Basic health insurance in Switzerland

• Basic health insurance covers conventional medical treatments. These are treatments that have been proven to work through medical trials.
• It also covers the following alternative treatments, subject to them being performed by a doctor with a Swiss degree and a specialist qualification in complementary medicine: acupuncture, anthroposophic medicine, homeopathy, phytotherapy and traditional Chinese medicine.
• Certain services or benefits are not covered or only partly covered by basic health insurance. These include glasses and contact lenses, dental treatments, screening examinations, stays on private or semi-private hospital wards and forms of complementary medicine such as massages and osteopathy. 

Supplementary insurance can help by covering the costs that basic health insurance will not cover in full or at all.

We recommend the following:
Supplementary outpatient insurance
Supplementary hospital insurance
Supplementary dental insurance

The care must be prescribed by a doctor with a Swiss degree. Only then will basic health insurance cover part of the costs. The services and benefits are regulated by the Health Insurance Act (HIA) and the Health Insurance Benefits Ordinance (HIBO).

Basic health insurance covers the cost of care and treatment in a hospital if it is included on the for your canton of residence. In the event of a hospital stay, insured persons must pay not only the deductible and excess but also a flat rate of CHF 15 per day ().

A simple example: If you are in hospital for 10 days, you will pay CHF 150.

Supplementary insurance can help by covering the costs that basic health insurance will not cover in full or at all.

We recommend the following:
Supplementary outpatient insurance
Supplementary hospital insurance

You initially pay bills yourself.

1. You settle the bill for your medical treatment.
2. You send the bill to your health insurer.
3. Your health insurer reviews the bill and refunds you the money minus the deductible, your excess and any non-covered costs.

You do not pay the bill yourself.

1. Your doctor, hospital or another specialist bills the health insurer directly. The health insurer pays the bill.
2. You only pay the deductible, excess and any costs that are not covered by the health insurer. Your health insurer will send you a bill for these.

The co-payment comprises the deductible, excess and hospital cost contribution.

Deductible: The deductible is the amount you need to pay each year towards any health insurance claims. KPT will only pay further costs that exceed this amount. The higher your deductible, the lower your premium. The minimum deductible is CHF 300 for adults and CHF 0 for children. You do not pay a basic health insurance deductible for maternity benefits.

Do you have low health costs and pay less than CHF 1,700 per year? Then select the highest deductible of CHF 2,500.

Do you have high health costs and pay more than CHF 1,700 per year? Then select the lowest deductible of CHF 300.

Excess: Once the deductible has been reached, you will only pay 10% of all further treatment costs. The maximum excess is CHF 700 per year for adults and CHF 350 per year for children. You do not pay a basic health insurance excess for maternity benefits.

Hospital cost contribution: You are liable to pay CHF 15 per day for hospital stays. Children under the age of 18, young adults under the age of 25 and in training/education and women receiving maternity care are exempt from this payment.