Moving to Switzerland is a major step. Between the administrative procedures, the language barrier, finding a place to live and getting to know your new surroundings, it’s easy to feel a bit lost. However, one of the first things you need to do is absolutely essential: choosing your health insurance.
Unlike many countries, Switzerland has a system where each person is responsible for taking out their own health insurance. This may seem complex at first, but it is based on a few simple principles.
In this guide, find out how the health insurance system in Switzerland works, what basic insurance covers, what supplemental insurance is for, and what to consider when choosing cover that suits your situation.
How does the health insurance system in Switzerland work?
The Swiss system is based on a simple principle: everyone living in Switzerland must take out basic health insurance.
The aim is to guarantee that everyone has access to high-quality medical care, regardless of their age, state of health or income. This principle of solidarity is one of the cornerstones of the Swiss healthcare system.
Unlike in other countries where cover is funded directly by the state or by the employer, every resident in Switzerland is free to choose their own insurance company and pays a monthly premium. Depending on income, the cantons provide financial assistance to help pay this premium; in some cases, this is only available upon request by the insured person, so it is important to look into this as soon as possible.
Compulsory insurance for all
If you are moving to Switzerland, you have three months from the date of your arrival to take out basic health insurance, which must be backdated to the day you entered Switzerland.
This requirement applies to most people residing in the country on a long-term basis, whether they are workers, students, families or pensioners.
Key points
- Basic health insurance is compulsory in Switzerland.
- You are free to choose your insurer.
- You must take out basic health insurance within three months of settling in.
- Coverage takes effect retroactively from your date of arrival in Switzerland.
Basic health insurance: essential cover
Basic health insurance, also known as compulsory health insurance (LAMal/KVG) , forms the foundation of the Swiss healthcare system.
Its purpose is simple: to ensure that everyone has access to essential healthcare when needed.
Whichever insurance company you choose, the benefits covered are set out by law. This means that two different insurers will reimburse the same basic care regardless of your state of health. What may vary, however, are the premiums, the insurance plans on offer or the quality of service. Some insurers also offer benefits, such as discounts on premiums for children in large families.
What does basic health insurance cover?
Basic insurance covers, in particular:
- doctor’s appointments;
- treatments prescribed by a doctor (psychotherapy, spa treatments, etc.);
- medicines prescribed by a doctor and included on the official lists;
- hospital care at the rate applicable in your canton of residence;
- medical tests prescribed by a doctor (CT scans, blood tests, etc.);
- maternity care;
- certain preventive measures.
This cover guarantees access to essential healthcare for all insured persons.
What basic insurance does not always cover
Certain services are not covered, or are only covered to a limited extent.
This applies in particular to:
- certain forms of alternative medicine;
- glasses and contact lenses for adults (with some exceptions);
- routine dental treatment;
- hospitalisation in a single or twin room;
- elective treatment outside Switzerland and emergency treatment carried out outside Europe.
Supplemental insurance policies exist precisely to top up this cover.
Deductible amounts and co-payment: two key concepts to understand
When you use your basic health insurance, you are responsible for paying part of the costs (cost-sharing).
The deductible
The deductible is the annual amount you choose to pay yourself before your insurance starts to reimburse the cost of treatment.
As a general rule, a higher deductible reduces your monthly premium. Conversely, a lower deductible results in a higher premium, but limits your out-of-pocket costs in the event of major medical treatment.
The choice depends mainly on your state of health, your budget and how often you see a doctor.
The co-payment
Once you have reached your deductible, you continue to contribute towards medical costs in the form of a 10% co-payment.
In other words, basic insurance reimburses the majority of expenses, but you are responsible for a portion of the costs, depending on your policy and within the limits set by law.
Basic insurance and supplemental insurance: what are the differences?
Although their names are similar, these two types of insurance serve different purposes.
| Basic insurance | Supplemental insurance |
|---|---|
| Compulsory | Optional |
| Benefits defined by law | Benefits defined by the insurer |
| From the age of 26, premiums are the same regardless of age or gender | Premiums may vary depending on age and gender |
| No health questionnaire | Health questionnaire and potential refusal of cover in the event of pre-existing medical conditions |
| Guarantees essential care | Allows you to supplement your basic insurance cover according to your needs |
In summary, basic insurance covers the essentials, whilst supplemental insurance complements it, allowing you to tailor your cover to your needs.
Why consider supplemental insurance?
Health needs change throughout your life.
Supplemental insurance allows you to top up the benefits provided by basic insurance and enjoy cover that is better suited to your situation.
Depending on the policy you choose, it may include, for example:
- better cover whilst travelling abroad;
- reimbursement for alternative medicine (e.g. osteopathy);
- a contribution towards the cost of dental treatment, or glasses or contact lenses;
- preventative care (e.g. check-ups or vaccinations);
- hospitalisation in a single or twin room;
- contributions towards certain activities that promote health and wellbeing (e.g. fitness or sporting activities).
Not all supplemental insurance policies offer the same cover. It is therefore worth comparing the options available based on your actual needs.
Frequently asked questions
Is basic health insurance compulsory in Switzerland?
Yes. Anyone moving to Switzerland for more than three months must take out basic health insurance.
Can I choose my insurance company freely?
Yes. You are free to choose whichever insurer you wish.
Are the benefits covered by basic health insurance the same everywhere?
Yes. They are defined by the Swiss Law on Health Insurance (LAMal/KVG) and are therefore the same regardless of the insurer.
Is supplemental insurance compulsory?
No. It is optional and allows you to supplement your basic health insurance to suit your needs.
Can I change my insurance provider?
Yes. You can switch insurers or amend certain aspects of your policy, usually once a year, subject to the applicable deadlines and conditions. However, most supplemental insurance policies have an initial term of three years, after which they are automatically renewed on an annual basis.
In summary
The Swiss health insurance system may seem different from that in your home country, but it is based on simple principles: compulsory basic insurance that guarantees access to essential care, and supplemental insurance that allows you to tailor your cover to suit your lifestyle.
Taking the time to understand these differences will help you make informed choices as soon as you arrive in Switzerland and ensure you have cover tailored to your needs.
If you would like further information on different health insurance options or need assistance with the process, Groupe Mutuel is able to provide information and advice to help you choose cover suited to your situation.
For the full picture, guides and checklists, read more at the Swiss Expat Guide
This article was written by Groupe Mutuel, a Swiss Starter Pack partner. It is general information, not advice.