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HEALTH INSURANCE

Is the high cost of Swiss private health insurance worth it?

When it comes to hospitalisations, Switzerland has different levels of health insurance, which range from basic to premium, the latter being the private coverage. What is it and do you need it?

Published: 17 February 2023 15:54 CET
Is the high cost of Swiss private health insurance worth it?
You'll get a a room like this (and other perks too) if you splurge on private health insurance.Photo by Martha Dominguez de Gouveia on

The best way to describe these levels is to compare them to hotels: the basic insurance is a two or three-star hotel — it has everything you need but without any extras.

Private insurance, on the other hand, entitles you to a five-star accommodation.

Another way to look at it is this: basic insurance is like flying Economy: you get a seat and you get to your destination just fine, but your comfort level may be lacking. In First-Class however, you want for nothing.

The difference between the various options outlined here is the price. It’s not so much what you prefer, but what you can afford.

The basic insurance

Basic insurance — KVG in German and LaMal in French and Italian —  is compulsory in Switzerland.  It is quite comprehensive and includes coverage for illness, medications, tests, maternity, physical therapy, preventive care, and many other treatments.

It also covers accidents for those who do not have accident insurance through their workplace.

Basically, whatever the doctor orders is covered by KVG / LaMal, at least partially.

It also gives you the right to choose your doctor and see a specialist without a referral, unless you took out one of the cheaper and more restrictive versions of the plan.

Overall, however, you will be given a high level of care.

The only difference between this and plans mentioned below is that if you need to be hospitalised, you will likely be put in a room with several other patients.

READ MORE: What isn’t covered by Switzerland’s compulsory health insurance?

Complementary insurance

In addition to KVG / LaMal, some people also buy a complementary insurance, which offers them additional benefits that the basic plan doesn’t cover.

This includes all types of alternative treatments like acupuncture, massage, foot reflexology, osteopathy, Chinese medicine, and other treatments.

This type of insurance may also cover (though party) your dental costs, gym memberships and other perks, all of which are described in this article:

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

It could also include a semi-private room in a hospital (depending on the kind of supplemental policy you purchase ), and the possibility to buy an upgrade to a private room.

Private insurance

This type of coverage, on top of the basic and supplemental one, is the very best you can have: the five-star hotel / First Class on the plane analogy mentioned above.

While with the basic insurance you can only be treated in public hospitals (that shouldn’t worry you though; they are very good in Switzerland), a private plan entitles you to be treated in a private clinic, where you will be put up in a private room and receive many other additional perks as well, such as choice of gourmet meals, slippers and bathrobe, and general pampering that you will most likely not get in a general ward of a public hospital.

Even more importantly, you can choose a clinic located outside your canton (which is not possible with KVG / LaMal, except for emergencies), and choose the doctor to treat you.

Given these choices, why would you not choose a private plan on top of your basic one?

In one word, cost.

As you know, premiums for the basic insurance are high, and especially so this year, when they rose by 6.6 percent on average and even more in some cantons.

READ MORE: EXPLAINED: Why do Swiss healthcare premiums vary so much per canton?

This means that on average, and depending on your age, residence, and the deductible you chose, you probably pay between 300 and 500 francs a month for your KVG / LaMal.

Paying for private coverage on top of that will add another 500 francs at least to your monthly premium, and that is something that many people just can’t afford.

Whether or not this is feasible (and desirable) for you depends on whether you are happy flying Economy or absolutely want to sit in First Class.

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For members

HEALTH INSURANCE

ANALYSIS: Do the Swiss really want ‘cheaper’ health insurance?

Calls for less expensive heath insurance premiums have been increasing in Switzerland in recent months. But do the people really want that?

Published: 29 September 2023 12:19 CEST
ANALYSIS: Do the Swiss really want 'cheaper' health insurance?

The rising cost of Switzerland’s obligatory health insurance has been fueling much debate among the politicians and public alike.

Various measures to cut the rampant costs have been proposed, ranging  from tying premiums to income and abolishing the current private system in favour of a public, government-run one similar to the schemes in place across Europe.

The reason for this radical change is that “with a single player, it will be easier to maintain decent prices,” according to MP Baptiste Hurni, who is behind this proposal.

READ ALSO : Would people in Switzerland benefit from a government healthcare scheme?

In the wake of the announcement earlier this week that rates will rise by 8.7 percent on average, calls for the public option — and cheaper health insurance — have been increasing.

Everyone agrees that cost-curbing reform of the healthcare scheme is urgently needed, but do the Swiss really want to scrap the private system and replace it with a ‘cheaper’ government-run one, or is it just a reflex reaction to bad news?

Competition and free choice

The idea of the government managing the healthcare system is not exactly new in Switzerland; it had been brought up in the past when insurance rates had gone up.

Two referendums were held on this issue in the past 16 years, and both times the idea of a public health insurance scheme was turned down: by 71 percent in 2007 and by 61.5 percent of the votes in 2014.

Both times, the decisions were based on practical and rational, rather than purely emotional, considerations.

As Swiss media explained it at the time, voters “noted the negative consequences of a public fund, citing in particular the absence of competition, the loss of free choice, and a certain unease with increased state intervention in the health sector.”

Additionally, “voters were not convinced that the new system would have been able to reduce health insurance premiums” — the argument that is still being raised today. 

Another argument that swayed the voters away from the government scheme is that the private insurance system provides a higher quality of services —including better access to specialists and shorter wait times for medical procedures than in countries with the public system.

According to a survey by the Organisation  for Economic Cooperation and Development  (OECD) on how long patients in various countries typically wait for an appointment with a specialist, the share of people in Switzerland waiting a month or more is 23 percent, compared to 36 percent in France, 52 percent in Sweden, and 61 percent in Norway.

OECD statistics also show that Switzerland has among the shortest waits for medical tests and procedures.

And there is more.

The Swiss are actually very happy with their private system.

A survey conducted in 11 countries by the US-based Commonwealth Fund Foundation showed that 88 percent of respondents rate the overall performance of Switzerland’s health system as ‘good’ or ‘very good’, putting Switzerland in the first place.

It is therefore doubtful that the Swiss, who are accustomed to (you may even say ‘spoiled’ by) the current system of healthcare, will be happy to switch to a lesser one.

As a forum commentator in one of the local newspapers pointed out “you will find faults in our system until you go abroad and see how good we really have it.”

And an important point was made by another forum user: “We all want high-quality health care and all the latest technology, but we should realise  this costs money and doesn’t come cheaply.”

No revolutions, please

Referring to the idea of replacing the present system with the public one, Health Minister Alain Berset said during a press conference this week that Switzerland has a “very good health system” and doesn’t need a radical overhaul.

“With the exception of 1848 [a year of political reform in Switzerland], I have never been a supporter of revolutions,” he added. “There is no need for one now.”

So what is the solution to soaring costs?

Instead of drastic changes, Berset said the current system, which has proven its worth since it was first introduced in the mid-1990s, should undergo cost-cutting measures.

Among the steps being debated are lower drug costs, more use of generic medication (which is less expensive than brand-name drugs), better transparency of costs billed by hospital and doctors; as well as fewer procedures for which there is no strict medical need.

READ ALSO: How Switzerland wants to cut soaring healthcare costs

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