On the surface, the Swiss healthcare provision model looks egalitarian. All residents are obliged by law to purchase the same basic package of insurance, and the premiums are subsidised for those on low incomes. So why is cost such a bone of contention?

The problem is that the healthcare itself is very expensive, the second most expensive system in the world after the United States. And most of the cost is shouldered by households one way or another. This hurts those on low to middle incomes the most.

Between health insurance premiums, out-of-pocket expenses and over-priced drugs, households are spending a significant chunk of their income on health. Amazingly, Swiss residents fund 59 per cent of the national expenditure on health, according to the Federal Office for Public Health figures for 2020. The rest comes from state coffers, and, to a small extent, from employers.

To bring it down to an individual level, Swiss residents shell out 478 francs per person per month on health costs. Compulsory health insurance premiums account for 252 francs of that total on average. The rest goes on supplementary (top-up) health insurance premiums (42 francs), co-payment on policies plus out-of-pocket expenses (174 francs) and ‘other funding’ (10).

Politicians across the spectrum seem to be incapable of doing anything to curb health inflation. The latest is that health insurance premiums are set to increase by 8.7 per cent in 2024. That’s not a projection but a fact, as announced by the health minister in September.

KEY POINTS: What you need to know about Switzerland’s health insurance price hikes

Public purse

The worst thing would be to miss out on your entitlements. To find out if you qualify for premium subsidies, you’ll have to go through your home canton. Each canton has its own reduction rates and rules on eligibility. In some, there are systems in place to identify and notify eligible people but in others, you have to check and apply yourself.

This possibility is definitely worth looking into if you think you might be eligible – around a quarter of the population qualify for these payments. In some cantons, the proportion of recipients is higher. Moneyland.ch has put together a list of the contact information for premium reductions in each canton.

Take the initiative

Generally speaking, to save money on healthcare costs, the insured have to take the initiative themselves. New arrivals to Switzerland are required to take out a policy within three months, and should definitely shop around. Pricing comparison websites such as moneyland.ch , comparis.ch and Priminfo (in the national languages only) help to cut through the noise and find the best deal for your individual circumstances.

Age and location are important criteria. There are infinite tiny pricing variations between the 40+ non-profit insurers (known as “Krankenkasse”, “caisse maladie” or “cassa malati”), which means you may even find a better deal by buying policies from different insurers for different members of the family.

For those who already have a policy, it makes sense to do an annual price check up when the following year’s rates are announced in the autumn. Chopping and changing, which everyone has a right to do once a year, can really pay off.

The window for changing providers has just closed but you can be ready to notify your current provider by November 30th next year. Handily, the comparison websites also provide template letters for cancelling a policy.

READ ALSO: Which Swiss health insurance providers have the lowest rates in 2024?

Different models

Even if you decide to stay with the same insurer, you can obviously change the type of policy to a cheaper version. The so-called standard model is the most expensive. Under this arrangement, you decide which doctor you’d like to see, including specialists, and make appointments when you feel the need. 

There are other cheaper managed care models which are designed to cut down on unnecessary visits to the doctor. With these, you have to have a telemedicine consultation or visit a pharmacy before you get the green light to make an appointment with a doctor. There is another model where you have to see your general practitioner to get a referral to a specialist.

Calculations

The best way to save overall is to get clever with your deductible. That’s the share of medical expenses that you have to pay from your own pocket in the space of the year before your insurer starts reimbursing. The lower the deductible, the higher the premium.

Making the right choice involves a certain risk. But it is at least possible to make an educated guess based on past experience. There are several bands between 300 and 2,500 francs per year for deductibles (the amounts are lower for children).

If you tend not to need medical care and think your health costs are likely to be low in the coming year, it would make sense to go for the maximum deductible, which can translate into a saving up around 40 per cent on premiums. If you have reason to believe your bills will add up to 2,000 francs or more, then you’re better off going for the minimum deductible.

Don’t double up

That’s all speaking about the mandatory insurance package, which includes illness, accident and maternity care. But make sure you really need that accident insurance. Anyone who is employed for more than 8 hours per week is covered by their employer’s accident insurance, in which case it should be removed from their personal policy.

If you are looking to save money on health insurance, chances are you won’t be looking for additional insurance, also known as supplementary insurance. These policies give you more freedom over choice of hospital, and also cover therapies and treatments that are not included in the basic mandatory package. You can have both policies from the same provider or mix and match.

Though it can be irritating to hear this, especially if you already have a health condition, there is one final way that you can save on health costs – don’t get sick. What this advice really means is to lead a healthy lifestyle by taking exercise, eating a balanced diet, not consuming too much alcohol and cutting out smoking. Those are things we have control over, unlike genetics and luck.