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How Does Healthcare Work in Switzerland?

The first thing you need to know is that Switzerland has universal healthcare that is paid for by the individual rather than through government taxes or by the employer. Health insurance in Switzerland is mandatory for anyone living in Switzerland or visiting for more than three months. It provides cover for accidents, illness, and maternity. You are free to choose your insurer, and as an insured individual, you have to pay a monthly contribution. Keep in mind that as an international student, special provisions may apply, or you may be eligible for an exemption from the Swiss health insurance obligation. So, clarify your situation as soon as you take up residency in Switzerland, and if you are not eligible for an exemption, choose your insurer. 

Swiss Healthcare System Pros and Cons

pros-and-cons-of-health-insuranceThere are many benefits of Switzerland’s healthcare system. The most important ones are that everyone is guaranteed high-quality service and coverage. However, this amazing healthcare does come with a price.

Pros

  • Healthcare is mandatory, so every resident in Switzerland is entitled to the same coverage and standard of care. So, even if you have a pre-existing condition, a Swiss health insurance company can’t deny you coverage or charge you much more compared to someone who does not have any medical condition.
  • You will pay the same rate for as long as you are in Switzerland. Even if you get injured or sick, your fee will not increase.
  • Healthcare standards across Switzerland are very high, so rest assured that you will receive excellent healthcare and treatment. 
  • The health coverage includes accidents, illnesses, emergencies, and maternity care. Plus, home visits are covered by insurance in most cases. Not to forget that physiotherapy, occupational therapy, speech therapy, nursing care, and nutritional counseling are also covered if the doctor recommends them.
  • The quality of the care is outstanding. You can expect excellent care, modern facilities, and world-class physicians.

Cons

  • Healthcare in Switzerland is quite expensive.
  • Patients have to pay for most of their treatment out-of-pocket, but they are reimbursed later.
  • Any stay in Switzerland that exceeds 90 days requires health insurance. So, even if you go for a three-month visit and feel healthy, you are legally required to get private health insurance.

An Overview of Private Health Insurance

What you need to know is that you can take out optional supplementary health insurance at an extra cost from the same or another insurer. Plus, you can choose the amount of coverage you want from a private insurer. Read on if you want to learn more about private health insurance in Switzerland. 

Does Switzerland have free healthcare?

Although Switzerland has a universal healthcare system, it does not have free public healthcare. All Switzerland residents have to pay for their own private health insurance. This applies to students, as well as visitors, if their visit lasts more than three months. 

Do you need Health Insurance in Switzerland?

Health insurance in Switzerland is compulsory, meaning that all residents in this country must have health insurance. So, if you plan to stay in Switzerland for more than 90 days, you are legally required to have health insurance. 

So, simply put, you need health insurance in Switzerland if:

  • You are a resident of the country, regardless of your nationality. Also, all your family members will need insurance as well.
  • You have a residence permit valid for more than 90 days.
  • You have a work contract in Switzerland and do not have equivalent health insurance from another country.
  • You have come to Switzerland with the intention of taking up residence.
  • You are a Swiss national or a national of an EU/EFTA country, working in Switzerland and are resident in an EU member state, in Iceland or Norway. This is also applicable to your unemployed family members.
  • You are a Swiss national or a national of an EU/EFTA country whose only income is a Swiss unemployed benefit or pension. And also if you are resident in a member state of the EU, in Iceland or Norway. This is also applicable to your unemployed family members. 
  • You are an employee temporarily posted abroad by your Swiss employer. This is also applicable to any unemployed family members.

How Does Private Health Insurance Work?

how-does-health-insurance-workMany Swiss residents choose a private supplementary package to access a broader and better range of treatments and health services. Private health insurance typically covers dental treatments, specialist treatments, and other complementary treatments such as osteopathy, private healthcare services, and many benefits during hospital stays such as private rooms, free choice of doctors, etc. 

Keep in mind that risk factors including age, existing health conditions, and lifestyle may determine premiums, meaning it can be a bit expensive for some. And even though companies must provide basic healthcare insurance, they are not obliged to provide a supplementary package to someone they view to be high risk.

What are the benefits of having private health insurance?

Benefits may vary from policy to policy, but they usually involve:

  • Orthodontic treatment
  • Spectacles or contact lenses
  • Choice of the doctor when one needs treatment

Swiss Health Insurance Plans, Costs, and Reimbursements

Now we will explore the two most important types of health insurance plans in Switzerland, how much Swiss insurance will cost you and how you can reduce it, what it covers, as well as claiming reimbursements.

Types of health insurance plans

As we have already mentioned, there are some differences in Swiss health insurance, and these differences are often caused by the insurance plan types, including business insurance plans. Here are the main two types of health insurance plans:

Basic healthcare plan

Health insurance benefits, also known as compulsory basic healthcare insurance, are precisely defined under the Swiss Federal Health Insurance Act. That is why all health insurers in Switzerland offer the same benefits under basic insurance. The basic healthcare plan assumes the basic costs of treatment in the case of illnesses, accidents, and maternity. Mandatory basic insurance guarantees basic coverage for everyone. However, there are gaps. This plan does not cover every treatment, especially when it comes to individual requirements, which can result in high health costs such as dentistry, prenatal care, travel insurance, and so on.

Supplementary insurance

Supplementary insurance provides a smart complement to basic insurance and helps you close all the gaps of the basic healthcare plan. This type of insurance covers dentistry, alternative medicine, prenatal care, travel insurance, enhanced hospital care, etc. You can benefit from the free selection of doctors and hospitals or entitlement to a private hospital room. This type of insurance is also useful when traveling both in Switzerland and abroad. Wherever you are, the unexpected can always happen, so it is better if you are prepared.

How much does Swiss health insurance cost?

Typically, Swiss residents have to pay a monthly fee, which may vary between Swiss health insurance companies. The Federal Office of Public Health (FOPH) announced that the average health insurance premium for 2022 will cost CHF315.30 ($339) per month, which is the lowest insurance premium price in the last 14 years. 

What is covered by private health insurance?

Private health insurance covers different additional treatments such as:

  • Dental treatment
  • Specialist treatments
  • Osteopathy 
  • Private healthcare services
  • Benefits during hospital stays (private room, free choice of doctor, etc.)

Health insurance reimbursements

Most Swiss health insurance companies will expect you to pay fees upfront and then claim reimbursements later. You will first need to submit a claim form through your insurer along with necessary invoices or receipts. Reimbursements typically take a few weeks to come through. Talk to your insurer for the details of the process and the waiting period.

Things you can do to reduce the cost of Swiss health insurance

There are a few tips to pay a lower health insurance monthly premium, such as:

  • Choosing a plan with a restricted choice of doctor or health maintenance organization (HMO).
  • Taking out a Telmed policy, which means you have to call a telephone service and get referred to a hospital or doctor.
  • Increasing your excess above CHF 300 per year;
  • Paying all of the amounts fees upfront, so that you can get a discount of around 2 percent.

Health Insurance in Switzerland Must-Knows
health-insurance-in-switzerland

There is a list of things you ought to know about health insurance in Switzerland. Here are some of them. 

Insurance is compulsory

Understanding the whole health insurance system in Switzerland is not necessary but what is crucial is to know that health insurance coverage is mandatory for any person residing in Switzerland for more than three months. If you work in Switzerland even for under three months, this applies to you too.  

Yes, even if you are from an EU country

Health insurance has to be taken no matter what your nationality is; it is also compulsory if you are from an EU or EFTA state but work in Switzerland without residing here. As for people who live in a neighboring country and come to Switzerland to work (cross-border commuters), they can choose whether to take out health insurance in their own country or Switzerland.

Student Health Insurance in Switzerland

Scorestudies includes higher benefits than the Swiss compulsory health insurance, it is very often on a full refund basis and no co- payment of 10% is required. In case of emergency, hospitalisation or prescribed medication, you are fully reimbursed by Allianz Care.

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It’s governed by the law

This basic universal coverage of health insurance is governed by a federal law called LAMal and comprises the same benefits for all insurers, but the monthly premiums vary a lot according to insurance model and age. This law aims to ensure high-quality health care for everyone, subsidize those who cannot afford it, and control costs. The basic insurance covers medical treatment in the event of illness and accident, and you are free to choose your own insurance company.

Basic insurance does not cover all medical expenses

You are charged 10% of the costs. This can rise to 20% at the pharmacy if you choose a branded drug when a cheaper generic alternative is available. Above a certain level of annual expenses (CHF 7,000 for adults and CHF 3,500 for children), the 10% contribution does not apply. Therefore, afterward, you do not have to pay at all.

However, there are some exceptions as to who is not required to pay and for treatments that are not covered.

How Can Foreigners and Students Qualify For Health Insurance?

As we already mentioned, health insurance in Switzerland is compulsory. So, in short, if you live in Switzerland for more than three months or if you work there, you qualify for basic health insurance. This applies to foreigners if they are issued with a residence permit for three months or more. The insurance obligation applies to students too. If you are from a non-EU country and don’t have a European Health Insurance Card, you are eligible to take out Swiss insurance. However, students holding a European Health Insurance Card may be exempt from compulsory health insurance in Switzerland.

What happens if I am not covered by health insurance in Switzerland?

If you fail to purchase health insurance in Switzerland by the 90-days deadline, your local authority will sign you up for a plan, but you will probably have to pay higher premiums. Plus, anyone in the country who does not have insurance (except those who are exempted) cannot access Swiss healthcare services other than emergency treatment which will be charged to you. Plus, the insurance company is authorized to charge not only regular premiums but also a penalty fee for the delayed entry. So, we would definitely not recommend that. 

Can I use my EHIC in Switzerland?

If you are an EU citizen with a European Health Insurance Card (EHIC) and do not earn an income in Switzerland, you can be exempted from compulsory health insurance in Switzerland. Remember to apply for exemption within three months of entering the country.

If you are a non-EU/EFTA citizen with an EHIC, you may also apply for an exemption. However, we can’t guarantee the exemption will be granted.

How much does a visit to the doctor in Switzerland cost?

A 15-minute consultation with a doctor in Switzerland costs around CHF 130. But longer consultation costs can start from CHF 300 for on-site treatment. And although basic health insurance covers medical and nursing care and outpatient follow-up, you will have to pay CHF 15 a day towards these costs.

Special Packages for International Students

Some companies offer special packages for foreign students. They are designed for non-EU students but can also be purchased by EU students.

For students from EU countries

Students holding a European Health insurance Card (EHIC) or with private insurance from an EU country may be exempt from compulsory health insurance in Switzerland. As for students who are working beside their studies, this exemption is not possible since it is only approved if you do not have any income.

For students from non-EU countries

If you are from a non-EU country and do not hold a European Health Insurance Card, you will have to take out Swiss insurance. Here are the available options:

  • Scorestudies

Scorestudies offers student insurance packages for international students at affordable rates. Scorestudies includes higher benefits than the Swiss compulsory health insurance, it is very often on a full refund basis, and no co-payment of 10% is required. In case of emergency, hospitalization, or prescribed medication, you are fully reimbursed by Allianz Care.

  • Academic Care

Academic Care by Groupe Mutuel is a student insurance package for international students at very cheap rates. The cheapest is the monthly premium one for students under 26 which is CHF 90 (with an annual deductible of CHF 500), while for those over 26, it’s CHF 125 (with an annual deductible of CHF 500).

  • Swisscare

With “studentplan,” Swisscare also offers a student insurance package for foreign students at cheap rates. Monthly premiums (Standard plan) for students up to 31 is CHF 65 (with an annual deductible of CHF 1000), while for students over 32, it’s CHF 85 (with an annual deductible of CHF 1000).

  • Student Care

Student Care offered by SWICA is also an affordable student insurance package for non-Swiss students. Monthly premiums for students under 25 are CHF 91.70 (with an annual deductible of CHF 500), while there are slightly higher prices for students over 25.

Non-EU/EFTA students with private insurance from their home country

Citizens of non-EU/EFTA countries with private insurance from their home country could also apply for an exemption, but it is rare that such exemption requests are approved.

Things You Can Do to Reduce the Cost of Swiss Health Insurance

  • Pay in advance. Most companies offer a discount of typically 2% if you pay the full year upfront instead of every month.
  • Increase the deductible (the amount you’ll need to pay before insurance payments kick in). You can choose deductibles of CHF 300 and CHF 2,500 on an adult policy. If you’re sure you won’t visit your doctor that month or year, you might want to risk paying a deductible in return for a lower premium. On the other hand, if you are sure you WILL need treatment, you should pay a higher premium instead.
  • Choose a lower-cost model. There is a range of models which vary by providers who can offer different discounts you should be on the search for.

Swiss health insurance might be expensive, but its quality makes it worth every Franc.

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