What is obligatory
Any person domiciled in Switzerland must take out basic health insurance according to the LAMal. Newcomers and parents of a newborn generally have three months to choose a fund. If affiliation is made on time, coverage begins retroactively to the date of arrival or birth.
The insurer must accept you for basic insurance, regardless of your age or state of health. LAMal benefits are defined by law and are identical from one fund to another; what mainly changes are the premium, the service, the model and your deductible.
The levers that vary your premium
- The canton and premium region: your home strongly influences the premium.
- Age: child, young adult and adult do not have the same prices.
- The deductible: for adults, it generally ranges from CHF 300 to CHF 2,500. The higher it is, the lower the premium, but the higher the risk you bear increases.
- The model: standard, family doctor, HMO, Telmed or hybrid models can reduce the premium if you accept a defined care pathway.
- Accident coverage: If you work at least eight hours per week with the same employer, you are generally covered against accidents by the employer and can often exclude the accident from LAMal.
Deductible, co-payment: what real cost?
The deductible is the annual amount that you pay yourself before the fund contributes to the costs. Once the deductible is reached, you still pay a 10% share on the costs covered, up to the annual legal ceiling. A high deductible can be interesting if you have few medical expenses, but it requires being able to absorb a significant cost in the event of illness.
Finwise helps you compare the probable total cost: annual premium, deductible, co-pay, accident included or not, and financial risk depending on your situation.
When to change health insurance?
The basic insurance can generally be changed for January 1, provided that the cancellation reaches the old fund on time, generally before the end of November. Under certain conditions, notably with the standard model and the minimum deductible, a change on July 1 may also be possible.
Supplementary insurance follows other rules: they are not subject to LAMal, may require a health questionnaire and must never be canceled before final acceptance by the new insurer.
Who is the analysis useful for?
- You arrive in Switzerland and must register on time.
- Your premium is increasing and you want to compare funds.
- You are hesitating between low deductible and high deductible.
- You want to switch to a family doctor, HMO or Telmed model without any unpleasant surprises.
- You want to separate basic and supplementary insurance to optimize your situation.
Finwise support
We compare recognized funds, models, deductibles and accident options according to your canton and your profile. We also help you secure deadlines, avoid double insurance and coordinate basic and supplementary insurance.