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HEALTH INSURANCE

How do I apply for health insurance benefits in Switzerland?

The cost of Swiss health insurance constantly on the rise, many households are hard pressed to pay for the monthly premiums. But some may be able to get financial aid.

How do I apply for health insurance benefits in Switzerland?
You can apply for healthcare subsidy online. Photo by Daria Nepriakhina on Unsplash

Switzerland has an excellent healthcare system, but it certainly doesn’t come cheap.

Its cost has risen over the past 20 years at twice the rate of economic growth, resulting in health insurance premiums that are 90 percent higher today than in 2002.

While premiums will go up throughout Switzerland, residents of some cantons have to pay more for healthcare than their counterparts in others.

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

As stated in the Swiss Federal Health Insurance Act of 1994, which made the basic health coverage ((KVG / LaMal) compulsory for every resident, the cost of insurance should not exceed 8 percent of a family or individual income.

What are health subsidies and who is eligible to receive them?

Subsidies are basically reductions in healthcare premiums.

If these premiums eat up at least the aforementioned 8 percent of your income, you qualify for this aid. Before deciding whether you receive the assistance, however, your canton of residence will look not only at your earnings, but at any other financial assets you hold as well as .

So if your income is low but you have plenty of money in the bank in the form of savings or other investments, you will not qualify.

Generally speaking, anyone who is a low earner or has a large number of children, could be eligible for subsidised premiums, though criteria, as well as amounts, may vary from one canton to another.

Note, however, that state subsidies apply only to the obligatory KVG / LaMal insurance, not to any supplemental polices you buy.

How to apply for these benefits?

This process depends on the canton where you live; in all cases, however, it is based on your most current tax declaration, which allows the authorities to see not only how much you earn and how many children you have, but also your total assets.

Some cantons will notify those who are eligible automatically when you file your tax return. In others, you must apply for the reduction yourself every year.

This is a list of all the cantonal authorities responsible for subsidies.

What documents must you provide?

When applying, send in the following:

  • Your last tax decision
  • Your Swiss identity card or your residence permit, as well as those of other members of your family
  • Health insurance policy for you and other members of the household

Some cantons may require other documents as well so inform yourself ahead of time.

If your request for a subsidy is approved, your will not receive any money yourself. Rather, the canton will pay directly to your health insurance carrier.

READ MORE: How people in Switzerland can save money on healthcare

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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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