Who is covered by health insurance, how you can save on premiums and what costs accident insurance covers - you can find out all this and more here.
01. Who and what is insured in a health insurance company?
Every person living in Switzerland must take out compulsory insurance with a health insurance company. You pay a monthly contribution, a so-called premium. With the health insurance you are insured for costs in case of illness, maternity or an accident. This means that you only have to pay a small part of the costs for visits to the doctor, hospital stays or certain medicines. The rest is paid by the health insurance.
Mandatory is the so-called Basic insurance. Health insurance companies have an obligation to accept every person, regardless of age and state of health, into the basic insurance plan. The insured persons are free to choose their health insurance company.
All are included in the basic insurance for the Same power insured. This includes, for example, treatment in a doctor's office and hospital, medically prescribed medication and laboratory tests, psychotherapy and physiotherapy, check-ups during pregnancy, vaccinations, health examinations for children and partial costs for emergency transport. Not covered by the basic insurance are ordinary dental treatments.
You can voluntary a Supplementary insurance and have to pay a higher premium for it. This pays for additional services such as dental treatment or the comfort of a double or single room in hospital.
The Accident insurance is included in the health insurance. However, employed persons are already insured against accidents through their employer (see also question 6). If this is the case for you, you can ask the health insurance company to remove the accident insurance from the policy. This will reduce the premium.
Here you will find a list of all basic insurance benefits.
The Health Guide Switzerland helps migrants to find their way around the Swiss healthcare system. This is available in 18 different languages.
Here you will find more information about health insurance
02. What is the cost of health insurance?
The health insurance costs on average about 3,700 francs per year.
The cost of health insurance is paid monthly.
Although the basic insurance includes the same benefits everywhere, you pay different premiums depending on the health insurance company. It is therefore worthwhile to inform yourself about the different premiums and to include this in the selection of a health insurance company.
You can find a premium overview here.
03. What do I have to pay myself, what does the health insurance pay?
In addition to the premium, you must also pay part of the treatment costs yourself. The participation is called Franchise. You can choose the amount of the deductible yourself. The lowest deductible is 300 francs, the highest 2500 francs. This means: With the highest deductible rate, you have to pay all medical expenses up to an amount of 2500 francs per year yourself. In return, the premium is lower. With a lower deductible (e.g. 300 francs) the monthly premiums are higher. However, the costs are covered if they exceed 300 francs. A high deductible rate (and low premiums) is only worthwhile if you are not very ill.
If your annual medical expenses exceed your deductible, you must pay an additional 10 percent toward the cost, called the Deductible. According to the law, the deductible amounts to a maximum of 700 francs per year.
The cost of Pregnancy and birth is covered in full by the health insurance fund from the outset.
04. What do I need to do to get health insurance to pay?
After your Doctor's visit you will receive an invoice. You must pay this yourself. Together with the invoice, you will receive a copy of the invoice (= reclaim voucher or invoice copy). You send this copy to your health insurance company. You will then receive - if the amount exceeds the deductible rate - 90 percent of it paid into the bank or post office account you specified.
The Hospital bill is either sent to your home or to the health insurance company. In most cases, the bill is paid directly by the health insurance company. The health insurance company or the hospital will send you a separate invoice for any costs that you have to bear (deductible, contribution to meals).
Also, certain medications prescribed by a physician Medication are paid by the health insurance. Either you receive the medication directly after showing the health insurance card and without paying. Or you pay for the medication yourself and send the invoice and prescription to the health insurance company later for reimbursement.
05. How can I save on health insurance costs?
Health insurance premiums can put a strain on the household budget. There are several ways to reduce the cost of premiums.
Through a high franchise: With a high deductible (maximum 2500 francs), the premium drops sharply. Attention: However, this is only worthwhile if you are not very ill and do not have to go to the doctor very often.
Through a affordable health insurance: Compare the premiums and benefits of health insurance companies with each other, for example here.
Through cantonal premium reductions: People with a low income are entitled to the cantonal premium reduction. This means that the canton pays part of the health insurance premiums. If you are entitled to a reduction, you will be informed automatically by the responsible office (cantonal social security office). You must submit a form for this in due time every year. In the canton of Obwalden you can find this under www.ow.ch more info. You can also contact us directly by mail to praemienverbilligung(at)ow.ch turn.
06. Who and what is covered by accident insurance?.
Accident insurance covers the costs of medical treatment following an accident. It also pays a daily allowance (wage replacement) in the event of temporary incapacity to work or pension benefits in the event of permanent incapacity and death.
All employees in Switzerland Employees are automatically insured against accidents by the employer.
- You work eight hours or more per week with an employer: then you are insured against occupational accidents and against so-called non-occupational accidents (accidents on the way to work and during leisure time).
- You work less than eight hours per week with an employer: then you are only insured against occupational accidents and against accidents on the way to work. For accidents in your free time (e.g. in the household) you must take out accident insurance with the health insurance company.
- Unemployed persons, who are entitled to unemployment benefits are compulsorily insured.
Not insured are persons who are not gainfully employed, for example housewives and househusbands, children, students, pensioners or unemployed persons who have lost their jobs. These persons are required to take out accident insurance with the health insurance company.