Basic health insurance (KVG)
The basic health insurance according to KVG: Services and Models
Since 1996, every Swiss citizen has had to take out compulsory basic health insurance under the Swiss Health Insurance Act (KVG). It enables you to benefit from basic health services in the event of illness, accident or pregnancy. While the benefits are the same for every health insurance company, the insurers charge different premiums. Savings can be made with alternative insurance models.
What does KVG basic insurance cover?
If you live in Switzerland, you must take out compulsory health insurance. As this is compulsory insurance, the health insurance funds must not deny anyone access to the so-called basic insurance. You receive insurance cover regardless of your age and any previous illnesses.
The KVG regulates which benefits must be covered by the compulsory basic insurance. The amount of cover is laid down in the Krankenpflege-Leistungsverordnung. In principle, the health insurance fund pays for necessary medical treatment and medication if these are "effective, expedient and economical".
Other benefits include:
- Emergency assistance
- Transports and rescue operations
- Accommodation in the hospital and in day-care facilities
- Rehabilitation and care
- therapeutic measures such as ergotherapy, physiotherapy and chiropractic
- certain alternative medical treatment methods
Basic insurance must be taken out for each child after birth. If you move to Switzerland for the first time, you have three months to find a suitable health insurance company.
Contribution to basic insurance costs
For basic medical care there is a cost sharing. This is divided into the so-called annual deductible and the deductible. The ordinary annual deductible is 300 Swiss francs per year. Up to this amount, you bear the costs of treatment and medication yourself. If the costs exceed the franchise, they will be covered by the health insurance. You only pay a deductible of 10 percent, a maximum of 700 Swiss francs per year for adults and 350 Swiss francs for children.
By choosing a higher deductible rate, you can reduce your monthly premiums. Adults over the age of 26 can set franchises of up to CHF 2,500 per year.
Same benefit - different premiums
Although the benefits in the basic insurance are the same, the health insurance companies charge different insurance premiums. The Federal Office of Public Health (FOPH) divides the health insurance funds into different premium regions. More medical services are available in urban regions than in rural ones. The monthly premiums also differ accordingly.
The alternative insurance models of basic insurance
You can save on insurance premiums by opting for an alternative insurance model. In the standard model, you have a free choice of doctor. The alternative insurance models limit the choice of your first contact person.
- Family doctor model: In the event of illness, you first contact your family doctor.
- HMO model: In the event of illness, you first go to a group practice (HMO).
- Telmed model: Your first point of contact is the hotline of a telemedicine advice centre.
If necessary, your first contact will refer you to a specialist or hospital for further treatment.
Compare health insurance companies and find the right insurance model
Not every health insurance company offers all alternative insurance models. Some insurers, on the other hand, supplement this selection and, for example, have models in their programme in which you first contact a partner pharmacy in the event of illness. Make our insurance comparison and find out which health insurance company offers you the cheapest basic insurance.