Health insurance made simple
Anyone can fall ill and require medical assistance. Everyone living in Switzerland has cover with a health insurer like CSS so that they don’t have to pay all the costs out of their own pocket. It’s important to know the terms used in this context, such as deductible, premium and retention fee, and we can help you understand them.
Health insurance in Switzerland
Our health insurance system is made up of two parts. On the one hand, there is mandatory healthcare insurance, also known as 'basic insurance', which is governed by social insurance law (Federal Health Insurance Act, KVG). In addition, there is voluntary supplementary insurance, which is governed by private law (Federal Insurance Contract Act, VVG).
Basic insurance is mandatory
So that they don't have to bear all the costs themselves if they fall ill, everyone living in Switzerland has cover with a health insurer like CSS. Mandatory basic insurance ensures that everyone in Switzerland has access to comprehensive, high-quality primary healthcare. Health insurers are not permitted to turn anyone down: They are required to accept everyone wishing to take out insurance and must offer the same services and benefits to all insured persons.
Basic insurance covers illness, accident and maternity
All health insurers pay the same benefits for illness, accident and maternity. The monthly premium for basic insurance depends on where you live and your age, insurance model and deductible. Notice of cancellation for basic insurance can be given by the end of November each year, or in exceptional cases at the end of March.
Choose your basic insurance
Go directly to your family doctor
Family doctor model
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The family doctor you know and trust is your main point of contact.
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You can see an eye doctor, gynaecologist or midwife directly.
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At least 10% premium discount.
Recommendation
All the benefits of a doctors’ network
HMO model
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The chosen doctor’s practice from the medical network or the group practice is your first point of contact.
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You can see an eye doctor, gynaecologist or midwife directly.
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At least 13% premium discount.
Advice digitally or by phone
Telmed
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Your first point of contact is the Well app or the telemedicine centre.
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You can see an eye doctor, gynaecologist or midwife directly.
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At least 10% premium discount.
Ideal for high medical bills
Multimed
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The Multimed practice, telemedicine centre or Well app is your first point of contact.
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You can see an eye doctor, gynaecologist or midwife directly.
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Premium discount of at least 15% and CHF 300 less as a retention fee.
Deductible and retention fee in a nutshell
The deductible is a form of co-payment in Swiss basic insurance. It is the amount that you, the insured person, pay towards your treatment costs. You can choose the deductible: You must pay at least the first CHF 300 of your treatment costs each year, or you can opt to pay up to CHF 2,500 or various amounts in-between. The deductible for children at CSS ranges from CHF 0 to CHF 600.
A high deductible means a lower premium: The higher a deductible you choose, the more you save on premiums.
Choose the right deductible
Check how much you spend on healthcare each year: under CHF 1,500? Choose a deductible of CHF 2,500. More than CHF 2'000? Choose CHF 300.
You can change your chosen deductible each year, regardless of your medical history. You have until 30 November to lower it and until 31 December to increase it.
When do you pay a retention fee?
Once the deductible amount has been reached, your health insurer pays a share of all further costs above this. You then only pay the retention fee and the contribution to hospital costs. Together, they make up your co-payment. All health insurers charge the same retention fee for basic insurance.
- Adults: 10%, up to a maximum amount of CHF 700 a year.
- Children: 10%, up to an amount of CHF 350 a year.
With Multimed, you benefit from a reduced retention fee of no more than CHF 400. For children, the maximum amount is always CHF 350.
Close gaps easily with supplementary insurance
In Switzerland, voluntary supplementary insurance rounds out the benefits covered by basic insurance. Because basic insurance doesn’t cover all the costs, health insurers offer different forms of insurance and cover.
Popular forms of cover include the costs of a stay in hospital or a stay abroad, specialists, alternative medicine, preventive examinations, orthodontics and vaccinations.
Basic insurance doesn’t cover all your healthcare costs
From alternative medicine to the Zilgrei method: Supplementary insurance from CSS closes the gaps in your cover. When applying for supplementary insurance, you need to answer questions about your health.
Anyone taking out supplementary insurance when they are young and healthy cannot suddenly be excluded or turned down in later life.
Private, semi-private, general – free choice in hospital
If a stay in hospital is called for, hospitalisation insurance is really worth having. Before being admitted, you choose whether you’d like to stay in a general, semi-private or private ward. Hospitalisation insurance gives you a free choice of hospital anywhere in Switzerland and pays contributions towards births at home or in a birth centre. What's more, you won't be faced with any additional expenses in the event of an emergency abroad.
Good to know: Children under 18 and adults under 25 who are still in education don't pay a retention fee on their stay in hospital.
What payments does health insurance cover?
All Swiss health insurers pay the same contributions under basic insurance – including CSS. The situation varies in the case of supplementary insurance, depending on the health insurer.
Have you ever asked yourself whether or not your insurance covers a particular benefit? myCSS lets you see right away what CSS pays: fitness, massage, acupuncture, dental braces and more.
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