In Switzerland, health insurance is an obligatory insurance for all citizens with some very minor obscure exceptions. It is often described as one of the biggest hot potatoes in the country, causers of debt and dinner table discussion topics.
So how much is it and how does it work? In this post our team takes a look.
First and foremost, health insurance is a must. If you don’t set it up by yourself, then it will be done for you and probably not at the price or provider you want. From the date you arrive in Switzerland, you have three months to set up your health insurance. And this date is usually backdated to the day that you arrive in the country.
Buyer Beware
One of the first things to be aware of, is that the cost of health insurance varies depending on your location and it can vary greatly.
- One of the first things that you will be asked is what level of excess do you want ? This means how much money are you prepared to pay for your health costs in a year before the insurance takes over the medical costs you have incurred.
- The higher your excess, the lower the premium and vice-versa. The lowest excess you can have is CHF 300.- per annum and the highest is CHF 2’500.00
- The above figure includes the charge of the medical profession and that of any treatments, prescriptions, tests and equipment. If you clear your excess then you pay 10% of costs above the excess to a maximum of CHF 700.00 per year.
- Beyond the excess having an influence on your coverage there are different models of coverage to be taken into consideration.
- These include “Telmed,” which is usually the cheapest option where you have to call a central call centre to seek initial advice for your condition. It reduces queues, pressure on doctors and an initial answer is answer is available quickly
- Another common model is HMO (Health Maintenance Organisation) where a variety of doctors and practitioners work together under the same roof sharing equipment and facilities. THE HMO clinic is a type of “gate keeper” to a specialist. Premiums are also lower in this area.
- The most commonly used model is the House doctor model who also acts as the gatekeeper to a specialist, but who will have an overview of your holistic health situation.
- The most expensive model is the model where you choose a doctor freely and make direct contact with any specialist.
When you are looking for your new health insurance, you will be asked whether you require accident insurance. Accident insurance is not required if you have a Swiss employer and work more than 8 hours per week. Your employer will then provide this insurance.
Insurance Providers operate in Swiss state languages, however a few of the larger providers may provide policies and documentation in English.
- Further choices lay in optional coverage which sit above the obligatory basic – this may include such things as alternative medicine, massage and private hospital rooms increasing the premiums further.
- The easiest place to set up basic coverage is at www.comparis.ch offering comparative costs for your area, provider and health insurance model choices. Here you can also request policies for your options. Beyond basic coverage it is worthwhile speaking to a local broker about your requirements. You can take out over obligatory insurance with a provider other than the basic insurance provider.
- Once you have received and signed your policy, you can expect to receive a health insurance card in a credit card format. Keep this in your wallet, as it tracks communications with doctors, pharmacists, other health professionals and your insurance provider.
- Choosing the “house doctor” option might mean that you have to check to see if your doctor of choice is available to take on new patients before setting things up. Comparis will also provide a list of doctors available in your area operating with choice of health insurance provider.
How does it work ?
When making an appointment to see a doctor or go to the emergency services, the reception will take your details from your health insurance card. The services provided will then be sent to your health insurance. You will receive a copy. The health insurance will start your “account” and then send you an overview of where it is financially in relation to your “excess”. If you have not reached the excess, you will receive an invoice from the insurance provider for the services you have used.
- If you have exceeded your excess and the health insurance is paying the invoice for the services, then you will receive a copy. Local ambulances and helicopters may have separate local arrangements and agreements with your health insurance, which sit outside of this agreement.
- If you receive a prescription to take to a pharmacy, the pharmacist will scan your health card automatically sending the bill to your insurance provider. These will react in the same way to your services invoice as from a doctor.
- Without your card, you may have to pay cash for the product on site and then send the receipt to the insurer personally. At the end of the year, the excess resets to “0” even if ongoing treatment for a condition is taking place.
- Your insurer will send you an update of the policy for the next year and its cost around October. If you perceive the cost to you high then you may find a new provider for the next year and give notice to the existing provider. This option may be restricted if you have a health condition.
There are a couple of lesser known financial benefits linked to health insurance. You may be able to obtain a subsidy against your insurance if you have a lower income. For lower income read about CHF 60’000.00 per annum for a family. Speak to your local communal office if you think you might qualify.
On the other side, if you have spent a lot on health during the year you may be able to set costs against tax. The rules for this vary from location to location and would be part of your tax return. If you wouldn’t usually do a tax return because of source tax but think you have had high health costs it may be worth requesting to do one for this reason.
Health Insurance can seem expensive particularly to people coming from abroad (unless perhaps USA), but this is using basis of solidarity where age does not have an impact on cost for adults. Overall waiting times are short and treatment thorough including health education, rehabilitation and prevention of risk of later emergencies.
Health insurance in Switzerland is complex and expensive! It pays to understand the rules and also to compare. Our team can support your enquiries for health insurance when you work with us.
Swissroll GmbH was founded over 20 years ago. During this time our team of experts has worked with hundreds of companies and literally thousands of contractors. Beyond our core function of payroll management, we offer advice to contractors coming to work in Switzerland for the first time. This includes advice on health insurance in Switzerland. Swissroll: “More than just payroll specialists”
Contact us now on: enquiries@swissroll.ch
