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HEALTH INSURANCE

Why Swiss health premiums are set to rise — and what you can do about it

Health insurance is a constant topic of discussion— and worry — in Switzerland. Unfortunately, premiums look set to rise significantly in 2023.

Why Swiss health premiums are set to rise — and what you can do about it
Health insurance is mandatory for everyone living in Austria, which covers check-ups and treatments. Photo by Pixabay

Premiums for compulsory health insurance will rise by an average of 5 percent in the fall, according to online price comparison site, Comparis.ch.

And many people could even see their premiums soar by more than 10 percent in 2023 — the sharpest hike in premiums in 20 years.

One of the reasons for the drastic increase of the already expensive premiums are lower cash reserves held by insurance carriers. 

Here’s what you need to know. 

READ MORE: ‘Worrying’: Swiss health insurers warn of significant price increases

What is a reserve and why is it important?

A ‘reserve’ is a sum of money that insurers are obligated to set aside to fulfil the policyholders’ claims. This is strictly regulated by the Federal Office of Public Health (FOPH).

According to Comparis, in 2021, “the reserves held by health insurers amounted to 12.4 billion francs, with the annual premium volume totalling some 34 billion francs”.

However, in the summer of that year, the Federal Council introduced a range of measures to actively encourage insurers to reduce their reserves, resulting in the announced hike in premiums.

“This happens because, once the reserves are used up after they have been reduced, premiums must be raised in order to compensate for increased costs during the period of reserve reduction. In other words, if reserves are reduced too quickly, premiums could rise sharply again”, Comparis explains.

However, the need for such a premium hike could have been avoided had there not been political intervention in the management of the reserves, Comparis said.

The government “has forced the health insurance companies to reduce their reserves. This is why many of them now lack the necessary financial cushion to absorb current cost fluctuations”, according to Felix Schneuwly, Comparis’ health insurance expert.

“Last year the Federal Council increased the pressure on insurers to draw on their reserves, even though an exceptional increase in costs was looming”, he added. “As a result, many funds have reduced their reserves excessively by setting premiums well below costs”.

The “exceptional increase” that Schneuwly referred to was the reason why health care costs skyrocketed in the first place: a significant rise in medical costs incurred during the two years of coronavirus pandemic, estimated to cost insurers one billion francs so far, not even taking into account about 265 million spent for Covid vaccinations in 2021.

On the whole, Santésuisse,  an umbrella organisation for health insurance companies, estimated that the pandemic cost Swiss insurers 1 billion francs so far. 

Drug prices are also an issue in Switzerland, where patients often pay much more than their counterparts in neighbouring European countries.

READ MORE: EXPLAINED: Why Swiss healthcare costs are rising and how you can save

When will you be notified of your premiums for 2023?

By law, you must receive a letter from your insurance company, notifying you of the premium for the following year, no later than October 31st.

If you then decide to cancel your current plan and switch to a cheaper one, you must notify your carrier, by registered post, by November 30th at the latest.

What cheaper insurance policies are there?

There are a number of ‘low-cost’ options for basic insurance, including the HMO, Telmed and bonus insurance programs.

With the HMO (Health Maintenance Organisation) model, you are not free to choose your doctor or hospital. Instead, your first point of contact will be with a doctor from an HMO, or group practice, who will coordinate your treatment. In exchange, you get a cheaper premium.

You can also take out a Telmed policy, where (in most cases) you receive medical advice in a first consultation over the phone before a referral to a doctor or hospital.

Some providers also offer a bonus insurance program where you start with a higher premium which then drops for every year that you do not submit an invoice to your provider.

This link provides more information about how you can save on health insurance premiums:

Five tips for getting cheaper health insurance in Switzerland

Good news, if there is any to be had, is that supplemental health insurance is not set to increase.

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HEALTH INSURANCE

Could glasses and contact lenses soon be covered by Swiss health insurance?

The Swiss health system is ranked among the best in the world, but some essentials, like glasses, aren't automatically covered by health insurance. That could soon change, however

Could glasses and contact lenses soon be covered by Swiss health insurance?

Green Party Federal Councillor Katharina Prelicz-Huber revealed in an interview with newspaper 20 Minuten this week that the Federal Parliament had tabled a motion to include prescription glasses and contact lenses in Switzerland’s mandatory health insurance scheme. 

Prelicz-Huber stated: “The purpose of compulsory health insurance is to provide the services you need to get or stay healthy,”

The motion forms part of the legislation that will be voted on during the 2024 summer session of the Federal Council. 

Proposed changes 

According to Switzerland’s peak optician body, 4 in 5 Swiss wear glasses or contact lenses at some point. 

It’s no surprise that statistics repository, Statista, projects the Swiss eyewear industry to be worth €1.37 billion by 2028. 

Currently, glasses and contact lenses are covered for up to 180 francs for children until age eighteen, if they are proscribed by a doctor.

Adults can also claim money back for glasses and contact lenses – however, they must be suffering from one of a short list of specific conditions such as keratoconus – where the cornea is distorted – or severe myopia, otherwise known as near-sightedness.

They must also have been specifically prescribed them by a doctor or optometrist. 

Otherwise, supplemental optical insurance must be purchased in Switzerland to ensure you can recoup the cost. 

Under the Green Party proposal, glasses, contact lenses, and other visual aids would be covered, regardless of age. 

Rising premiums prompt opposition 

Not everybody agrees with the proposal. 

The right-wing SVP has already spoken out against it, with Federal Councillor Diana Gutjahr arguing: “If we seriously want to slow down the burdensome and constantly rising health costs for the benefit of the population, we [must] show the political will not to constantly expand the benefits of compulsory health insurance.”

A spokesman for the the health insurance advocacy group Santesuisse, Matthias Müller, echoed Gutjahr, claiming that insurance constitutes “financing for extraordinary events such as illness.”

“If almost everyone benefits from a certain service, it is no longer an insurance benefit.”

A date for the vote has yet to be announced. 

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