The healthcare system in Switzerland

How is the healthcare system organised in Switzerland? How much does it cost and what cover does Swiss social protection provide? 

 

Here is some information on the KVG scheme in Switzerland.

 
The basic health insurance scheme in Switzerland is called the KVG (Krankenversicherungsgesetz).
Membership of the KVG is compulsory for Swiss citizens and residents.
Exemption from membership of the KVG may be granted, for three years at most, to people who are living in Switzerland for training or development purposes. To qualify for this exemption, you must have equivalent insurance cover.
Each individual enrols with the KVG through a private health insurance plan (there is no state health insurance in Switzerland).
Health insurance is paid for by the employee while accident insurance is paid for by the employer. 
The employee is free to choose their insurer, although there are sometimes agreements in place between companies and insurers.
 
What cover does the KVG provide?
Basic KVG insurance covers:
- treatment dispensed by a doctor and prescription drugs,
- hospital treatment on a general ward,
- maternity,
- other benefits under certain conditions (vaccinations, health checks, gynaecology etc.)
A number of benefits such as dental, optical, alternative medicine, physiotherapy and acupuncture are not covered by the KVG. It is therefore in the patient’s interest to contribute to a top-up insurance scheme that covers these services. Unlike membership of the KVG which is compulsory, membership of a top-up scheme is optional.
 
How much does it cost?
The premium varies depending on the cover selected (with additional cover or not), age of the insured (different rates for children, young adults and adults) and the district where you live.
Even with the same level of cover, the insurance premium can vary from one insurer to another. You should therefore compare prices before purchasing.
 
Reimbursement is subject to:
- an annual excess: the insured chooses the amount of the excess which varies between €300 and €1,500 per year. This is the annual amount which the insured must contribute towards their healthcare costs. 
For example: with an excess of €1,000, expenses will not be reimbursed until they exceed €1,000 over the year. Once the annual health expenses exceed this amount, the insurance starts to cover the costs.
- the retention: this is an additional charge paid by the insured toward healthcare expenses representing around 10% of costs reimbursed by the KVG. This retention is only applied once the excess has been exceeded.
 
What you need to do:
Each individual can choose a doctor within their area of residence.
The doctor is responsible for referring patients to a specialist if necessary.
 
Date of publication May 1 2012