LAMal and complementary: two different logics
Basic LAMal insurance is compulsory in Switzerland and its benefits are defined by law. The funds must accept you, without a health questionnaire. Supplementary insurance is optional and falls under the LCA, private insurance law. Benefits, premiums, exclusions and conditions therefore vary greatly depending on the insurer.
Concretely, a supplement can finance services not covered or only partially covered by basic insurance: complementary medicine, glasses and lenses, prevention, fitness, treatments abroad, dental care, orthodontics, hospital comfort or expanded free choice of hospital.
The most important rule before changing
Never cancel an existing supplement before having received written acceptance of the new insurance. Unlike the LAMal, the insurer can refuse your request, accept with reservation or exclude certain benefits after analysis of the health questionnaire.
Termination deadlines depend on the general conditions. Many contracts provide for receipt of termination no later than September 30 for exit by December 31, but some impose longer deadlines or minimum periods. The CGA and the police are always authentic.
What Finwise checks with you
- Your real needs: family, glasses, dental care, alternative medicine, sport, travel, maternity or hospitalization.
- Your eligibility: health questionnaire, current treatments, history, possible reservations or waiting times.
- The premium/benefits ratio: annual ceilings, reimbursed percentages, deductibles, recognized suppliers and exclusions.
- Duplicates: coverage already included via employer, credit card, travel insurance, LAA accident or existing contract.
- The calendar: request the new offer, wait for acceptance, then only organize termination if the change is advantageous.
Hospitalization
Basic insurance covers hospitalization in a common ward according to LAMal rules. Additional hospitalization can add more freedom and comfort: choice of hospital throughout Switzerland according to the formula, semi-private or private room, expanded free choice of doctor, or flexible model allowing you to decide on the division at the time of entry to the hospital.
This coverage must be chosen with caution, as it is often subject to health questionnaires, waiting times and specific conditions, particularly in the event of maternity or planned intervention.
Dental
Current dental costs are poorly covered by LAMal, except for serious illnesses or accidents according to the applicable rules. A dental supplement can participate in check-ups, dental hygiene, cavities, treatments, implants or orthodontics, but the ceilings, reimbursed percentages and waiting times vary greatly from one offer to another.
For children, orthodontics deserves analysis early, before the need is already diagnosed. For adults, you must compare the cost of the premium with the actual usable ceilings.
Ambulatory, prevention and complementary medicine
Outpatient supplements can cover highly sought-after services: osteopathy, acupuncture, naturopathy or other therapies recognized by the insurer, glasses and lenses, medicines not reimbursed by basic insurance, vaccines, prevention, fitness subscriptions, relief and treatments abroad. The important thing is not to choose the longest list, but the one that corresponds to your way of treating yourself.
When to subscribe?
The best time is often before the appearance of a health problem, before an important family project or upon arrival in Switzerland. Once a diagnosis, treatment or medical recommendation exists, the insurer can place a reservation or refuse certain benefits. The questionnaire must be completed completely and accurately: an omission may result in termination of the contract and refusal of services.
Our support
Finwise helps you turn a complex comparison into a clear decision: which complements to keep, which to add, which to avoid, and in what order to act. We analyze your needs, your budget, your existing contracts and the conditions of Swiss insurers to limit unpleasant surprises.