The health insurance system in Switzerland briefly explained
The health insurance system in Switzerland consists of two parts. Compulsory basic health insurance ensures that the costs of basic health care are covered. Any benefits beyond this can be supplemented and covered by voluntary supplementary insurance. We explain the basics of health insurance in Switzerland and how to find the best insurance for you.
The basic insurance
Compulsory health care insurance (OKP) is a statutory health insurance that is mandatory for all persons residing in Switzerland. The OKP covers basic medical care, the benefits are defined by law and are therefore the same for all health insurance companies. This means that certain services such as doctor’s visits, hospital admissions, medications and treatments are covered by the health insurance.
There are differences in the choice of deductible and insurance model. While the deductible regulates the cost sharing by the policyholder, the insurance model defines the process of how a medical service must be claimed.
The insurance benefits are therefore the same for all mandatory health insurance plans. However, there are significant price differences depending on the choice of deductible, insurance model and health insurance company.
The additional insurance
For all benefits that go beyond the basic care defined by law, voluntary supplementary health insurance (VVG) can be insured. The benefits from supplementary insurances vary greatly from health insurance company to health insurance company. Prices can also differ significantly from each other. It is important to consider in advance exactly which services you really need in order to determine the optimal cost/benefit ratio for you.
Some examples of possible benefits that can be covered by supplementary insurance are dental insurance, out-of-canton hospitalization, cost sharing for fitness center subscriptions, hospitalization with private benefits, medications covered by health insurance and special treatment methods.
It is also important to note that there are always legislative adjustments to what services are covered by basic insurance. For example, as of July 1, 2022, it was decided that the service categories of psychological psychotherapists and podiatrists must be covered by mandatory basic insurance.
You should not wait to take out supplementary insurance. If you develop a health problem before you have insurance, health plans may deny you coverage or exclude you from certain benefits related to your medical problem.
How do I find the right health insurance?
Choosing the cheapest basic insurance is usually easy, as you can use a comparison portal such as insurando.ch in this regard. Choosing the optimal supplementary insurance, on the other hand, is far more complex. The optimal cost/benefit ratio for each insured person must be determined individually.
Our advisors have years of experience in finding the best supplemental health insurance for you. We can help you decide by giving you an overview of the different services and costs. Contact us for a consultation and let’s work together to find the best supplemental health insurance plan for you.