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HEALTH INSURANCE

Do foreign students in Switzerland need to get a Swiss health insurance policy?

With the academic year starting at Switzerland's universities in September, many students from abroad may not know what the rules are about Swiss health insurance.

Published: 6 September 2022 16:56 CEST
Do foreign students in Switzerland need to get a Swiss health insurance policy?
Depending on where they come from, foreign students might have to buy healthcare insurance. Photo: Pixabay

Once you have been accepted to a Swiss university, having already had to obtain and provide a myriad of various documents, there is still one important step: health insurance.

Everyone in Switzerland is required to have a basic healthcare coverage (KVG / LaMal) — whether you are a permanent resident or a foreign student. The difference is whether you have to take out a Swiss policy or can continue to use the one you have from your own country.

According to the Federal Office of Public Health (FOPH), “students from an EU/EFTA country are not required to take out Swiss health insurance, provided that they are not working and remain insured under the social security system of their country of residence. They are entitled to receive medical treatment in Switzerland upon presentation of the European Health Insurance Card (EHIC)”. 

Students from EU / EFTA who have private insurance can apply for exemption if their cover is equivalent to that offered by EHIC.

However, if you are from outside Europe, that is from a third nation like the UK or the United States, you have two options, according to FOPH: if you a have private insurance offering coverage equivalent to that of a Swiss health insurer, you can be exempted from buying a policy here for three years; this period can then be extended for another three years if your own insurance is still in place. Afterwards, and provided you are still in Switzerland, you will have to purchase a Swiss insurance.

READ MORE: EXPLAINED: How can foreigners get into a Swiss university?

How do you go about purchasing a Swiss health insurance?

Like any new arrival in Switzerland — student or a ‘regular’ foreigner’ — you must take out insurance within three months of your arrival.

If you think you don’t have to do this as you never get sick or visit a doctor, then you are wrong — everyone in Switzerland must be insured.

And if you believe that you can stay under the radar and authorities won’t even know you have no policy, then this too is wrong.

The Swiss are very well organised when it comes to administrative matters, and sooner or later (probably sooner) they will find you and send you a gentle reminder of your duty to be insured. If you still refuse to comply, they will buy a policy for you and (not so gently) send you a bill.

As a foreign student and basically a guest in Switzerland, you don’t want that to happen. This is true not only from the legal point of view, but the medical one as well: if you get ill, you will receive only emergency treatment but will not be eligible for follow-up treatments without an insurance.

Which company should you choose?

There are dozens of carriers in Switzerland, providing more or less the same basic coverage (they are not allowed to compete on obligatory insurance rates; only on supplemental policies).

A recent report by RTS public broadcaster also mentioned that some smaller carriers like Advisor, Evasane, Scorestudies, Swica and Swisscare, offer cheaper than standard premiums, which could be attractive to foreign students.  

However, before you purchase one of these plans consider that while their rates may be lower, varying between 60 and 140 francs per month (as opposed to between 250 and 400, depending on your age, canton, and co-pay deductible), they also have stricter reimbursement conditions, RTS reported.

This means that you may have to pay more out of pocket for medications and other costs than under more mainstream policies.

There are, however, ways to purchase a cheaper insurance. They are outlined here:

How to save money by changing your Swiss health policy

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For members

HEALTH INSURANCE

It’s not over: What happens now after Swiss reject health insurance changes?

On Sunday, Swiss voters rejected two initiatives to curb the price of obligatory health insurance premiums. But this doesn't mean nothing will change.

Published: 10 June 2024 15:18 CEST
It's not over: What happens now after Swiss reject health insurance changes?

Though early surveys indicated that the initiative spearheaded by the Social Democratic Party, seeking to cap insurance rates at 10 percent of income, would be overwhelmingly accepted, on Sunday 55.5 percent of voters turned it down.

Among the main reasons for the rejection was that implementing this measure (which already exists in Switzerland in the form of subsidies for low-income families) would cost several billion francs a year, further increasing the already very high healthcare costs.

While Social Democrats said the referendum results “are disappointing,” according to business association Economiesuisse,“the Swiss understood that the ‘10-percent initiative’ was misleading.” 

With the ‘no’ vote, “billions of francs in additional costs will be avoided,” the group added.

Another commentator pointed out that “the left is launching initiatives without ever saying how we are going to finance it all.” 

The second health insurance initiative voted on Sunday, that sought to provide a ‘brake’ on health costs, was turned down by 62.7 percent of voters. 

READ ALSO: Support for proposals to curb Swiss health insurance costs wanes 

What will happen to health insurance premiums now?

The Federal Council and the parliament have urged the ‘no’ vote to both, creating counter-proposals to each of the two initiatives — that is, their own bills in response to the concerns raised in the initiatives.

Counter-proposals, which are usually more moderate and more ‘implementable’ than original initiatives — come into force automatically if the initiative is rejected.

Under the counter-proposal to the ’10 percent’ initiative, cantons will have to earmark between 3.5 and 7.5 percent of their budgets for premium reductions of the costs of compulsory health insurance on their territories, while the federal government will continue to contribute 7.5 percent.

While this implies that hundreds of millions of francs of public money will be spent to alleviate the ‘premium burden’ of low-income households, it will still be less than about 6 billion that the original initiative required.

What about the ‘cost brake’ initiative?

In this case, the counter-proposal provides for the government to set a limit every four years on the increase in the costs of compulsory health insurance.

The Federal Council as well as the cantons will consider not only wage growth (as the original initiative sought to do), but also the aging population and other demographic trends, medical progress, as well as  other factors that play a role in health insurance premiums.

Additionally, the Federal Council wants to set up a commission for monitoring costs and quality of health insurance.

And there is more

The left-wing parties have already said they would continue to force  referendums aiming to cut the cost of health insurance.

The Greens are now focusing on basing insurance premiums on income.

As for Social Democrats, the party said it will now “work on launching an initiative for public health insurance.”

Neither of these ideas are new.

The implementation of income-based premiums, while supported by various parties, doesn’t seem likely.

The current system is widely thought to be “fair and balanced”, according to Lukas Engelberger, president of Cantonal Health Directors Association.

That’s because the system in place is based on solidarity  — the idea that all insured people form a group.

It can be thought of in terms of a huge pot to which each resident of Switzerland makes a contribution (that is, premium payments), so that in an emergency there are enough resources available to give someone the help they need when they need it.

If the present approach were to change, however, and become income-based, it would be difficult to maintain the solidarity component which, according to officials, has proven its worth.

READ ALSO:  How the Swiss health insurance system is based on solidarity 

In terms of one state-run health insurance scheme, as is the case elsewhere in Europe, Social Democrats have been calling for scrapping of multiple private carriers in favour of the government running the scheme for a while.

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.

In a 2014 referendum on this subject, 62 percent of voters said ‘no’ to the plan,  with those opposing arguing that a private insurance system offers more choices  and provides a higher quality of services —including better access to specialists and shorter wait times for medical procedures —  than a public option.

They also pointed out that higher premiums are inevitable given an ageing population and higher life expectancy, and shifting to a public system would generate few savings.

However, attitudes may have changed in the last 10 years.

A survey conducted by the Basel Center for Health Economics (BCHE) in January 2024, showed that 68 percent of Switzerland’s population would like the current system to be replaced by a single health insurer.

READ ALSO: Could Switzerland ever change to state-run health insurance scheme? 

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