Healthcare insurance in Switzerland made easy

Some of us are expats and we’ve been there. You arrived to Switzerland and either your employer is offering you a healthcare insurance or you need to choose one but you know nothing about it. There’s actually quite a lot of info in English out there but it is pretty confusing. If you don’t want to spend hours reading comments, browsing websites and communities and asking every friend you have, you got to the right place.

Our blog is about alternative medicine, and we will provide you some good tips and links on that at the end of this article. However we thought you may also need a quick overview of the basic insurance. If you are interested on having the whole picture, we have another post in which we give you the insight of the healthcare industry in Switzerland.

We are going to explain you strictly what you need to know and get you simple advice. First advice, you don’t need to put too much energy into this, the service is good <i class=”ion-happy-outline”></i>.

 

1. Healthcare insurance in Switzerland is compulsory (and it’s good)

The federal government published a law in 1994 (effective 1996) declaring that every person living in Switzerland must have healthcare insurance providing basic services. Benefits provided by the basic insurance are detailed on the federal government law publication LAMal.

Any other benefit needs to be negotiated with your insurer and added on top of your basic LAMal insurance.

The basic compulsory insurance will cover most of the situations you have in mind, if you want to see an easy to digest explanation of the services covered in LAMal regulation you can check this post from Comparis.

 

2. The structure of the healthcare services in three simple steps

A) Choose a model

Basic healthcare insurance comes in different models though remember all assure the same service.

  • Traditional – you visit the doctor of your choice.
  • HMO – you first need to consult at a HMO Center (Health Maintenance Organization or network of doctors) (up to 25% discount).
  • Family doctor – you first need to consult your family doctor (up to 20% discount).
  • TelMed – you first need to call your insurer for advice (up to 15% discount).

There can be also differences on prices between providers even if you choose the same model. This means same model + same service = different prices. The hidden part in the equation is the customer service. Our top advice, ask them if you need to pay the bill prior to the reimbursement or they accept doctors sending the bill to them. It makes the whole thing easier.

If you want to know more we recommend you to read this entry in Comparis. You will find good advice about basic insurance on their articles, you can also ask for offers to providers but for every offer you ask you will get a few emails with lots of information and call backs so mind yourmouse before clicking.

B) Understand the reimbursement

  1. Deductible. When you choose your model you also need to choose a deductible. Up to 2500 CHF, this is money that you will need to pay before being eligible for reimbursement.
  2. Coinsurance. 10% of the charges at always at your cost, even after reaching your deductible.

C) Add your optional services

Here is where the game starts. Insurers have designed all kind of offers to complement what you get on the compulsory healthcare insurance. There are so many offers that if we explain each of them we will get you reading up to retirement. We are going to explain you which kind of offers you will get.

  • Additional outpatient (ambulatoire) services. Possibilities are endless. Insurers will wrap services, give it a healthy name and offer it to you. They have different approaches. With some of them you can add services for a fee, kind of make your salad style, other have closed packages. They all go around the same services; extra coverage for trips, extra coverage for glasses, extra coverage in case of accident, and so on.
  • Additional inpatient (hospitalisation) services. Basically you can insure your cost if you want to choose a single room at the hospital, the doctor performing surgery or even a hospital in a different canton. This is about your stay at the hospital.
  • Alternative medicine. This is actually included on the above but we decided to make a bullet point for because here is where the opportunity lies. For a few francs a month you can benefit of reimbursement for a wide range of services. You will end paying as little as 10 CHF for massages, yoga, meditation, nutritional advice, hypnosis, acupuncture session. We wrote a post explaining you what you need to know and we have created a comparative table so you can get a clear view of the different offers prior to contacting any insurer.

 

3. Our final Tips

  • Choose an insurer that allows doctors to send the bill directly to them.
  • Make a clear list of which complementary services you need. You can check a couple of insurers to get an idea of the services.
  • Have a thought about the deductible. To give you an idea a doctor consultation will be between 60 and 200 CHF. A scanner on the 300 CHF. It does grow quickly.
  • Get a complementary for alternative medicine and use it!  Check our tips on this post

Do you have any question you like us to answer?  You don’t find your insurer on the list? Anything you want to share with us? Tell us on the comments section below and we will answer it.

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