SWITZERLAND HEALTHCARE SYSTEM

Like many countries in Europe, Switzerland has also established a system to guarantee healthcare for all its citizens. However, Switzerland’s approach and solution was very different to that of France and the United Kingdom. Instead, Switzerland requires its private insurance companies to provide coverage to all Swiss citizens and residents, regardless of age or medical history. In exchange, Swiss residents and citizens are required by law to purchase health insurance from these insurers.

THE SWISS HEALTH-CARE SYSTEM

Principles
Healthcare in Switzerland is regulated by the Federal Health Insurance Act of 1994. It stipulates that Health insurance is compulsory for all persons residing in Switzerland. Insurers are obliged to cover you as per the minimum benefit defined by the government, and it is mandatory that you take up cover for yourself and your family. Insurers cover the costs of medical treatment and hospitalisation, with patients sharing some costs through an annual excess. This ‘excess’ component ensures that premiums remain competitive and affordable to policyholders, while penalising unnecessary medical treatment

This last part is to ensure premiums remains affordable, and incentivize you to avoid unnecessary treatments. The government also regulates drug prices and fees for lab tests and medical devices, and so keep expenses under control. By selecting higher or lower levels of annual excess, you can adjust your premium rate accordingly. Lower premiums can also be secured by joining a plan where the insurer requires pre-checkups and treatment in participating hospitals, clinics and physicians.

Reimbursment
Reimbursements are regulated by the government and are reimbursed at 90% of cost once the excess has been reached. Excess can ranges from CHF 300 to a maximum of CHF 2,500 as chosen by the insured person - with premiums adjusted accordingly. The 10% co-payment can not exceed 700 CHF per year. Beyond this limit, reimbursements are 100%.

  1. In-hospital treatment – Inpatient treatment in a public hospital is covered as per the above rule, but does exclude semi-private or private ward, or in a private hospital.
  2. Out-of-hospital treatment – Physician compensation is negotiated between the insurance companies and doctors on a canton by canton basis, and are subject to the excess and co-payment rules above.
  3. Medicine – Generic medicine is covered as per the here above rules with one exception - should you want brand-name drugs, then the co-payment jumps to 20 percent.
  4. Ophthalmic and dentistry – Opthalmic and dentistry cover can be purchased as supplementary options, else this is not usually covered.

Funding
As insurance system in Switzerland is based on a private and commercial approach, together with variable levels of excess; much of the cost of healthcare is borne by individuals. However, the Swiss government will provide a direct cash subsidy to people if their standard health insurance premium equals more than 8 percent of personal income. About 35 to 40 percent of households get some form of subsidy, thus, the Swiss government only pays for 24.9% of health care costs. In total, the Swiss system cost amounts to 10.8 percent of GDP, which is just slightly higher than European standards.

Private Insurances
All insurance is private. In exchange for providing standard health insurance to all consumers, regardless of their medical history or age, insurance companies operate a risk-adjusted payment arrangement with the government so as not to be disadvantaged if they are insuring an unhealthier population. Insurers usually provide the regulated cover, offering options to customize the level of excess and co-payment. They also have supplementary insurances options, which are not regulated, and offer better benefits. Some estimates indicate that 40% of Swiss citizens have supplemental insurance presently.

Swiss Insurances Abroad
Two rules apply here. (1) should you move to an EU/EFTA country, then the agreement on the freedom of movement of persons applies. This agreement stipulates that the appropriate state is generally the country in which you are working or living. As an example, a Swiss citizen established in France and working in France would be governed by the French social security system. (2) should you emigrate to a state beyond the EU/EFTA, it is no longer possible to remain in the compulsory basic health insurance scheme. Some health insurance providers do offer the option to ‘internationalise’ your cover. However, since the insurance providers are not obligated under Swiss Law to provide this option, most do not.

YOUR INSURANCE OPTIONS

Before leaving, we recommend that you get in touch directly with your insurance company to ask if it does offer the possibility of health insurance abroad. Should they not, we can suggest some useful providers who offer international health insurance solutions.

You should also ask whether you can suspend your supplementary insurance policy upon leaving, as doing such would enable you to resume your insurance cover when you return to Switzerland on the same conditions as prior to your departure.

If you have questions, or need some guidance, give us a buzz .