Dear Frau: How does Swiss Health Insurance Work?

Welcome to another edition of Dear Frau. It's kind of like Dear Abby, except with an international twist. If you've got a question about expat life in Switzerland or moving to Switzerland, don't hesitate to contact the Frau and maybe your little Frage will be in the next edition of Dear Frau.

Dear Frau,

I am relocating to Fribourg with my husband from September through July, 2012. He received a Fulbright grant to study at the University of Fribourg, and I get to tag along. We're currently trying to navigate the private insurance world; he'll be covered by the university but I have to buy my insurance. Do you have any pointers on how Swiss health insurance works for expats and what companies to contact?

Sincerely,

Yet to be insured expat in Switzerland

Dear yet to be insured expat in Switzerland,

Swiss health insurance works no differently for expats than it does for Swiss people. Everyone in Switzerland is required to have health insurance—if you can’t prove to your city hall that you have it, they will personally sign you up. Health insurance is not paid for by employers, like it is in the United States. This is both good and bad. Good because no matter your employment status, you have insurance. Bad because it can be expensive. But the best part about Swiss insurance is that you CANNOT be denied basic health insurance for any reason.

The Frau is of the opinion that the basic, compulsory Swiss health insurance is satisfactory for most people and that there is no point to pay more than necessary to have benefits like private rooms at a hospital, since opportunities to upgrade can be paid for separately if desired.

All Swiss health insurers offer basic insurance. All you need to do is compare the price, because as far as the Frau knows, the benefits will be basically the same. (Basic insurance does not include dental or eye care).

Before the Frau signed up for insurance, she got quotes from a couple insurers and compared insurance rates on comparis.ch.

Basically, she ended up choosing Helsana, because their website was in English and they had one of the lower prices, but then Helsana somehow signed her up with SanSan, a division of Helsana that does not have a website in English. The Frau is not sure how this happened but then again she’s not sure how a lot of things happen in the country, and she’s been here over five years.

Nevertheless, despite missing her fantastic international insurance through CIGNA, which also covered dental and eye care with no deductibles, so far the Swiss insurance through SanSan has been satisfactory and for medications/vitamins not covered by it, the Frau hops over the border and buys in Germany where they are 75% less expensive. (Before you move, buy basic medicines, for example, Centrum Vitamins in the US are about $6.95 but in Switzerland the same bottle is $50).

With the basic insurance you have several options; the Frau chose the option that allowed her to go to any doctor, since even though she lives in Canton Aargau she already had several doctors she went to in Zurich at the time she had to switch from international to Swiss insurance. This option for free choice of doctors costs about CHF 20 more a month on her plan. The Frau pays about CHF 162 ($222) a month for basic Swiss insurance with this option with a CHF 2500 ($3440) deductible, which is the highest deductible. With lower deductibles, the monthly fees are higher.

As far as the Frau can tell, someone on basic Swiss insurance will end up spending about CHF 5000 ($6881) a year to be insured before the insurance company starts paying your medical bills. (This CHF 5000 includes the monthly fees, the deductible, and the extra CHF 700 they don’t tell you about that you must also pay before the insurance pays additional costs). There are some exceptions, i.e. pregnant women are exempt from paying deductible costs for most doctor visits and normal procedures related to pregnancy.

For more information, the Frau recommends reading the following:

Health insurance for people new to Switzerland

Benefits and FAQ about Swiss health insurance (download the PDFs, they are very helpful).

Anyone else want to chime in about their experience with Swiss insurance or what insurers they’ve liked/hated?