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HEALTH INSURANCE

Is Swiss health insurance cheaper or even free for pensioners?

In the United States, people over the age of 65 are entitled to government-sponsored Medicare insurance which covers their health costs. Does a similar system exist in Switzerland as well, or must seniors continue to pay for health insurance themselves?

Is Swiss health insurance cheaper or even free for pensioners?
Swiss health insurance rates are not determined by age. Photo by Mockup Graphics on Unsplash

Swiss and American healthcare systems are (literally and figuratively) worlds apart, and not just in terms of insurance costs.

READ ALSO: How does the Swiss healthcare system compare with the US?

The same is also true about the financing of EU health schemes versus Switzerland’s.

One major difference is that, in contrast to its European neighbours, Switzerland’s system is not tax-based or financed by employers, but rather by individuals themselves.

And that principle applies to people of all ages, including pensioners, who must continue to pay for their own health insurance after retirement.

READ ALSO: How is Swiss healthcare system different from the rest of Europe?

So the answer to the question of whether retirees in Switzerland are entitled to free healthcare is ‘no.’

Why is this?

As stated above, Switzerland’s system is different than practically anywhere else.

That’s because under the Swiss Federal Health Insurance Act of 1994, which went into effect in 1996 after being approved by Swiss citizens in a referendum, basic health insurance — KVG in German and LaMal in French and Italian — is compulsory for everyone in Switzerland.

(While there are some specific exceptions to this rule, they don’t include pensioners).

The legislation mandates all residents of Switzerland, regardless of age, to purchase a policy from one of dozens of private carriers approved by the Federal Office of Public Health (FOPH).

The good news (all things considered) is that health insurance rates are not based on age and will therefore not soar the moment you turn 65 (even though, statistically, this age group has comparatively more health problems)

This means that pensioners pay the same premiums as working adults over the age of 25.

Do seniors at least benefit from lower rates?

Again, no.

Premiums are determined by factors such as your canton of residence and the deductible / co-pay amount you choose, but not by your age.

It is true, however, that for many older people who are no longer employed, the continually increasing insurance premiums are a major financial burden.

In such cases help is available, though it is not tied to age but rather to income.

According to the KVG / LaMal law, the cost of insurance should not exceed 8 percent of a family or individual income.

However, according to FOPH’s analysis, policy holders in certain Swiss regions spend much more — between 14 and 27 percent of their earnings — to pay for the premiums.

For those people, subsidies (reductions in healthcare premiums) are available.

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, vary from one canton to another.

Before deciding whether you receive the assistance, however, your canton of residence will look not only at your retirement pension, but at any other financial assets you hold as well.

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 be eligible for this financial aid.

READ ALSO: How does the Swiss pension system work – and how much will I receive?
 

Member comments

  1. Clarification on USA Medicare:
    Medicare is a program that you pay into both during your working years, and, after.
    You become eligible for Medicare when you reach age 65 but it is not free, rather, the monthly cost can be $400-500 per month.
    The primary problem with Medicare is the limitations on what is does and does not cover.
    For those things is does not cover, you are responsible.
    That is a big problem as medical cost in the USA are out-of-control.

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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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