Information regarding health insurance

Newly arrived in Switzerland

Are you moving to Switzerland in the near future? Or are you already here? Are you an expat who is working here? If so, find out now about basic insurance (OKP/AOS/AOMS), which is obligatory in Switzerland, and possible supplementary insurance, which improves your protection. The health insurance company CONCORDIA will competently advise you on the subject.

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This is what you must know:

  • Anyone living in Switzerland must be insured against the consequences of illness and accidents.
  • Basic insurance (OKP/AOS/AOMS) is mandatory for everyone, regardless of age, place of origin or residence status.
  • You can top up basic insurance with supplementary insurance for things such dental treatments, alternative methods and travel.

For you, this means:

  • Insure yourself and your immediate family with a Swiss health insurance provider no later than three months after your move to Switzerland. After comparing health insurance options, you can decide yourself which insurance provider best covers your needs.
  • Costs for the gynaecologist and preparation for childbirth are partially covered with basic insurance. A supplementary insurance pays on invoices for the dentist.
Each health insurance provider must accept you unconditionally – that is, without a health examination – for mandatory health care insurance. The benefits are the same with all insurance providers, since they are prescribed by law. You yourself always bear a part of the costs as the insured person.

You insure yourself this way:

Basic insurance is mandatory for everyone. It covers the costs of the diagnosis or treatment of illnesses, in the event of pregnancy and accident as well as the consequences all the way to physiotherapy. Federal regulations govern which costs the insurance provider takes over and for which part of the costs you yourself must pay. Cost sharing is influenced by:

  • The deductible: It is a participation in the health costs that you as the insured person bear before your health insurance participates in the costs at all. In Switzerland, with basic insurance, you can choose between six yearly deductibles: CHF 300, CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 and CHF 2,500. The choice of your deductible affects the amount of your premiums. Let our specialists advise you ((LINK)).
  • The retention fee: It is prescribed by law and always amounts to 10 %. This means you pay that 10  % of the invoice that exceeds the deductible amount. The remaining 90 % is taken over by your health insurance. However, there is a limit of additional costs of CHF 700 per year for adults and CHF 350 per year up to and including the age of 18.

You choose a deductible of CHF 300 and receive a doctor’s bill of CHF 7,300:
Your deductible                                           CHF 300
10 % of the costs exceeding this                CHF 700 (maximum CHF 700)
Your costs                                                   CHF 1,000

From age 26, you pay an additional participation of CHF 15 per day in the event of a hospital stay.
In the case of maternity, no cost sharing shall be imposed for the statutory benefits of the basic insurance plan. However, if the pregnancy does not proceed in a normal manner, this is considered to be an illness, and cost sharing shall be imposed.
Each person has different needs. Even when it comes to the coverage of healthcare services. For this purpose, the supplementary insurances are there. They supplement the benefits above and beyond basic insurance.

Here too, you yourself decide with whom you want to be insured. Basic insurance and supplementary insurance can be concluded with different insurance providers. However, it is easier with statements and in the administration when you rely on one partner.

Please note the following:
Unlike with basic insurance, the insurance provider is not obligated to admit you to its supplementary insurance plans. The insurance provider has the right either to refuse a new contract without giving a reason or to attach conditions on a new insurance contract.

Do you want to know what the health insurance pays in gynaecology and for the ultrasound?
Or in cardiology?
Maybe you have a desire to have children?
What is with the medicines and medicinal products, generic medicines and on-line pharmacies? 

What are your needs?
Click here to learn more about our offer or contact your personal advisor.

If you are a new resident in Switzerland, initially, it will be challenging to understand the health insurance system of Switzerland. Here you will find tips to help you optimise your premiums:

1. If you are in good health, it makes sense to set the franchise as high as possible. This means that you yourself, in fact, shell out doctor and medication bills up until the maximum amount of CHF 2,500, but because of this, you also pay less in premiums per month.

2. In Switzerland, we have the family doctor model. This means that before each consultation with a specialist, you must go first to the family doctor chosen by you. In many cases, your doctor can help and you can save the high expenditure of a specialist. That also pays off for you with the premiums. Furthermore your family doctor helps you to quickly obtain an appointment with a specialist if necessary.

3. Experienced teams of doctors work in the HMO health centres. In some regions, family doctors have joined together to form HMO networks of doctors or a group practice. Here too, your personal doctor attends to you. This doctor is the first reference point and contact person for you, and will refer you to a specialist when necessary. This efficiency helps to save costs and has a positive impact on your premiums.

4. With the smartDoc telemedicine model, you decide when, where and how to take care of your medical concerns. When you have a medical problem, you first contact the Medgate virtual health practice, by telephone or via the CONCORDIA Medgate app. The Medgate doctors then determine the further treatment steps if necessary. Save time in the waiting room and benefit from attractive premiums.

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