Just arrived in Switzerland? A guide to the health insurance system

The Swiss health insurance system raises questions for newcomers, as it differs from the systems in other countries in several respects. This article explains the essentials and what you need to look out for.

Health insurance in Switzerland: Compulsory for everyone

Health insurance is a legal requirement in Switzerland. Anyone who is resident in Switzerland must take out compulsory basic insurance, no later than three months after arrival. This obligation applies regardless of age, income or nationality.

Important: the benefits covered by basic insurance are stipulated by law. This means that all health insurance companies cover the same basic medical services. However, there are differences in premiums, insurance models and service. 

Premiums: Not income-dependent

Many newcomers are surprised to find that health insurance premiums in Switzerland are not linked to income. Each person pays a per capita premium. The amount depends on factors like:

• Place of residence (canton and premium region)
• Age
• The chosen insurance model
• The insurer

That means families pay a separate premium for each family member, including children.

Get health insurance advice from Helsana

Deductible: What is it exactly?

One key term in the Swiss system is “deductible”. This corresponds to the amount that you, as the insured person, pay per year before the insurance covers costs. Good to know:

• The minimum deductible for adults is CHF 300 per year
• By choosing a higher deductible, you can pay lower monthly premiums, but you will have to cover more costs yourself if you fall ill 

If you’re new to Switzerland, it’s important to be realistic in choosing your deductible. If you rarely make use of medical benefits, you can save money with a higher deductible. If you go to the doctor regularly or take medication, you may well be better off with a lower deductible.

Excess: Co-payment after deductible

Even once you reach the deductible, as an insured person, you still contribute to costs. This portion is called the excess or co-payment.

• The excess equates to 10% of treatment costs
• It is limited to a maximum of CHF 700 per year (for adults) 

Put simply: once the deductible is paid, insurance covers most costs. A small proportion remains the responsibility of the insured person, up to the specified upper limit.

Accident insurance: You may already have it

Another important point relates to accident cover. If you work for at least eight hours a week for the same employer in Switzerland, you are automatically insured against both occupational and non-occupational accidents through your employer.

In this case, you can exclude accident coverage from your health insurance, which reduces the premium. If you work fewer hours, are self-employed, or are not in gainful employment, you should get accident coverage included in your health insurance. 

Supplementary insurance: Voluntary, but subject to conditions

Alongside basic insurance, there is voluntary supplementary insurance. This covers benefits that are only partially covered by basic insurance or not at all, such as additional comfort in the hospital or certain outpatient benefits. In contrast to basic insurance:

• Supplementary insurance usually requires a health declaration
• Applications may be rejected or restricted
• Acceptance is not guaranteed 

An important tip for newcomers to Switzerland: you should only cancel existing supplementary insurance once you have written confirmation of a new insurance policy.

Conclusion: Know before you go

The Swiss health insurance system is reliable, but it can be a bit of a mystery for newcomers to Switzerland. It handles deductibles, excess and premiums in a way that differs from many other systems.

By obtaining information early on and realistically assessing your needs, you will be establishing a solid foundation for your new life in Switzerland.