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Published on 20.02.2024

Medication in Switzerland: What’s covered by the health insurance?

Medications are getting more complex. New pharmaceuticals are always being developed, hitting the market at sometimes exuberant price points. The Federal Statistical Office estimates that 12% of all healthcare spending is due to medication alone. Simplecare is here to show you what is covered by your insurance and how much you have to pay for critical medication, vaccinations, and check-ups.

Do I have to pay for my own medication?

Medication in Switzerland works on the system of pharmaceutical specialties. This list of government-approved medications is continuously updated and checked for its viability. Your basic health insurance will pay for all medication on this list, as long you’ve already paid your maximum deductible in healthcare costs for the year (ranging from CHF 300 to CHF 2500) and it’s prescribed by your doctor. You will also have to pay at least 10% of the medication’s cost after your deductible is met.

Let’s assume this example: your yearly deductible is CHF 300, and you’ve already spent CHF 300 on other healthcare costs. If your doctor prescribes a medication costing CHF 600, you would pay 10% of the price – CHF 60.

Note that your basic health insurance can also pay for medication from a pharmacy, if the ingredients feature on the ‘list of medicines with tariff.

Can supplementary insurance cover my medication?

Many medications are not featured on the list of specialties, and if a new drug appears on the market, it might take years to be approved by basic health insurance. This is where supplementary insurance packages step in. To save money in the long run and avoid a scenario where you can’t access a beneficial medication due to financial constraints, sign up for a supplementary insurance solution.

Most providers will cover 90% of your prescription’s cost, if no other options exist on the list of specialties. This is especially helpful for your treatments in alternative and complimentary medicine, where many prescriptions aren’t covered by basic health insurance. Apart from medication, these insurance packages can also give you coverage for glasses, gym memberships, treatments abroad, and much more. If you’re curious to learn more, contact us for a personal consultation, where we find the best supplementary insurance tailored to your specific needs.

How are vaccines and check-ups covered?

Vaccinations that are considered crucial by the Federal Office of Public Health, like shots for measles, tetanus, or cervical cancer, are covered by your basic health insurance. Depending on the type of vaccine, you will still have to pay a part of the cost and fulfill your yearly deductible.

For all other vaccinations, among them those you would take before going on a trip abroad, supplementary insurance options will usually cover several hundred francs a year.

General check-ups for healthy clients, like a doctor’s visit to measure blood pressure and cholesterol levels, are not covered by your basic health insurance. These check-ups can however be covered by a supplementary insurance option, usually being combined into the same package alongside vaccinations.

If you want to learn more about the coverage limits for basic and supplementary health insurance, contact us for a personal expert consultation:

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