Basic or supplementary? A plain-language guide to Swiss health insurance
Every resident needs basic cover, but supplementary insurance is where the real choices are. Here is how the two fit together and what to think about before you sign.
One of the first questions I hear from clients, especially people who have recently moved to Switzerland, is simple: "What do I actually need?" The honest answer is that Swiss health insurance has two layers, and they work very differently.
Layer one: basic insurance
Basic insurance (Grundversicherung, governed by the Health Insurance Act, KVG/LAMal) is compulsory for everyone living in Switzerland. It covers treatment in case of illness, accident (if you are not covered by an employer's accident insurance) and maternity.
The key thing to understand: the benefits of basic insurance are defined by law and are the same with every insurer. What differs is the premium, the service and the insurance model you choose. Insurers also cannot refuse you for basic cover.
The levers you control in basic insurance are:
- Your deductible (franchise). For adults it ranges from CHF 300 to CHF 2,500. A higher deductible means a lower premium, but more out of your own pocket before the insurer pays.
- Your insurance model. Alongside the standard model with free choice of doctor, there are models such as family-doctor, HMO and telemedicine models. You agree to a first point of contact and usually pay a lower premium in return.
- Your insurer. Since the benefits are identical, it is worth comparing premiums. The federal government's comparison site, priminfo.admin.ch, is a good neutral starting point.
Layer two: supplementary insurance
Supplementary insurance (Zusatzversicherung) is optional and covers what basic insurance doesn't, or covers it more comfortably. Typical examples include a semi-private or private hospital ward, broader cover for alternative medicine, glasses and lenses, dental treatment, or treatment abroad.
Supplementary insurance follows different rules. Insurers may ask health questions before accepting you, can apply exclusions, and contract terms can be longer. That is why timing matters: it is usually easier to take out supplementary cover while you are young and healthy than after a diagnosis.
Basic insurance is about what you must have. Supplementary insurance is about what you want to have, and what you can afford if things go wrong.
Three questions to ask yourself
- How often do I see a doctor? If rarely, a higher deductible may save you money. If you have regular treatment, a low deductible often works out cheaper overall.
- What would a hospital stay mean for me? If choosing your doctor or having a quieter room matters, look at hospital supplementary cover.
- What gaps do I already know about? Dental work, glasses, physiotherapy or complementary therapies are common reasons to add specific supplementary products.
One practical warning
If you are switching, never cancel a supplementary policy before the new insurer has confirmed in writing that it accepts you. Basic insurance must accept you; supplementary insurance does not have to.
If you'd like to talk through your own situation, you can reach me by phone or email at the bottom of this page.
