Private Medical Insurance for Expats Living in Switzerland

Switzerland gives an image of high quality and high cost, which is well preserved within the Swiss healthcare system. With its overall health care expenditure at the top of the league tables, its hospitals and primary care are first class, as you would expect. The increase in health care spend between Switzerland and its other European neighbours, isn’t as great as you would expect when measured as a proportion of GDP. Switzerland’s health care expenditure in 2014 was around 11.7% of GDP.

Citizens of Switzerland often complain about the cost of health care but luckily, they have a dividend for this through extended life expectancy. Even though the Swiss are known for munching on cheese, chocolate and smoking the odd cigar, they still live longer than almost any other nation.

The process of the healthcare system

It is written into Swiss law that everyone in the country must buy and maintain health insurance. Although the system is universal, it is administered by the district in which the individual resides or occasionally in the district where the individual works. There are normally two or more insurance providers or sick funds within each district, which helps to provide an element of competition. However, this is somewhat limited due to the provision of benefits being the same for all. Profit is not a feature with Switzerland’s sick funds, which are run on a similar basis to Britain’s friendly societies, which go back to Victorian times.

Paul Tidy, who set up BUPA international’s operation in Switzerland, mentioned that each district will have two or more sickness funds and that each fund will have contracts in place with local hospitals within their district.

Insurance Excesses and charges

Depending on the region you are living in, premiums can be reduced by up to 40% if an excess on the policy is agreed. Excesses, also known as deductibles, work on the same basis as car insurance, where the insured party pays the agreed excess on any claim. Those who require medical care pay the first 10% of the cost of treatment, which is capped to protect people from having large bills.

Expats get three-month leeway

Expats are advised to register with their district within three months of arriving in the country.  Some of the costs are borne by the canton itself, which is the reason why expats moving to the country will have to go to the residency office of the local canton, where they will be told if a local policy is needed. There is a procedure in place for checking if expats have medical insurance, with one of the sickness funds, and whether they would be willing to accept their international policies in lieu of the sickness fund.

The majority of foreign civil servants, NGO staff and members of permanent missions, are exempted from mandatory insurance but they can join the state health system after six months’ of residency.

Foreign nationals, who travel abroad, do not have an easy process if the individual’s international cover is deemed to be inadequate under Swiss law. Districts can be inconsistent in what they are willing to accept, causing globetrotter’s to end up with two policies. Double insuring is not the intention but a Swiss based expat, who spends half of the year outside the country and who is in need of full protection, may find double insurance to be unavoidable

Globetrotters would need to confirm that any international policy they hold would be good for wherever they travelled, in case they has a flare-up of an existing condition.

It has been stated that expats could be doubly insuring, if their canton did not recognise their international policy. The decision depends on the benefit limits and where these limits are not met, the cantons decisions can be highly variable.

The majority of expats will end up with a local policy, while using an international plan as a top-up. There are good benefits under the state plans such as maternity check-ups and limited dental work, and they are quite comprehensive. Acceptance is decided on a case-by-case basis depending on your employment status and whether you are a student or a retiree. Where you are living and working is another factor.

Employers pay into the national scheme with some of the contribution going to pay welfare benefits.

Some insurers won’t cover Switzerland

Because of the differences between how some districts interpret the rules, it isn’t surprising that some insurers are reluctant to insure or put limitations on their policies.

International premiums

For people paying for international insurance by themselves rather than through an employer, the solution must be to stick with the Swiss national plan and supplement it with travel cover. Repatriation cover could be considered as a luxury, in a country like Switzerland, which provides good healthcare.

For young adults who are doubling insurance, international plans could be good value against the Swiss federal system, due to commercial plans no longer covering the old and middle-ages as they do within the community rated Swiss system. However, this strategy depends on getting your international plan approved.