For members


Reader question: Do I have to pay for prescription drugs in Switzerland?

Generally speaking, medications prescribed by a doctor are covered by healthcare insurance. But this doesn’t mean you won’t have to pay any costs at all.

Reader question: Do I have to pay for prescription drugs in Switzerland?
How much you will have to pay for drugs will depend on various factors. Photo: Pixabay

As is the case everywhere else, there are two types of medicines in Switzerland: those you buy without a prescription (over-the-counter — OTC) and those who are by doctor’s orders only.

As a general rule, compulsory health insurance (KVG in German and LaMal in French and Italian) reimburses medicines prescribed by a doctor, as long as they are included on the list of drugs officially approved by Switzerland’s regulatory body, Swissmedic — in total, about 2,500 medications.

The list is quite extensive, comprising not only brand-name and generic meds but also many biosimilars — medicines that are almost an identical copy of an original product manufactured by a different company.

Also covered are some alternative-medicine drugs, including homeopathy and physiotherapy. 

What happens when a doctor prescribes a drug that is not authorised in Switzerland?

In principle, the compulsory health insurance will not cover the costs and you will have to pay for it yourself.

However, there are exceptions to this rule.

For instance, even if a particular medication is not approved in Switzerland, but is imported from a country where it is authorised by a body that is considered equivalent to Swissmedic (for example, the European Medicines Agency), then KVG / LaMal will pay for it.

Also, if the cost of a drug is not covered by the compulsory health insurance, and you have taken out a complementary policy, it is possible the latter will pay for it.

These insurance providers have their own lists of medicines which they cover, though certain conditions and limitations may apply.

In general, neither basic nor supplementary insurance will pay for so-called  Pharmaceuticals for Special Application (LPPA). This list mainly includes “comfort” products, for example appetite suppressants or products that reduce hair loss.

READ ALSO: Should you buy supplemental health insurance in Switzerland?

How much of the cost does insurance pay?

As is the case for medical treatments in general, KVG / LaMal will pay 90 percent of the cost of medication for which no generics exist.

If, however, an equivalent generic drug is available, but you still choose the brand medicine, then your insurance carrier will cover 80 percent of the price. This means that you will have to pay either 10 or 20 percent of the cost yourself.

This will happen until you use up our entire deductible (franchise), in addition to your 10-percent share of the costs that exceed the deductible — a maximum of 700 francs per year for adults and 350 francs for children.

If you have a low deductible (300 francs), this means that once you use up 1,000 francs toward your medical costs (doctor’s visits, treatments, and medicines combined), you will then not have to pay anything toward your prescription drugs.

By the same token, if you have chosen the highest franchise — 2,500 francs — and add to it the 700-franc co-pay, you may never get to the point where all your medications will be completely covered by the insurance.

READ ALSO: Which Swiss health insurance deductible makes most sense?

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For members


Reader question: Can I use my EU health insurance instead of buying Swiss cover?

Given the high cost of the obligatory health insurance in Switzerland, you may be tempted to avoid purchasing one. Are you allowed to use insurance from another country instead?

Reader question: Can I use my EU health insurance instead of buying Swiss cover?

The announcement on Tuesday September 26th that health insurance premiums in Switzerland will go up by 8.7 percent on average in 2024 has upset many people, as such a significant hike is likely to strain their budgets. 

If you come from an EU or EFTA state, you may be wondering whether your health insurance from your home country can be used instead of the Swiss one.

The answer depends on your status in Switzerland.

If you are just a visitor who is staying in the country for up to 90 days, you are not required to take out Swiss insurance. Your European Health Insurance Card (EHIC) will cover you, free of charge, for medical emergencies (just as a Swiss tourist would be within the European Union / EFTA).

But if you are a permanent resident with a B, C, or L permit, you can’t rely on your EHIC to get you medical care in Switzerland.

Swiss law clearly states that “anyone settling in Switzerland must obtain insurance within three months after taking up residence.”

How do Swiss authorities know you are a resident and not a tourist?

If you comply with the law (as you should), you must register with your commune of residence within 14 days of your arrival. When you do so, you will no longer be able to remain under the radar, especially in a well-organised country like Switzerland.

Once you register, you will receive a letter from your canton saying that you must take out a Swiss health insurance policy within 90 days, and send them proof that you have done so.

Not complying with this rule will affect you in many ways, none of them good.

Firstly, the canton will keep sending you several letters reminding you of your obligation to buy insurance. If you still abstain from doing so, authorities will purchase a policy on your behalf and send you a bill.

If you still refuse to pay it, then legal proceedings will be filed against you. You will be ‘harassed’ by the debt enforcement office in your municipality and eventually taken to court.

There are other consequences as well.

Without proof of (Swiss) health insurance you will not be able to get a job or rent an apartment, and showing your EHIC instead will get you nowhere.

And, you will not be entitled to medical help without a proper insurance coverage, and will be treated only in case of emergencies.

All this to say that any attempts to beat the system will turn against you.

READ ALSO: What happens if I don’t buy Swiss health insurance?

However, there are some situations (aside from being a tourist) when you can be legally exempted from purchasing a Swiss health policy.

For instance, you are not required to take out insurance if:

  • You are retired and get a pension exclusively in an EU or EFTA state
  • You are a cross-border worker with healthcare policy in a EU or EFTA state
  • You are a foreign student and have comparable insurance from your country
  • You work for international organisations or are a diplomat