Health insurance in Switzerland

Three months from the date you move in. Cover then applies retroactively from your first day in Switzerland – so you pay the premiums for those months afterwards. Someone who registers in early March after moving in January receives three premium invoices at once.

If you let the deadline pass, your municipality of residence assigns you to an insurer. You then have no say over the insurer or the model, and the assigned solution is as a rule more expensive than one you choose yourself. The municipality may also levy a surcharge.

The same deadline applies to newborns, counting from birth. If the child is registered in time, cover starts on the first day of life. With late registration the insurer may require a health check for supplementary insurance – but not for basic insurance.

In practice this means: see to it early, but without rushing. You can compare insurers calmly and join retroactively – cover exists from day one anyway. Anyone who obtains a quote before moving usually has the registration done on the first day and need not worry about back payments.

Not in basic insurance. Every authorised health insurer must accept every person subject to the insurance obligation in its area of operation – regardless of age and state of health. There is no health check, no reservation and no waiting period.

The range of benefits is laid down by law and is the same at every insurer. Differences arise above all in the premium, the insurance model and the service.

It is different for supplementary insurance. It is voluntary and follows private insurance law. There the company may ask health questions, enter reservations or reject an application. Basic and supplementary insurance should therefore be considered separately.

Statutory deadlines apply to changing your basic insurance; the new insurer must accept you where the insurance obligation exists. A change is usually possible at the end of the year, and further dates apply to certain insurance models. Anyone holding supplementary insurance should check its terms and notice periods separately.

The deductible is your annual share of the costs: up to this amount you bear insured treatment costs yourself. After that basic insurance contributes to the remaining costs; in addition a retention fee of ten per cent generally applies up to the statutory maximum.

For adults the ordinary deductible is CHF 300; depending on the insurer, higher deductibles up to CHF 2’500 can be chosen.

A higher deductible generally leads to a lower premium, but raises the amount you initially bear yourself when you claim. With a lower deductible the premium is usually higher, but the deductible amount you bear yourself is smaller. Which variant is financially better depends on the specific premium and the health costs actually incurred.

Different deductible amounts apply to children. The deductible can be changed with effect from the beginning of a calendar year. Our comparison shows the premiums for the deductible you have selected; no personal recommendation is associated with it.

All three are models with a restricted choice of providers. They determine whom you turn to first when you fall ill – and in return the premium falls.

With the family doctor model you choose a fixed practice that treats you and refers you where necessary. With the HMO model a particular group practice or network of doctors is your point of contact. With telemedicine you first describe your problem by phone, app or video; there you learn whether and where you should go.

Crucially: the range of benefits stays the same in every model. Only the first step is restricted, not what is paid for. Emergencies are excluded, and with many tariffs so are ophthalmologists and gynaecologists. How large the saving turns out to be depends on the insurer and the specific tariff.

A word on how binding this is: anyone who does not observe the agreed first step risks the insurer reducing its share of the costs. The model is therefore not a suggestion but part of the contract. You can change at the end of each year – if your circumstances change, through a move or a chronic illness for instance, it is worth reviewing again.

You have a one-off right of option between Swiss basic insurance and the insurance of your country of residence. It must be exercised within three months of starting work and then applies, as a rule, for the entire duration of your employment in Switzerland.

Anyone who does not come forward automatically becomes subject to the insurance obligation in Switzerland. A later change is possible only on particular events – a change of residence or a longer interruption of employment, for example.

The decision does not concern you alone: family members who are not gainfully employed are frequently included. Because premiums, benefits and tax effects differ markedly between the countries, it is worth calculating both variants before the deadline expires.

A common misunderstanding: the right of option concerns health insurance only, not the rest of social insurance. Pension, accident and unemployment cover continue to follow the Swiss place of work. Anyone opting for their country of residence also needs a certificate from the competent authority – without it the employer will register you in Switzerland.

Children up to 18 pay considerably less than adults – depending on canton, insurer and model roughly a quarter to a third of the adult premium.

Important for those arriving from Germany: there is no contribution-free family insurance in Switzerland. Every child receives its own policy and its own premium, from the first day of life. For a family of four this adds up accordingly.

There is relief, however. Many insurers grant sibling discounts from the second or third child, and the cantonal premium reduction applies far more often to families than to single people. Children also have their own scale of deductibles from CHF 0 to 600; choosing CHF 0 is common, because children see the doctor more often.

By comparison with Germany: there family insurance is free of contributions, whereas in Switzerland every family member pays their own premium. Depending on canton and model, a family of four quickly reaches a four-figure monthly amount. When comparing salaries between the two countries, this is the item most often overlooked.

The cantons reduce the premium for households in modest economic circumstances. It is financed by the Confederation and the canton; payment usually goes directly to the health insurer, so your invoice is reduced accordingly.

The rules differ considerably from canton to canton – in the income thresholds, the scope and the procedure. Some cantons check on their own initiative using tax data and write to you, others require an application of your own, often with a deadline in spring for the following year.

For newcomers this is a frequent gap: anyone without a Swiss tax assessment in their first year is not covered by the automatic check and has to take action themselves. A look at your canton’s website is therefore worthwhile right after registering.

The scale is considerable: depending on canton and household the reduction can amount to several hundred francs a month, and more for families with children. It is not charity but a fixed part of the system – around a quarter of everyone insured in Switzerland receives it. An application is therefore worthwhile even if you are not sure whether you qualify.

For emergencies during a temporary stay abroad, basic insurance covers at most twice what the same treatment would have cost in Switzerland.

In countries with high treatment costs that is often nowhere near enough; the rest is left to you. For plannable treatment abroad, basic insurance does not pay at all as a matter of principle.

Within the EU and EFTA the European Health Insurance Card helps: with it you receive medically necessary treatment on the terms of the country you are staying in. For anything beyond that – worldwide cover, repatriation, free choice of clinic – there is supplementary insurance. It is voluntary and not part of basic insurance.

One particularity applies to cross-border commuters: anyone insured in Switzerland who wishes to be treated in their country of residence needs a certificate of their own for this – as a rule the S1 form. Without it, treatment in the country of residence may go unpaid. It is best to settle this when taking out the policy, not once you fall ill.