Health insurance made simple
Deductible, premium, retention fee: these are just a few of the terms commonly heard in relation to health insurance. Our overview provides clarity.
Health insurance for your health
"It's better to worry a little more about your health every day than to worry a lot about your illness later." These words of wisdom were spoken by naturopath Sebastian Kneipp 150 years ago.
No-one is invulnerable, and any one of us can suddenly find ourselves in need of medical care, a stay in hospital or several operations. So that they don't have to bear all the costs themselves if they fall ill, everyone living in Switzerland has cover with a health insurer like CSS.
The Swiss health insurance system
Our health insurance system is made up of two parts. On the one hand, there is mandatory healthcare insurance, also known as 'basic insurance', which is governed by social security law (Federal Health Insurance Act, KVG). In addition, there is voluntary supplementary insurance, which is governed by private law (Federal Insurance Contract Act, VVG).
Health insurance premiums at a glance
Mandatory basic insurance ensures that everyone in Switzerland has access to comprehensive, high-quality primary healthcare. Health insurers are not permitted to turn anyone down: they are required to accept everyone wishing to take out insurance and must offer the same services and benefits to all insured persons. Basic insurance covers illness, accident and maternity, and can be changed at the end of November and in exceptional cases at the end of March.
Save on basic insurance: choose the right model
Telemedicine, family doctor model or doctors' network: the Multimed, Family Doctor, HMO and Telmed alternative insurance models let you save on premiums while still enjoying the same benefits. Choose the insurance that’s right for you:
Deductible and retention fee
The deductible is a form of co-payment in Swiss basic insurance. It is a standard fixed amount that you, the insured person, pay towards your treatment costs. You can choose the deductible: you must pay at least the first CHF 300 of your treatment costs each year, or you can opt to pay up to CHF 2,500 or various amounts in-between. The deductible for children at CSS ranges from CHF 0 to CHF 600.
The deductible is not the same as the retention fee
Once the deductible amount has been reached, your health insurer pays a share of all further costs above this.
- Adults: 10% up to a maximum of CHF 700 a year.
- Children: 10% up to a maximum of CHF 350 a year.
In Switzerland, voluntary supplementary insurance rounds out the benefits covered by basic insurance. Health insurers offer different forms of insurance and cover.
Popular forms of cover include the costs of a stay in hospital or a stay abroad, specialists, alternative medicine, preventive examinations, orthodontics and vaccinations.
Basic insurance doesn’t cover all your healthcare costs
From alternative medicine to the Zilgrei method: supplementary insurance from CSS closes the gaps in your cover. When applying for supplementary insurance, you need to answer questions about your health.
If a stay in hospital is called for, hospitalisation insurance is really worth having. Before being admitted, you choose whether you’d like to stay in a general, semi-private or private ward. Hospitalisation insurance gives you a free choice of hospital anywhere in Switzerland and pays contributions towards births at home or in a birth centre. What's more, you won't be faced with any additional expenses in the event of an emergency abroad.
Good to know: Children under 18 and adults under 25 who are still in education don't pay a retention fee on their stay in hospital.
What does CSS pay?
All Swiss health insurers pay the same contributions under basic insurance – including CSS. The situation varies in the case of supplementary insurance depending on the health insurer. Find out what costs CSS covers.