Sunday, August 14, 2011

Dear Frau: How does Swiss Health Insurance Work?

Welcome to another edition of Dear Frau. It's kind of like Dear Abby, except with an international twist. If you've got a question about expat life in Switzerland or moving to Switzerland, don't hesitate to contact the Frau and maybe your little Frage will be in the next edition of Dear Frau.

Dear Frau,

I am relocating to Fribourg with my husband from September through July, 2012. He received a Fulbright grant to study at the University of Fribourg, and I get to tag along. We're currently trying to navigate the private insurance world; he'll be covered by the university but I have to buy my insurance. Do you have any pointers on how Swiss health insurance works for expats and what companies to contact?


Yet to be insured expat in Switzerland

Dear yet to be insured expat in Switzerland,

Swiss health insurance works no differently for expats than it does for Swiss people. Everyone in Switzerland is required to have health insurance—if you can’t prove to your city hall that you have it, they will personally sign you up. Health insurance is not paid for by employers, like it is in the United States. This is both good and bad. Good because no matter your employment status, you have insurance. Bad because it can be expensive. But the best part about Swiss insurance is that you CANNOT be denied basic health insurance for any reason.

The Frau is of the opinion that the basic, compulsory Swiss health insurance is satisfactory for most people and that there is no point to pay more than necessary to have benefits like private rooms at a hospital, since opportunities to upgrade can be paid for separately if desired.

All Swiss health insurers offer basic insurance. All you need to do is compare the price, because as far as the Frau knows, the benefits will be basically the same. (Basic insurance does not include dental or eye care).

Before the Frau signed up for insurance, she got quotes from a couple insurers and compared insurance rates on

Basically, she ended up choosing Helsana, because their website was in English and they had one of the lower prices, but then Helsana somehow signed her up with SanSan, a division of Helsana that does not have a website in English. The Frau is not sure how this happened but then again she’s not sure how a lot of things happen in the country, and she’s been here over five years.

Nevertheless, despite missing her fantastic international insurance through CIGNA, which also covered dental and eye care with no deductibles, so far the Swiss insurance through SanSan has been satisfactory and for medications/vitamins not covered by it, the Frau hops over the border and buys in Germany where they are 75% less expensive. (Before you move, buy basic medicines, for example, Centrum Vitamins in the US are about $6.95 but in Switzerland the same bottle is $50).

With the basic insurance you have several options; the Frau chose the option that allowed her to go to any doctor, since even though she lives in Canton Aargau she already had several doctors she went to in Zurich at the time she had to switch from international to Swiss insurance. This option for free choice of doctors costs about CHF 20 more a month on her plan. The Frau pays about CHF 162 ($222) a month for basic Swiss insurance with this option with a CHF 2500 ($3440) deductible, which is the highest deductible. With lower deductibles, the monthly fees are higher.

As far as the Frau can tell, someone on basic Swiss insurance will end up spending about CHF 5000 ($6881) a year to be insured before the insurance company starts paying your medical bills. (This CHF 5000 includes the monthly fees, the deductible, and the extra CHF 700 they don’t tell you about that you must also pay before the insurance pays additional costs). There are some exceptions, i.e. pregnant women are exempt from paying deductible costs for most doctor visits and normal procedures related to pregnancy.

For more information, the Frau recommends reading the following:

Health insurance for people new to Switzerland

Benefits and FAQ about Swiss health insurance (download the PDFs, they are very helpful).

Anyone else want to chime in about their experience with Swiss insurance or what insurers they’ve liked/hated?


Kelli Shoe said...

I have the more expensive Avanex plan due to my husband's belief that I'm a hypochondriac. Had great luck with it so far, including acceptance at my OB-GYN, walk-in clinics and apothecaries.

Because of the short time of your stay, I second the advice to stock pile basic OTC meds. I used the mail order feature through my US insurance to build up my birth control pills and regular RXs in order to delay needing doctors here.

Safe travels.

Adrian said...

Something most people don't see when they compare Swiss health care and insurance costs is the difference between illness and accident.

I walked my dog and got bit by a tick. This was considered an accident and not illness. Hence, it was not covered by health insurance but my employer's accident insurance. So, if you don't work for whatever reason ask for the accident raider on your health insurance.

Amy said...

Re: the 700 chf additional - I thought that was a safety net/stop loss? In other words, you pay your premium, your deductible, and then 10% of additional costs ... but only up to 700 chf. So, if you had 8000 chf of medical costs above your deductible, you'd only pay 700 chf, not 800 chf.

I've in the throes of choosing insurance now, so I've also been reading a lot :)

Amy said...

Also, thanks for the links - more things to read :)

Chantal said...

Thanks, Adrian, yes, I forgot to mention the accident insurance, which IS covered by employers if you work. If not, I believe it costs about an extra CHF 20 a month. So if you fall and break your arm skiing, this is an accident, and covered by accident insurance and not your regular health insurance.

Another thing to note is as far as I know, Swiss insurance covers you outside of Switzerland as well, up to twice the cost that the procedure would cost in Switzerland. So sadly, the main country they recommend travel insurance for is the U.S., where apparently medical costs are even more than twice the Swiss ones...

Chantal said...

Amy, yes, thanks for that, I believe you are correct, they call that CHF 700 cost-sharing.

Allison L said...

There was a point where I wanted to personally go into the Agilia office and give them a piece of my mind. Crappiest services that I've ever received and they didn't work well with what the canton Zurich said I was to do.

We ended up having to contact a ombudsman to be the intermediary between us. Thankfully we won and didn't lose out on 1,300 CHF.

I haven't even been to the doctor in Switzerland. Hopefully won't have to. Sucked it up when I had some bad colds. Made sure to stock up on BC while I was in the US. Along with going to my Dr.s there.

Chantal said...

Sorry to hear about your bad experiences. I've had a few, but in general I like the fact that most Swiss doctors don't seem to be as rushed as American ones and that they actually listen to you first at a desk in their office while you're fully clothed before examining you. Most charge you by the minute, so they're happy to take as much time with you as you want them too.

Hattie said...

Frau: I wish there had been someone to explain the Swiss system to me so clearly! I never did figure it out in all the years I lived there.

Steven said...

If she's the partner of a visiting researcher (grad student, postdoc, visiting fellow, etc...) she's probably eligible for Swisscare (

This insurance is way way cheaper than any of the other listed (~280 CHF per quarter for me with a 500 CHF deductible).

Chantal said...

Thanks for the info Steven. That's good to know!

Ashley said...

Indeed, paying for your own health insurance plans is advantageous in some way. However, in today's economy, it would be better if the Swedish government would do something about this set up.

Valerie Phillips said...

I believe in Switzerland, everyone is required to have health insurance. In the United States though, employees are the one paying the insurances.

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Samuel Wilson said...

I guess it's not surprising that some health insurance companies have ridiculous policies. Of course, if you put yourself in their shoes you also wouldn't want to cover an accident prone person.
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Billy said...

Health insurance plans are among the best investments you can give to yourself. It can be used in case of severe health conditions. In case of head injuries and other serious ailments caused by accidents, it is also important to get a lawyer that will help you file a complaint against the other party. Lawyers can also help you hasten any compensation you can get from your insurance company. motorcycle accident attorney los angeles

Anne said...

It is indeed a very good idea to invest some of your money to health insurances. This will give you the confidence to pay your hospital bills in case of accidents. Aside from this, it is also imperative to hire a lawyer that will be able to hasten the process of claiming any benefit.

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RJ said...

Dear Frau,

I really like your article on health insurance in Switzerland (and your other articles in general). I usually go to North America to stock up on meds there, which helps with the shocking costs in the CH!
I've created a site about expat life in Basel, CH with a page there too!
Hope you're enjoying it here. We should exchange links in our resource sections..
Take care,

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go insurance said...

I have a good experience with insurance companies, most agencies offer similar travel insurance plans for roughly the same cost. Some even include your airfare automatically.

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