New in Switzerland
Are you planning on moving to Switzerland or are already here? Welcome! Get information now on the health insurance system in Switzerland.
Calculate premiums now
What you need to know:
- Everyone who lives in Switzerland must have insurance against the consequences of illness and accident.
- Basic insurance is called mandatory health insurance and is compulsory for everyone, regardless of age, origin and residence status.
- You can add to basic insurance with supplementary insurance, for example for dental treatment, alternative medicine and emergencies during travel.
What this means for you:
- You must get insurance cover with a Swiss health insurer for yourself and your family by three months after your relocation to Switzerland at the latest. You can decide for yourself which insurer best convinces you. Compare different providers to do so.
- Every health insurer must accept you unconditionally in basic insurance – that means without a health check. The benefits are the same with every insurer as they are defined by law. You always bear a portion of the costs yourself as the insured person.
Basic insurance: these costs are covered by the insured
- Deductible: The deductible is a part of the health care costs which the insured person must pay. You can choose this amount among those available. During the calendar year, you pay all costs incurred until the chosen deductible amount has been reached. Health insurance takes over after that. The chosen franchise impacts the amount of the premium. The higher the franchise, the lower the insurance premium. In basic insurance, you can choose between the following deductibles:
Children up to 18 years: CHF 0, 100, 200, 300, 400, 500, 600
Adults: CHF 300, 500, 1'000, 1'500, 2'000, 2'500The deductible can always be adjusted for the beginning of the following calendar year. With CONCORDIA, this can also be done online, subject to the applicable deadlines: Change in Deductible for Mandatory Health Care Insurance KVG/LAMal.
- Retention fee: If the medical costs exceed the chosen deductible during the course of the calendar year, the health insurer will cover 90 % of the remaining costs. 10 % must be borne by the insured person as a retention fee. For select medications, this fee is 40 %. The retention fee is capped per year at a maximum of CHF 350 for insured persons up to 18 years of age and at a maximum of CHF 700 afterwards.
Example:
You have chosen a deductible of CHF 300 and receive an invoice for CHF 8'300:
You pay the chosen deductible amount of CHF 300.
For the remaining CHF 8'000, you have to pay a retention fee of 10 %. This would be CHF 800.
However, the annual maximum amount of the retention fee is restricted to CHF 700 per year.
For this reason you pay CHF 1'000 in total (CHF 300 deductible + CHF 700 retention fee). The remaining costs are covered by the health insurer.
Hospital contribution
- From the age of 18, insureds are charged an additional CHF 15 per day for hospital stays, provided they are not undergoing training. From the age of 25, the hospital contribution applies for all insureds.
- During pregnancy, no cost contribution can be charged for statutory benefits from basic insurance. If complications should occur during the pregnancy, it is treated as an illness and cost contributions are charged.
Supplementary insurance: for individual needs
Every person has different needs. This is also the case when it comes to health insurance cover. That’s what supplementary insurance is for. Its benefits go beyond those of basic insurance.
You yourself choose which insurer you want to have supplementary insurance cover from. You can take out basic insurance and supplementary insurance with different insurers. However, invoicing and administration is easier if you rely on one insurer.
Please note:
Unlike basic insurance, insurance companies are not obliged to provide you with supplementary insurance. They can deny the request for a new policy without providing reasons or apply exclusions. To apply for supplementary insurance, you must fill out a questionnaire about your health..
Tips for your start in Switzerland
-
1. Which deductible suits me best?If you can boast good health, then it is reasonable to choose the highest possible deductible. Although this means that you must pay for doctors’ bills and medications up to the CHF 2,500 annual maximum, you pay lower premiums every month. If you don’t need regular treatments, then you will presumably need the full amount of the annual deductible only in exceptional cases. Get personal advice for your questions on the deductible.
-
2. I have to go to the doctor – What do I have to do?
Depending on the basic insurance model you have chosen, you are obligated to follow a certain process in the event of medical issues. How it works at CONCORDIA:
- Traditional model: You can freely choose your doctor and contact specialists directly.
- myDoc family doctor model: Your first contact in the event of medical concerns is always your family doctor. If necessary, you will be referred to a specialised practice.
- HMO model: For this model, you always contact your chosen HMO health centre first in the event of medical issues. An HMO health centre combines a wide array of medical expertise and thus numerous doctors under one roof.
- smartDoc telemedicine model: In the event of medical issues, you always contact the virtual health practice Medgate first. You can do so by phone or chat in the CONCORDIA Medgate app.
-
3. How are invoices for medical examinations paid?
The benefit claimed is charged after you see a family doctor or specialist or stay in the hospital. The invoice will be sent either directly to your health insurance or to you. If you receive the invoice, you can submit it to your health insurance for reimbursement. You can do so in paper form or digitally. With CONCORDIA, you can submit your invoices easily and quickly in the myCONCORDIA customer portal .
Your health insurance reviews and reimburses the invoice. Then you as the insured will receive a so-called statement of benefits. This applies for invoices that are sent directly to the health insurer by the doctor as well as for those that were submitted by the insured person. For every invoice, you pay the portion that is due based on the deductible you have chosen and the retention fee. Your health insurance pays the rest.
Find out more here about statement of benefits and how to check invoices.