth in Switzerland
- In an emergency
- Swiss healthcare: pros and cons
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The Swiss healthcare system is universal but it is administered by individual cantons. This means that everyone living in Switzerland must have basic health and accident insurance (Soziale Krankenversicherung / Assurance maladie / Assicurazione-Mallatie).
Unlike other European countries, the Swiss healthcare system is not tax-based or financed by employers but is paid for by the individual through contributions into Swiss health insurance schemes. In 2017, an adult pays an average of CHF 447 in Swiss health insurance premiums. In addition to paying monthly premiums to the insurer, you must also pay a contribution towards the cost of any medical consultations and treatments, up to a fixed amount.
Each family member must be insured individually. Babies are insured from birth but to continue cover, you must take out health insurance for your child within three months of the birth. Children don’t need to be insured by the same company as their parents. Once a child turns 18, they are officially responsible for their own health insurance payments.
If you are in Switzerland for less than three months, you may be exempt from the requirement for holding basic health insurance if you have an European Health Insurance Card (EHIC), your own private health insurance policy, travel insurance or a company healthcare plan – but check with your cantonal authorities to make sure.
After three months everyone must have organised cover with an authorised Swiss insurer, even if you have an international health insurance policy as these are not usually recognised in Switzerland. Some categories are exempt, however; a detailed explanation of conditions and costs is outlined in our guide to health insurance in Switzerland.
Many people top up the basic cover with supplementary private health insurance. Switzerland has one of the largest private healthcare sectors in the world, with good choice and competition.
- Switzerland spends the highest percentage of GDP on healthcare (around 11.4 percent) compared to all EU countries.
- Basic health insurance is compulsory in Switzerland, although you are free to choose your own Swiss health insurance company.
- In the EU’s latest statistics, Switzerland was the only country compared to the EU to total more than EUR 4,500 per inhabitant on healthcare expenditure.
- The OECD reports that Switzerland’s healthcare expenditure is the second highest among all OECD countries (along with the Netherlands), with the US in first place, totalling almost double the OECD average spent per inhabitant.
- Out-of-pocket spending, however, accounted for just over a quarter of all health spending, which is relatively high compared to the OECD average of 19.5 perent and neighbouring countries such as Austria (17 percent), Germany (13 percent) and France (7 percent).
- Healthcare is largely organised by Switzerland’s individual communes. The health ministers from all cantons form the Swiss Conference of the Cantonal Ministers of Public Health (GDK), which aims to promote cooperation and implement common policies between cantons.
- You can only change your insurance provider/package once a year, provided you give notice before 30 November, although some insurers allow bi-yearly cancellations with three-months notice. Health insurance prices vary depending on the canton.
There are around 60 registered health insurance companies in Switzerland (see a list here in German), each offering the same benefits in their basic health insurance policies and they are obliged to accept anyone who applies, regardless of pre-existing health conditions. You are free to choose your own insurer. Some of the largest health insurance companies in Switzerland include:
The basic health insurance policy covers:
- Out-patient treatment by officially recognised doctors
- Emergency treatment
- A contribution to transport/rescue expenses
- Medicines prescribed by a doctor and on an official list
- Maternity check-ups, tests, ante-natal classes, childbirth
- Abortions and gynaecological check-ups
- Rehabilitation after operations or illness
- Medical treatment when on short trips outside of Switzerland
- Some alternative therapies, like homeopathy and Chinese medicine and psychotherapy if this is given within the medical practice.
Your Swiss health insurance may cover you in certain situations outside of Switzerland, most commonly short trips in other EU countries. For emergency treatment in non-EU countries, you may also be able to claim a reimbursement, although there is a maximum limit of 90 percent of what the treatment would have cost in Switzerland. Whether you are covered and the actual percentage you will be reimbursed, however, depends on your individual insurer.
Swiss health insurance premiums
Monthly premiums may vary from company to company and most charge less for those aged under 25. You can pay cheaper Swiss health insurance if you:
- choose a policy with a restricted choice of doctor or HMO (health maintenance organisation);
- take out a Telmed policy which requires you to call a telephone counselling service staffed by medical professionals who can refer you to a doctor or hospital;
- increase your excess from CHF 300 up to CHF 2,500 per year, which means that you pay more if you’re ill but have lower premiums when you’re well;
- have a ‘modest’ income – this is determined by individual cantons and you need to contact your local cantonal authorities for more information.
You can take out optional supplementary health insurance at an extra cost from the same or separate insurer. Benefits vary from policy to policy but may include orthodontic treatment, spectacles/contact lenses, choice of doctor when you need treatment in hospitals, and stays in a private or semi-private hospital ward. The more benefits you get, the higher the premium. Companies can refuse to insure you or refuse or terminate the policy if you give incomplete or inaccurate information.
Look on the Federal Office for Public Health website for a list of insurers and an annually published list of premiums to compare prices.
In any given year, adults have to pay the first CHF 300 of any medical treatment themselves, except for maternity services. This contribution is called an ‘excess’. The insurance will only pay what exceeds the excess and even then, the patient has to pay 10 percent of that amount. This is called the ‘deductible’ and is limited to CHF 700 per year or CHF 350 per year for children. If you need to go to hospital, you also have to pay CHF 15 per day.
After your consultation or treatment, you’ll receive a bill from the doctor or hospital. You need to pay within a specified period of time and then send a copy to your insurance company, who will reimburse you the amount covered by your scheme. If you visit a medical centre that has an agreement with your Swiss health insurer, instead you will only pay your share upfront, with the reimbursement already deducted.
If you have to go to hospital but don’t have adequate health insurance for your treatment you may be asked to pay a deposit of up to CHF 10,000.
If you already have an EHIC you can get public medical treatment in Switzerland at a reduced cost while you are in the country for the first three months. EHIC does not cover private treatment. Keep any paperwork and receipts to apply for refunds or reimbursement on your return to your home country.
Once you take up permanent residence and/or employment you are no longer covered by the EHIC and must register with a Swiss health insurance company.
You are usually free to choose your own family doctor (Doktor/ Arzt / Médicin / Medico) unless your insurance policy places a restriction on choice of doctor, for example, if you have a cheaper policy plan (see above). In Switzerland, people also choose a paediatrician to look after the health of their children. The doctor can treat you and refer you onto specialists in a polyclinic (out-patient clinic) or hospital. Unless your insurance policy specifies otherwise, you may also consult specialists without a referral from your doctor and be covered by your insurance.
You can find a doctor by personal recommendation, at www.doktor.ch or www.doctorfmh.ch, or by looking in the health section of the Swiss Yellow Pages where you’ll find doctors, dentists, pharmacists and other health professionals. Your embassy or consulate may be able to recommend a doctor who speaks your native language.
You’ll need to book your appointment beforehand and give 24 hours notice if you need to cancel – otherwise you can be charged. Take your Swiss health insurance card when you visit the doctor.
Call your local doctors’ telephone answer service for the contact number of the out-of-hours doctor.
Swiss hospitals are called Krankenhaus / Spital / Hospital / Ospedale – look for a sign with a white ‘H’ on a blue background. Unless it’s an emergency, you have to be referred to a Swiss hospital by a doctor. You’ll need to take your EHIC or proof of your Swiss health insurance policy.
The hospital will usually be in your local canton. There are three types of wards: general (two to four patients), semi-private (two patients) or private for one patient only. If you have private health insurance you can also choose your own doctor.
Basic health insurance covers medical and nursing care and outpatient follow-up although you will be asked to pay CHF 15 per day towards these costs. See Expatica’s list of hospitals in Switzerland.
Pharmacies in Switzerland
Pharmacies (Apotheke/Pharmacie/Farmacia), clearly marked with a green cross, are good places to get health advice as well as medicines. The first time you get prescription medicines from a pharmacy you’ll be asked for a small, one-off fee to open a patient file in which the pharmacy will record all your medications. If you go to another pharmacy you’ll have to do the same there so it makes sense to try to go to the same pharmacy each time.
Pharmacy opening hours
Pharmacies are open usual business hours, 8am to 12pm then 2pm to 6pm Mondays to Fridays; Saturdays they close earlier around 5pm.
If you need an emergency out-of-hours pharmacy you can find the nearest one to you on this SOS-Pharmacy website (in English). Medicines cost more at out-of-hours pharmacies.
If you’ve been prescribed a branded medicine you’ll can be asked to pay a deductible of up to 20 percent but only 10 percent on generic medicines, so ask the pharmacist if there’s a generic equivalent for cheaper prices. Non-prescription medication is not covered by insurance. The government provides information here (in German) on accepted medicines and reimbursement rates under Swiss health insurance.
A Swiss dentist is called Zahnärzte / Dentiste / Dentista and may work in either a private dental practice or public dental clinic. Most dental care is not covered by the basic health insurance and can be extremely expensive in Switzerland. Unless you’re covered by private insurance, it might be worth comparing extensive dental treatment on a trip back home.
Adults must pay for their own dental check-ups and treatment although treatment for problems caused by serious, unavoidable illness is covered by the basic Swiss health insurance.
Children’s teeth are checked free of charge annually by school dentists but parents must pay to treat dental decay, although some local authorities may subsidise the cost. Most people take out complementary insurance to cover dental costs.
Your first point of contact will be with your family doctor or gynaecologist, although you may also book an appointment with a midwife. You’ll see the doctor or midwife throughout your pregnancy for tests and check-ups. You can give birth in Switzerland in a hospital, birthing centre or at home.
The basic health insurance covers you for seven check-ups, two ultrasounds, CHF 100 for ante-natal classes, the cost of childbirth and post-natal care, three breastfeeding sessions and a follow-up exam. You pay nothing towards these costs.
For more information, see our guide to having a baby in Switzerland.
Termination of pregnancy
In Switzerland it’s legal to have an abortion up to 12 weeks after conception without a doctor’s consent; from the 13th week, a doctor must confirm that it is necessary for the woman’s physical or psychological health to terminate the pregnancy. The cost of a termination is covered by the basic health insurance.
Emergency treatment is covered by the basic health insurance and you can consult with any doctor or hospital directly in an emergency, even if you have a restricted choice, HMO or Telmed policy. You may be asked for your health insurance details even in an emergency so keep them with you at all times.
There are emergency doctors’ services throughout the night and at weekends; call your family doctor for the number.
For urgent medical treatment, go to the A&E or ER (Notaufnahme / d’urgence / pronto soccors) of the nearest hospital; most public hospitals have 24-hour A&E departments.
For an ambulance, call 144, free of charge from any public phone. They will only take the patient to hospital; relatives or friends will have to make their own way. Insurance will cover 50 percent of the ambulance cost, though no more than CHF 500 per year if there is no immediate danger to life, so you might want to take the patient to hospital by car or public transport if they are well enough to travel this way.
Other useful numbers, free of charge, from any payphone include:
- 112 – general emergencies.
- 117 – police.
- 1818 – information service in German, French, Italian and English.
- 1414 – Swiss Rescue.
See our complete list of emergency numbers in Switzerland.
- I need an ambulance! – Ich brauche einen Krankenwagen!
- I need a doctor – Ich brauche einen Arzt.
- Call an ambulance – Appelez une ambulance!
- I need a doctor – J’ai besoin d’un médicin.
- Call an ambulance – Chiamate un’ambulanza!
- I need a doctor – Ho bisogno di un medico.
There are many Swiss healthcare system pros and cons, depending on what services you need.
- While basic insurance policies do cover costs for medical treatment abroad, it is only in cases of an emergency. If you frequently travel outside if the EU you’re unlikely to be covered for general healthcare needs. You may need to arrange an add-on package (supplementary insurance) or private travel insurance for worldwide cover.
- As Switzerland has been less affected by economic crises compared to other EU countries, public spending per capita has been continually growing in recent years. Switzerland’s annual healthcare expenditure amounts to some CHF 70 billion, with one in 10 Swiss jobs based in the healthcare sector.
- However, a huge rise in healthcare costs poses major challenges to Switzerland’s healthcare system; healthcare costs in Switzerland have risen by around a third within the last decade. This trend will likely continue over the next two decades as healthcare advances, higher personal consumption of medical services and incentives drive costs up. Some experts predict Swiss health insurance premiums could double in the next 20 years.
- The Swiss healthcare system is relatively decentralised, meaning prices can vary considerably depending on the canton you live. Responsibility for the provision and funding of healthcare lies mainly with Switzerland’s 26 cantons; only some areas are regulated by the federal government, thus limiting federal competencies. Cantons also supervise (or own), maintain and, combined with mandatory health insurance funding, co-finance hospitals and nursing homes, meaning quality can also vary between cantons.
- The basic Swiss health insurance plan can equal up to some 8 percent of personal income. If a Swiss health insurance plan is more expensive than this, the applicant may be eligible for a cash subsidy to cover the additional premium amount.
- Switzerland is an active nation, of which roughly one-fifth maintains gym memberships. The Swiss consider being active an important aspect of life, and you can find certain insurers that include gym membership costs on their insurance policies as a benefit.
The amount provided for fitness training depends on your insurance policy, and provider. Whilst many insurers may cover between CHF 200 and CHF 500, others may place a proportional limit, such as 50 or 75 percent. Make sure you compare health insurance companies carefully see which policies include a fitness benefit. The amount provided for fitness training depends on your insurance provider; some insurers may cover between CHF 200 and CHF 500, while others may place a proportional limit, such as 50–75 percent.
- Changing insurers is a relatively easy process, provided the cancellation notice periods and terms are abided by, meaning residents can regularly take advantage of lower offers.
- Basic Swiss health insurance may not be adequate for certain medical needs, although you can take out supplementary health insurance to include additional coverage such as fitness packages, orthodontic treatment, spectacles/contact lenses, choice of doctor when you need treatment in hospitals, and stays in a private or semi-private hospital ward
- Read more about Swiss healthcare system pros and cons.