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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

How Switzerland’s two crucial health insurance referendums could impact you

The price of Swiss health insurance premiums has been rising significantly in the past few years, prompting political parties to launch two cost-cutting initiatives. The votes will take place in June and there's a lot at stake.

Published: 24 April 2024 15:33 CEST
Updated: 28 April 2024 08:44 CEST
How Switzerland's two crucial health insurance referendums could impact you

On June 9th, the Swiss will cast their votes on two issues aiming, though in different ways, to curb the continually increasing cost of the obligatory health insurance (KVG / LaMal).

This is what’s at stake.

The ’10-percent’ initiative

In view of the high (and rising) premiums and other costs of living, which eat up a big chunk of the budgets of low- and middle-income consumers, the Social Democratic Party has spearheaded a national vote to cap the insurance rates at 10 percent of income.

Anything over this limit should be paid for by the federal and cantonal government, the party says.

While this strategy may sound enticing to everyone tired of paying high premiums, the government warns that while this proposal looks good on paper, the ‘yes’ vote could unleash some serious consequences.

Its main argument is that this measure would cost several billion francs per year, and does not provide any incentives to control health costs.

Instead, the Federal Council and the parliament have concocted their own ‘counter initiative’ that they want voters to approve.

Under this proposal, cantons will have to increase the amount of financial help they pay toward health premiums for low-income people. 

READ ALSO: How do I apply for health insurance benefits in Switzerland?

‘For Lower Premiums’ initiative

For its part, the Centre party has come up with its own proposal to reduce health insurance costs, which will also be voted on June 9th.

It provides for a ‘brake’ on health costs, which should evolve according to the economy and wages.

This brake would work in the same way as the federal spending brake. Therefore, when healthcare costs exceed wages for a given year by 20 percent, the government must take action to bring the  costs down.

The government is asking voters to turn down the Centre’s proposal because it doesn’t take into account factors such as demography, technological progress in healthcare, as well as the dependence of salaries on economic developments.

Here too, the Federal Council and parliament have put out their own counter-project, providing for more targeted measures, including specific cost control objectives for healthcare services.

Are there any other proposals on the table aiming to curb the cost of insurance premiums?

Yes.

While they are not on the ballot, two ideas have been debated in past months.

One calls for scrapping multiple private carriers  in favour of a government-run single health insurance scheme, similar to that in the EU. 

The other idea floating around is to replace the current system where rates are determined by factors such as age and canton of residence, and base them on wages instead. 

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