Compulsory health insurance
In case of illness or accident, the compulsory basic health insurance covers basic medical services. A monthly insurance payment is charged for such services. In case of illness, each insured person bears a certain part of expenses for the treatment provided. Share in expenses consists of a changed franchise and the insurant’s compensation for losses.
A franchise is the annual amount that the insured person must pay for the treatment. This amount ranges from 300 to 2,500 Swiss francs for adults and can be changed annually. The higher the chosen franchise, the lower the monthly insurance payment. The franchise does not cover children.
Participation of the insurant in compensation for losses
In case of an insured event, participation of the insurant in compensation for losses is 10% of the treatment cost, maximum 700 Swiss francs per calendar year for adults and 350 Swiss francs for children and adolescents under 18 years of age.
Health insurance model
The Swiss insurance offices know different models of compulsory health insurance that comply with the Compulsory Health Insurance Law (KVG), which includes the following:
- Standard model: the right to choose a doctor at will of the insured person.
- Family doctor model: in case of illness, the first visit is made to the family doctor to whom the insured person is assigned.
- HMO model: in case of illness, the first visit is made to the medical center.
- Telemedicine model: in case of illness, the first consultation is carried out by the insurance office over the phone.
Any citizen who works in Switzerland for less than 8 hours and is not insured by the employer against accidents is obliged to conclude an accident insurance agreement with an insurance office. Accident insurance is compulsory for children and adolescents.
In case of hospitalization, the compulsory basic health insurance guarantees the patient to be hospitalized exclusively in a semi-private room. Note: it is necessary to conclude a corresponding additional insurance agreement to obtain personal space in a private or semi-private room and the right to choose a doctor at will.