November is Health Insurance Month
Unless you are on an expatriate contract and receive global health insurance from your home country, you have probably chosen a Swiss health-insurance policy from one of the several dozen providers. Basic health insurance is obligatory in Switzerland, and therefore no company is allowed to refuse this coverage, irrespective of any pre-existing health or medical condition(s). You can also buy supplemental or complementary insurance; however, this is optional and insurance providers are not obliged to provide this to you. Both basic and supplemental insurance coverage differ considerably from one company to another. For the basic insurance (Grundversicherung), the services they have to cover are defined by law and are the same for all insurances. However, the prices can differ significantly, depending, for example, on your deductible, as can options like choice of doctors, need to get a referral, availability of medical helplines, etc. For the supplemental insurance (Zusatzversicherung), not only the price, but also the services that are covered differ widely, and you should look for the one that best fits your needs.
If you are unhappy with your health insurance provider or feel that it is no longer optimal for your family’s needs, you can change your health insurance after cancelling your previous policy, but this can only be done at a specific time of the year, normally in November. Furthermore, different terms apply to the changing of basic insurance and supplemental insurance.
Insurance companies must send their insured a letter to communicate their new premiums by October 31 each year; this letter should also inform customers of their right to cancel. An average increase of about 4% each year is normal, although some premiums can go up as much as 20%. You have the right to change your basic insurance coverage effective January 1, but the notice to cancel your current insurance coverage must be received by your current provider by November 30. Since there can always be delays, it is recommended that you send the cancellation letter by registered mail until mid-November, so that you can prove that you have given notice in due time. Because no insurance company is allowed to refuse you basic health insurance, you can also give notice before having received the confirmation of acceptance from your new provider, even if you are already receiving medical treatment. Once the cancellation letter has been sent and received, the switch to a new insurer becomes final when the existing insurance company receives a confirmation letter from the new one, which needs to happen before the end of the year to ensure uninterrupted coverage. Note, however, that outstanding monthly premiums may prevent you from being allowed to change your insurance.
Only if you have a basic health insurance policy with minimal deductibles (CHF 300 for adults and CHF 0 for children) and free choice of healthcare providers, you may also be entitled to change your health insurance company mid-year, effective July 1; this option, however, requires that the cancellation notice be received by your company no later than March 31. Policyholders whose premiums are increased mid-year must be informed by their insurance provider by the end of April. In this case, you have until the end of May to cancel the contract and switch to another insurance provider, which will commence on July 1.
If you would like more services than a basic health insurance plan provides, you can opt to take out additional insurance, referred to as supplemental or complementary insurance. This optional insurance can cover a range of services not covered by your basic insurance, including dental/orthodontal care, alternative medicine, prenatal care, enhanced hospital care, travel insurance, eye-wear, payments if you are unable to work, etc. Insurance companies are not obliged to provide you these optional insurances and are free to determine their cancellation periods, which are far less flexible than basic insurance policies. The cancellation periods are often longer, many requiring you to stay with them for several years, as well as a minimum of 3 or 6 months notice (6 months before the end of the year translates to an end-of-June deadline); these cancellation periods are stated in the General Terms and Conditions of the supplemental insurance policies. If you wish to take out supplemental insurance with another provider, make sure you wait until your new provider confirms your acceptance, as insurers are not obliged to accept all applicants for supplemental insurance. Supplemental insurance is separate from basic insurance even when bought together; so if you cancel your basic insurance policy but wish to keep your supplemental insurance with your existing provider, you must point this out very clearly in your cancellation letter: “This cancellation only applies to my basic insurance policy. My supplemental insurance shall remain with your company.” If the premiums for your supplemental insurance rise, or if your premiums increase because you enter a higher age group, then cancellation of the policy becomes easier—normally only one month from notification of higher premiums or by year’s end, as stated in the terms of the General Conditions of Insurance.
Finding a New Insurer, Comparing Prices and Coverage
With over 50 different health insurance providers in Switzerland, it can be quite daunting to find the right one for you. The Office Fédéral de la Santé Publique (OFSP) keeps a register of qualifying providers and has a tool for comparing providers called Priminfo (https://www.priminfo.admin.ch/de/praemien; DE, FR, and IT). The new premiums for the following year are published by the end of September each year on Priminfo. In addition, there are commercial comparison websites, such as Comparis (https://en.comparis.ch/krankenkassen/default; DE, FR, IT, and EN) and Bonus (https://www.bonus.ch/Krankenkassen/Vergleich-krankenkasse-praemien.aspx; DE, FR, and IT), that will outline the prices and services for each insurance company to help you find the right one for your family’s needs.Share