Health Insurance (Krankenkasse)
Hi, and welcome to the first instalment of “Living in Switzerland.” This blog will focus on all the nitty-gritty details of moving to Switzerland, whether long-term, short-term, or something in between.
For the first post, let’s explore Switzerland's obligatory health insurance, how it works, when you need to sign up, and where you can find help navigating the many options.
Who Needs Krankenkasse?
Swiss health insurance is called Krankenkasse (at least in the Swiss-German-speaking cantons. It is called Assurance Maladie in the French-speaking regions and Assicurazione Malattia in the Italian-speaking areas; more on language and cantons in later posts) and is obligatory for all residents in Switzerland. Krankenkasse needs to be set up within the first 3 months of living in the country and will be retroactively covered from the date of your residency. Therefore, you are also expected to pay it from that date of residency, even if the health insurer takes several months to finalise your policy.
Generally, Swiss companies are fair regarding bills and will allow you to divide an invoice into several instalments if you cannot pay it all at once. My advice is to set aside a minimum of 300 CHF from each paycheck until you have your Krankenkasse set up to avoid prolonged payments, as they will only add up!
If you are planning on staying in the country for less than 3 months, you will most likely qualify to skip signing up for the obligatory Krankenkasse system if you have existing EU/EFTA Health Insurance or if you have health insurance that covers international travel or is a Cross-Border Commuter (depending on their working arrangments).
Where Do I Find Information?
Switzerland is generally organised with plenty of informative websites, as long as you know where to look. The trouble is, as newcomers to a country, it’s not always easy to know exactly where to look!
If you don’t want to troll through each Krankenkasse’s individual website or you’re not even sure which options are out there, the best place to start is Comparish.ch. Comparish is a popular Swiss comparison platform that helps users compare prices and services for health insurance, among other services. It allows foreigners to select one of four languages: German, French, Italian, or English, making it easier for them to navigate the information.
What Does It All Mean?
When filling out the Krankenkasse form, you will be asked many questions, and not all of them are straightforward for a newcomer. Here is a quick breakdown of terms you will see and what they mean:
Basic Health Insurance: Mandatory insurance in Switzerland covering essential medical treatments and hospital care.
Supplementary Insurance: Optional insurance that covers additional services not included in basic health insurance, like private hospital rooms.
Deductible/Franchise: The annual amount you pay out-of-pocket before your health insurance starts covering costs.
Telmed/Callmed: In this model, you must first call a medical helpline before visiting a doctor for advice and care coordination.
HMO: Health Maintenance Organisation model, where you must visit doctors within a specific network or medical centre.
Free Choice of Doctors: The ability to choose any doctor or specialist without being restricted to a network.
Family Doctor: A model where all medical care is coordinated through a general practitioner who refers you to specialists if needed.
But don’t worry. Should you choose a Telmed model, for example, and don’t have time or forget to call before going in, you can always call them back retrospectively. Additionally, most Krankenkasse can set up regular appointments until a certain date, meaning you don’t have to call every time you have a physio or therapy appointment. It’s smart to check your provider's policy beforehand, as some might not be as lenient as others, and no one likes an unexpected penalty invoice.
Do I Need Private Accident Insurance?
As a general rule, no. If you are employed by a company in Switzerland and work more than 8 hours per week, the company must provide you with accident insurance. If you work for yourself, however, or are in between jobs, accident insurance is necessary, and most Krankenkasse can add this to your basic insurance.
Additionally, when transitioning between jobs, the company is legally bound to give you one month of prolonged accident insurance after your contract has finished, provided you have not started working for another company yet. This can also be extended for up to six months after the end of the contract, should you need it, at a fair cost.
Other Important Information To Note:
Choosing a Deductible/Franchise: This was mentioned briefly above as being the out-of-pocket price you will have to pay yourself before the Krankenkasse kicks in, but what was not mentioned is that after you have paid your deductible, you are still required to pay 10% of the cost of further medical bills (this is known as the "co-payment" or Selbstbehalt). However, this co-payment is capped at 700 CHF per year for adults and 350 CHF per year for children. Once you reach this additional amount, the insurance covers 100% of the costs for that year.
Switching Health Insurers: You can only change your Krankenkasse once per year, usually at the end of November. This also means you are locked into your deductible/franchise amount for at least one year, so make sure you are happy with your choice. The health insurance follows the calendar year, meaning if you change your Krankenkasse before the end of November, the new one will start on January 1st of the following year.
Subsidies for Health Insurance: Also called Prämienverbilligung, these subsidies vary from canton to canton and can generally be found by searching online for “Prämienverbilligung” followed by the name of your canton (for example, here is the page for canton Bern). The amount of the subsidy depends on several factors, including your income, marital status, number of children, and overall financial situation. It's important to check the specific criteria in your canton, as each has its own rules and application process for obtaining these subsidies.
I hope you found this post helpful! Stay tuned for more insights into life in Switzerland, and feel free to share this post with anyone who might find it useful.
