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HEALTH

Should you buy supplemental health insurance in Switzerland?

Complementary insurance pays for services not included in the basic coverage. Whether or not you should purchase this policy depends on what your needs are.

Published: 5 March 2021 16:18 CET
Should you buy supplemental health insurance in Switzerland?
Supplemental health insurance may be useful in Switzerland. Photo by HANNAH MCKAY / POOL / AFP

What’s the difference between basic and supplemental insurance?

Switzerland’s compulsory basic health insurance (KVG / LaMal) covers a wide variety of treatments.

Among them are doctor’s care and hospital stay, medical tests, physiotherapy, occupational therapy, nutritional counselling, speech therapy, mental health therapy, chiropractic therapy, rehabilitation therapy, and prescribed medications.

Basically, anything your doctor orders, the insurance will pay for, with the exception of experimental drugs or treatments which have not been approved in Switzerland.

Additionally, if you get sick or have an accident abroad, KVG / LaMal  will pay the costs of emergency treatment in a foreign hospital, up to twice the amount that the same treatment would cost in your canton of residence.

There are some out-of-pocket expenses you are expected to pay. Only after your chosen deductible amount  (“franchise”) has been reached does the insurance company start to pay out.

But after the deductible is reached, you will still have to pay 10 percent of treatment and medication costs, up to 700 francs for adults and 350 for children per year.

There is also a 15-franc per day charge for hospital stays.

READ MORE: Five tips for getting cheaper health insurance in Switzerland 

What about the supplemental insurance?

This type of insurance offers certain benefits that KVG / LaMal covers only partly, or not at all. This includes complementary treatments such as:

  • Memberships or passes for gyms and swimming pools.
  • Home nursing services and domestic help
  • Glasses and contact lenses
  • Medical accessories and devices
  • Emergency transport and transfer transport as well as rescue and salvage costs
  • Cost of dental treatment, corrective dentistry and maxillofacial surgery
  • Wellness services such as massage therapy

Additionally, it may cover alternative medicine treatments and psychotherapy performed by therapists without medical training. 

The cost of the supplementary insurance may vary from one company to another and is likely to be limited to a maximum amount you can spend per calendar year.

You can take out this policy from any of the dozens of insurance carriers in Switzerland — not necessarily the one where you have your basic coverage.

And unlike the compulsory coverage, there are no deductibles for supplementary insurance.

Can anyone in Switzerland buy supplemental insurance?

Depending on your medical history and current health, it may be difficult or expensive.

While insurance companies must offer the same obligatory KVG / LaMal  coverage to everyone, regardless of health status, carriers can deny supplemental benefits to people deemed ‘at risk’.

This includes those with pre-existing medical conditions or history of repeated treatments.

So if you are relatively healthy and have no chronic illnesses necessitating frequent treatments, you will not have a problem getting supplemental coverage.

But if you have a record of illnesses, your pre-existing conditions may be excluded from coverage, or else the premium might be very high.

To see what your chances are of getting these additional perks, and how much they would cost, you can go on some insurance sites and fill out the questionnaires, such as here and here.

EXPLAINED: How to change your health insurance carrier in Switzerland and save money 

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HEALTH

How you can save money on healthcare in Switzerland

Between insurance premiums and over-priced drugs and other costs, healthcare in Switzerland comes at a steep price. Clare O'Dea looks at why the costs are so high and some of the ways you can save money.

Published: 18 December 2023 10:40 CET
How you can save money on healthcare in Switzerland

On the surface, the Swiss healthcare provision model looks egalitarian. All residents are obliged by law to purchase the same basic package of insurance, and the premiums are subsidised for those on low incomes. So why is cost such a bone of contention?

The problem is that the healthcare itself is very expensive, the second most expensive system in the world after the United States. And most of the cost is shouldered by households one way or another. This hurts those on low to middle incomes the most.

Between health insurance premiums, out-of-pocket expenses and over-priced drugs, households are spending a significant chunk of their income on health. Amazingly, Swiss residents fund 59 per cent of the national expenditure on health, according to the Federal Office for Public Health figures for 2020. The rest comes from state coffers, and, to a small extent, from employers.

To bring it down to an individual level, Swiss residents shell out 478 francs per person per month on health costs. Compulsory health insurance premiums account for 252 francs of that total on average. The rest goes on supplementary (top-up) health insurance premiums (42 francs), co-payment on policies plus out-of-pocket expenses (174 francs) and ‘other funding’ (10).

Politicians across the spectrum seem to be incapable of doing anything to curb health inflation. The latest is that health insurance premiums are set to increase by 8.7 per cent in 2024. That’s not a projection but a fact, as announced by the health minister in September.

KEY POINTS: What you need to know about Switzerland’s health insurance price hikes

Public purse

The worst thing would be to miss out on your entitlements. To find out if you qualify for premium subsidies, you’ll have to go through your home canton. Each canton has its own reduction rates and rules on eligibility. In some, there are systems in place to identify and notify eligible people but in others, you have to check and apply yourself.

This possibility is definitely worth looking into if you think you might be eligible – around a quarter of the population qualify for these payments. In some cantons, the proportion of recipients is higher. Moneyland.ch has put together a list of the contact information for premium reductions in each canton.

Take the initiative

Generally speaking, to save money on healthcare costs, the insured have to take the initiative themselves. New arrivals to Switzerland are required to take out a policy within three months, and should definitely shop around. Pricing comparison websites such as moneyland.ch , comparis.ch and Priminfo (in the national languages only) help to cut through the noise and find the best deal for your individual circumstances.

Age and location are important criteria. There are infinite tiny pricing variations between the 40+ non-profit insurers (known as “Krankenkasse”, “caisse maladie” or “cassa malati”), which means you may even find a better deal by buying policies from different insurers for different members of the family.

For those who already have a policy, it makes sense to do an annual price check up when the following year’s rates are announced in the autumn. Chopping and changing, which everyone has a right to do once a year, can really pay off.

The window for changing providers has just closed but you can be ready to notify your current provider by November 30th next year. Handily, the comparison websites also provide template letters for cancelling a policy.

READ ALSO: Which Swiss health insurance providers have the lowest rates in 2024?

Different models

Even if you decide to stay with the same insurer, you can obviously change the type of policy to a cheaper version. The so-called standard model is the most expensive. Under this arrangement, you decide which doctor you’d like to see, including specialists, and make appointments when you feel the need. 

There are other cheaper managed care models which are designed to cut down on unnecessary visits to the doctor. With these, you have to have a telemedicine consultation or visit a pharmacy before you get the green light to make an appointment with a doctor. There is another model where you have to see your general practitioner to get a referral to a specialist.

Calculations

The best way to save overall is to get clever with your deductible. That’s the share of medical expenses that you have to pay from your own pocket in the space of the year before your insurer starts reimbursing. The lower the deductible, the higher the premium.

Making the right choice involves a certain risk. But it is at least possible to make an educated guess based on past experience. There are several bands between 300 and 2,500 francs per year for deductibles (the amounts are lower for children).

If you tend not to need medical care and think your health costs are likely to be low in the coming year, it would make sense to go for the maximum deductible, which can translate into a saving up around 40 per cent on premiums. If you have reason to believe your bills will add up to 2,000 francs or more, then you’re better off going for the minimum deductible.

Don’t double up

That’s all speaking about the mandatory insurance package, which includes illness, accident and maternity care. But make sure you really need that accident insurance. Anyone who is employed for more than 8 hours per week is covered by their employer’s accident insurance, in which case it should be removed from their personal policy.

If you are looking to save money on health insurance, chances are you won’t be looking for additional insurance, also known as supplementary insurance. These policies give you more freedom over choice of hospital, and also cover therapies and treatments that are not included in the basic mandatory package. You can have both policies from the same provider or mix and match.

Though it can be irritating to hear this, especially if you already have a health condition, there is one final way that you can save on health costs – don’t get sick. What this advice really means is to lead a healthy lifestyle by taking exercise, eating a balanced diet, not consuming too much alcohol and cutting out smoking. Those are things we have control over, unlike genetics and luck.

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