Expatriate Medical Insurance in Switzerland

Switzerland as a whole has excellent healthcare facilities, emergency services and outstanding medical staff, and Basel is no exception. One reason for this is that basic insurance health insurance in Switzerland is mandated by law. Upon moving to Basel, it is compulsory to choose a provider and take out health insurance within three months of arriving in Basel.

I came from Canada, where healthcare is free and universal, so the Swiss medical insurance system was a confusing for me, due to the wealth of different providers and expatriate health insurance plans available from each. I thought I’d do my best to explain the system to you, so that you have an easier time than I did! I’m not an insurance expert (take this as my disclaimer), so be sure to do your own further research to get the coverage that best fits your lifestyle!

Everyone who lives in Basel (or anywhere else in Switzerland) must have a basic health insurance plan (Soziale Krankenversicherung). In addition to expats and their families getting health insurance within the first three months in Switzerland, newborn babies must also be insured within three months of birth. Furthermore, partners and children should be insured individually, as they are not necessarily covered by one person’s plan. You need a reliable provider and plan that comprehensively covers you and your family for any unforeseen health issues that come up.

Which health insurance provider is acceptable is highly regulated by the Swiss government. Swiss officials involved will often not accept global health insurance policies, even if they provide coverage in Switzerland. There are numerous state-run Swiss insurance companies from which you can obtain health insurance that will satisfy the law.

If you’re looking for Household insurance, third party liability, life insurance or motor vehicle insurance information, this link will take you to the post on that.

 

Accident insurance vs. Health Insurance

In Switzerland, there is an important distinction made between accident insurance and health insurance. Accident insurance covers emergency situations that occur unexpectedly. Health insurance covers illnesses, from colds to cancer.

By law, your employer is obliged to provide employees with accident insurance (UVG – Unfallversicherungsgesetz). You don’t get a say in the provider of this accident insurance. The costs are split between employee and employer, and are generally automatically deducted from your pay. Accident insurance covers accidents both during and outside of working hours. The coverage includes reimbursement for care services, other accident-related expenses, and provides a daily allowance, if you are temporarily unable to work. The same insurance provides a pension, in case you are permanently incapacitated. If you decide to become self-employed, you can get accident insurance from your health insurance provider.

The specific details of an accident insurance policy differs for each company policy, and covers most situations, but may not cover high risk activities (off-piste skiing, mountain helicopter airlifts, extreme sports, etc.), so be sure to check! It also may not be valid outside of Switzerland, so be sure to check your policy before you travel abroad, either for work or holidays.

 

Deductibles and Co-pay for Swiss Medical Insurance

Depending on the plan you take, the deductible for your insurance is variable, between full coverage and a 2500 CHF deductible. Basically, the lower the deductible, the higher your premium is. The insured person is also generally charged a 10% co-pay (the patient pays 10% of the total treatment costs, even after the deductible is payed ) up to a maximum predefined level per year (usually about 700 CHF, on top of the deductible).

While the system may seem overly complex and a litte unfair, it has the advantage of preventing abuse of the system, as the patient always has to bear some level of cost for treatment.

 

Choosing an Expatriate Medical Insurance Provider

Choosing your Swiss health insurance provider depends on what you want out of your coverage, and how often you generally go to the doctor. If you rarely see a physician, and are not prone to frequent illness, you might consider a low cost insurance, with a high deductible. If you have a chronic illness, you might consider a plan that has a lower deductible. There are convenient comparison calculators online where you can explore different plans. This will depend on your Swiss postal code (4 digit), your age, and what kind of plan you want, Standard, General Practitioner, HMO or Telmed. A brief description of each is below, with a more detailed description here.

 

• Standard Basic Health Insurance

Standard basic health insurance is the compulsory health insurance provided by all Swiss health insurance companies. The benefits are identical irrespective of the health insurance company. It is possible to consult the doctor of your choice.

 

• The GP Model

In the GP model, the patient must always contact his GP upon becoming ill, unless it’s an emergency (as defined by the insurance). The GP is selected from a list provided by the insurance. The GP will decide whether or not the patient is referred on to a specialist.

 

• The HMO (Health Maintenance Organization)

In the HMO model, the policyholder is obliged to consult a certain physician at an HMO centre, upon becoming ill, unless it’s an emergency. The HMO physician gets paid a flat monthly rate for all treatment his patients get. The flat rate makes it the best interest of the HMO physician to restrict treatment to only what his patient really needs.

 

• TELMED

Telmed policyholders call an information line before going to the doctor. The telephone service will give information about what to do, or tell the policyholder to go to the doctor or the hospital. A telephone consultation is unnecessary for emergencies, and some other types of examinations.

 

Students, Researchers, Interns and Au pairs

There are also providers that cater specifically to students, researchers, interns and other trainees and au pairs. The insurance is generally lower cost, and meets the minimum legal requirements, but is only available with evidence of eligibility.

 

Supplementary Insurance / Top-ups

This type of insurance coverage is voluntary and provides a higher level of services (i.e, a private hospital room, instead of a shared room) or additional services (homeopathic treatment, dental care, contact lenses.). Premiums are often based on the risk to the health insurance fund, and they can refuse to insure depending on their health.

 

Ambulances

This is an area where you have to be careful! With basic insurance, the insurance company pays 50% up to 5000 CHF per year for emergency transport, meaning you have to cover 50% of the bill! From people I’ve talked to, this is between 300-1800 CHF for a single ambulance trip, depending on how far away you had to be taken and what services are necessary! If you have a way to get to the hospital without calling an ambulance, when you move to Basel, and it doesn’t pose a threat to your condition, you might consider having someone drive you to the emergency room! You can get supplementary policies that give full coverage for emergency transport, if you so desire.

 

Private Healthcare

While public basic healthcare is enough for many expatriates in Switzerland, there is also a broad selection of private healthcare facilities, if you can afford these. Generally, this kind of service will come out of your pocket, as it will not be covered by accident or health insurances.

 

Changing Insurers

If you want to change your provider or type of policy, for any reason other than a cost increase, there are specific dates when this must be done (usually December or June), and you have to provide at least 3 months notice in writing (by the end of September or March). If the company has increased costs of your policy, you can provide them one month’s notice and must cancel in writing by the end of November to change in December. If you have supplementary policies, be sure that you have been accepted for similar insurance by your new provider, before terminating your old insurance!

 

Terminating Your Policy Upon Leaving Switzerland for Good

If you leave Switzerland, you can provide proof of your deregistration (which you receive from your local Resident’s Office), then you may terminate a policy at any time of the year.

I hope this post has provided you with some relevant information on expatriate medical insurance. You should consider this a broad overview and be sure to do your own research to define your insurance needs.