Save & optimize

Saving in mandatory health insurance (basic insurance)?

In mandatory health insurance, you have numerous options to save on premiums. We will explain to you below how this works. Templates to support correspondence with your health insurance are attached to this documentation.

Saving with the deductible?

The insured individuals have to contribute to the costs of the services provided to them. This cost sharing consists of a fixed annual amount (deductible) on the one hand, and 10% of the costs exceeding the deductible (co-payment) on the other hand. The standard deductible for adults aged 18 and above is 300 Swiss francs per year (0 francs for children). Insured individuals can choose a higher deductible and pay lower premiums for it. Insurance companies can offer the following deductible levels:

• Adults (18 years and older): 500, 1000, 1500, 2000, 2500 Swiss Francs
• Children: 100, 200, 300, 400, 500, 600 Swiss Francs

Attention: You pay lower premiums, but you must cover the costs of services received up to the chosen deductible amount. If you choose a higher deductible, make sure you have access to the relevant amount of money. Also, do not be tempted to avoid or delay seeing the doctor just to save premiums or costs.

The co-payment amounts to 10% of the costs exceeding the deductible, except for original medications that are interchangeable with generics (20%). Your doctor or pharmacist will provide you with information on this matter. In principle, the co-payment is capped at a maximum of 700 Swiss francs per year (350 francs for children).

If multiple children from the same family are insured with the same insurer, the cost-sharing is at most the deductible and the maximum co-payment amount for one adult. For selectable deductibles, the contribution may not exceed twice the maximum amount per child (selectable deductible and co-payment).

The co-payment is 15 Swiss francs per day of hospital stay. No contribution is required for children up to 18 years old, young adults up to 25 years old who are in education, and women for maternity services.

Save by limiting choice of doctor and hospital?
With HMO

An HMO (Health Maintenance Organization) is an organization of doctors who operate within a group practice. Under this model, you always first visit your doctor at the HMO practice. If necessary, you may be referred from there to specialists (if available within the HMO practice, otherwise outside). The HMO center includes general practitioners as well as specialists and therapists from various fields.

You may generally continue to directly visit your gynecologist or ophthalmologist.

Mit dem Hausarztmodell

A primary care physician network is a regional association of independently practicing general practitioners. As a policyholder, you can choose one of these doctors as your primary care physician and thereby waive your right to freely choose a doctor.

You commit to always consult your primary care physician first. They are the first point of contact and coordinator for all medical matters (except in emergencies) and determine whether they can provide the treatment themselves or if the involvement of a specialist is necessary.

Note: You can usually continue to directly visit your gynecologist or ophthalmologist.

With prior telephone consultation.

In addition to models with limited doctor choice (HMO or primary care physician), various insurers offer models that include a telephone medical consultation before each doctor visit. This restriction also allows you to save on premiums. Inquire with insurers about which models they offer.

Saving with the bonus model?

The premium is reduced with each year in which you do not submit any bills for reimbursement.

Note: The initial premium is 10% higher than the standard premium, and the deductible cannot be increased. However, the premium can be reduced to half of the initial premium within 5 years.

Only take out such insurance if you rarely or never require medical treatment. However, do not be tempted to avoid or delay seeing the doctor just to save costs.

Saving while employed?
Premium savings due to exclusion of accident coverage

If you are employed for eight or more hours per week and are insured by your employer against occupational and non-occupational accidents, you should exclude accident coverage from your health insurance. To do this, you must provide your insurer with confirmation from your employer that you are insured against occupational and non-occupational accidents according to the Accident Insurance Act (UVG). You will then pay lower health insurance premiums starting from the following month after your letter.