Basic health insurance

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Basic health insurance in Switzerland

Health insurance in Switzerland is compulsory for every resident of Switzerland.

The most important information:

– a person with residence in Switzerland is obliged within 3 months of the German “Einreisedatum” to have a basic health insurance. The most important information: You have to register in Switzerland within 3 months after the German “Einreisedatum”. (If, after 3 months, the municipality does not receive the health insurance in Switzerland, you will be obliged to apply for it. If, after 3 months, the municipality has not received information about your registration with a health insurance fund, it will as a rule allocate it itself. Often, in such cases, the health insurance in Switzerland and its price does not benefit you and you may be charged an additional administrative fee or fine.
– The basic health insurance in Switzerland protects you in case of illness, maternity and accidents.
– basic health insurance in Switzerland offers all insured persons the same services, regardless of their state of health and age
– the insured person pays the premiums individually
– The price of the monthly premiums for basic health insurance in Switzerland depends on the insured’s age, place of residence, the amount of the Franchise, i.e. own contribution, and the insurance model
– Each person insured in Switzerland can voluntarily choose his or her insurance company, insurance model and franchise
– There are different models of health insurance in Switzerland, there are 4 basic ones: free choice of doctor, family doctor, medical practice, telemedicine, (you have to follow the rules of this model when you go to the doctor)
– Regardless of the health insurance model you choose, in Switzerland you can go directly to the emergency room in case of emergency
– you can change your health insurance company, insurance model and Franchise every year
– Franchise – for adults between 300 and 2500 CHF, for children between 0 and 600 CHF
– Selbsbehalt – 10% max. CHF 700 for adults, CHF 350 for children
– The insured is entitled to apply for “Prämienverbillig”. The insured person is entitled to apply for “Prämienverbilligung”, i.e. a subsidy for health insurance in Switzerland.

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Basic health insurance in Switzerland

Everyone in Switzerland can choose an insurer from around 60 health insurance companies, the so-called health insurance funds, which operate in Switzerland. Every resident is free to choose an insurer, as they must provide the same care and all benefits under the basic health insurance in Switzerland. This ensures that medical care is of a high standard and everyone has access to it. Under the basic health insurance, there is a choice of different healthcare models, which gives you the opportunity to save money on your premiums every month, e.g. by forgoing, for example, a visit to your family doctor and replacing this with a teleportation. In this case, you contact your doctor by phone or via a mobile app with a doctor from the medical centre your health insurance company works with, give your symptoms and the doctor will then determine whether he or she can help you directly or refer you to a general practitioner or specialist.

Basic health insurance in Switzerland covers benefits for illness, accident or maternity. The basic insurance in Switzerland covers the costs of hospital treatment in a general ward in the canton where you live, treatments at a specialist doctor throughout Switzerland, cost sharing in case of emergencies worldwide, as well as medicines and laboratory tests.

In the case of personal accidents, the basic insurance will only cover the costs, provided you have included them in this insurance and do not have any other insurance as part of your accident insurance in Switzerland.

Accident insurance in Switzerland

If you work for one employer for more than 8 hours a week, this employer is obliged to insure you in case of an accident. This contract contains information about your hospital treatment in the event of an accident. Of course you have the option to choose higher accident cover yourself and to be treated, for example, in a semi-private or private hospital, which guarantees you additional accident cover. If you work less than 8 hours a week for one employer or not at all, or if you are self-employed, you are required to join accident insurance to your health insurance in Switzerland.

Basic health insurance in Switzerland, how much does it cost?

If you use medical services, the costs of these services must be covered. The costs are estimated on the basis of the Franchise, the deductible percentage and the contribution to hospital costs, if applicable. You have to pay an additional CHF 15 per day for in-patient hospital stays.

Everyone decides for themselves how high the annual cost contribution is, after having used the medical services. You can determine for yourself how much the insured person will pay, starting at 2500, 2000, 1500, 1000, 500 or 300 francs per year. This amount is called the “Franchise” in Switzerland. The implication is that the lower the annual contribution, the higher our monthly insurance premium.

Franchise in Switzerland, the so-called deductible

A franchise, is the amount you have to pay each year towards your health insurance in Switzerland before the insurance company will cover part of the cost of medical services, which include, among other things: medical visits, examinations, medicines and hospitalisation.

What contribution rate should I choose?

Higher contribution rates mean lower monthly insurance instalments, so you can save money, but there is also a so-called risk amount. When you visit the doctor, if you get a large bill, you have to pay the deductible amount. It is therefore worth thinking beforehand about how much you are able to spend on basic health insurance in Switzerland, it is worth asking yourself how often do I get sick, how many times a year or so do I go to the doctor? If you are generally healthy and rarely visit the doctor, you can afford a higher deductible, whereas if your state of health requires frequent visits to the doctor and you do not want to take any risks, it is best to use the lowest deductible. You also have the option to increase or decrease your deductible rate each year, at the end of the calendar year.

Deductible

Once you have reached the deductible you have set, you only pay part of the costs for further treatment, the so-called deductible. In order to be reimbursed for doctor’s visits or medication, you have to submit receipts for this treatment to your insurance company. The amount of the deductible is regulated by the Health Insurance Act. Usually it is 10% and the maximum is CHF 700 per calendar year. If this amount has been paid in full, the rest of the costs are covered by your insurance company. For children we count the deductible as 10% up to CHF 350 per year.
Premium what is it?

Your insurance premium, called the premium, is the amount you pay each month for insurance in Switzerland. The premium you pay depends on where you live, your health insurance model and your own contribution. The higher your own contribution, the lower your health insurance premium each month.

What directly affects my premium/monthly contribution?

Region of residence

Your health insurance premium in Switzerland is influenced by the region in which you live. The Federal Department of the Interior regulates which municipality belongs to which region.

Insurance model

You have to choose the right insurance model for your basic health insurance in Switzerland. Here we distinguish between insurance models between, among others, free choice of doctor, model with house doctor, telemedicine or medical practice. Depending on the health insurance model chosen in Switzerland, we have to adapt to its rules. By choosing an alternative basic insurance model in Switzerland to the free choice of doctor, we gain discounts on our monthly premium.

Choice of Franchise

You can choose between Franchise 300, 500, 1000, 1500, 2000 and 2500 CHF per year.

If you choose a higher health insurance contribution than the lowest, CHF 300 per year, you can save significantly on premiums. However, this involves a high financial risk in case of illness. As regards children up to the age of 18, the minimum contribution is CHF 0.