Introduction
In Switzerland, health insurance is a legal requirement for all residents. Its cost represents a significant portion of household budgets and varies considerably depending on several key factors.
Understanding these variations and the available options allows residents to make informed decisions about their medical coverage while optimizing their expenses in this essential area.
Let’s take a closer look at how Swiss health insurance works, its costs, and the ways to save money.
The fundamental principles
Basic health insurance, known as LaMal (Federal Health Insurance Law), is mandatory for everyone residing in Switzerland, regardless of nationality or residency status. This requirement takes effect within three months of moving to Swiss territory. This basic insurance covers a wide range of medical services:
- Consultations with general practitioners and specialists
- Hospital treatments (in the general ward)
- Prescribed medications listed on the official drug list
- Certain preventive and screening exams
- Care during pregnancy and childbirth
Factors influencing the cost
Unlike in other countries, health insurance premiums in Switzerland are not calculated based on income. Several factors determine the cost:
-> The chosen annual deductible (franchise)
Deductibles range from CHF 300 to CHF 2,500 for adults. The higher the deductible, the lower the monthly premium. This choice should be based on your health condition and how often you expect to need medical care.
"For a healthy person who rarely visits the doctor, choosing a high deductible can lead to significant savings on annual premiums."
-> Canton of residence
Premiums vary greatly between cantons. Urban areas like Geneva and Zurich usually have higher premiums than rural regions. This difference is due to factors like the density of medical facilities and local healthcare usage habits.
-> Age of the insured person
Children (up to age 18) and young adults (up to 25) receive reduced premiums. From age 26, all insured people with the same insurance provider, living in the same canton, and using the same insurance model, theoretically pay the same premium, no matter their age.
-> The insurance model chosen
Several alternative models can reduce premiums:
- Family doctor model: You must first consult your general practitioner (GP).
- HMO model: You get care through a specific health center (Health Maintenance Organization).
- Telemedicine model: You must first have a phone consultation with a medical advice center.
Average costs and variations
According to recent data, the average monthly premium for an adult with the minimum deductible (CHF 300) is around CHF 450. However, this average hides significant differences:
- In some urban cantons, like Geneva, premiums can exceed CHF 500 per month
- In more rural cantons, they can drop below CHF 400
For a family of four (two adults and two children), the annual budget for basic health insurance can easily reach CHF 12,000 to 15,000, which represents a substantial financial burden.
Optional insurance coverage
In addition to basic insurance, residents can take out supplementary insurance that covers:
- Hospital stays in semi-private or private rooms
- Alternative medicine (acupuncture, homeopathy, etc.)
- Dental care
- Costs for glasses and contact lenses
These complementary insurance plans are not mandatory, unlike basic insurance, and their prices vary greatly depending on age, health condition, and the level of coverage desired.
Financial aid and optimization
Given the significant impact of premiums on household budgets, several solutions are available:
-> Cantonal subsidies
Each canton offers a premium reduction system for people with modest incomes.
The eligibility criteria and amounts vary from one canton to another.
-> Changing insurer annually
Policyholders can change their health insurance provider each year to benefit from better rates.
Cancellation must usually be sent before November 30 for the change to take effect on January 1 of the following year.
The potential savings from switching insurers can reach several hundred francs per year, with no difference in the benefits covered by basic insurance, since these are identical across all providers.
Conclusion
The Swiss health insurance system, although expensive, provides high-quality medical coverage to the entire population.
To optimize your expenses while maintaining adequate protection, it is recommended to regularly review your situation and explore the different options available.
The specialists at Assurance Genevoise can support you in this process and help you identify the solution best suited to your needs and budget.
