What Does Swiss Supplemental Health Insurance Actually Cover?

In Switzerland, you can get supplemental health insurance to complement the basic, mandatory health insurance which all residents must have. If you want to know what is already covered by mandatory health insurance, you can find out in the guide to Swiss compulsory health insurance coverages.

Unlike compulsory health insurance offers, which all have the same insurance coverage, supplemental outpatient health insurance offers bundle many different coverages and each offer is different. There are a few things which all insurers cover, but many are only covered by some insurance companies, or are only included in more expensive insurance models or in optional insurance riders.

You can find the offers which match your specific needs using the filters in the interactive supplemental health insurance comparison on moneyland.ch. You can also sort offers based on how good specific coverages are.

To calculate the cost of supplemental health insurance, first look at coverage for things you already pay for out of your own pocket (gym memberships or glasses and contact lenses, for example). You can then deduct those benefits from the total cost of insurance premiums, since they are direct savings. The remaining amount is what you would pay for the other insurance coverages.

Costs which are covered by all supplementary outpatient insurance offers:

• Medicines

All supplemental health insurance offers provide coverage for some medicines which are not covered by mandatory health insurance. The majority cover medicines approved by the Swiss Agency for Therapeutic Products (Swissmedic), but some insurance providers use their own lists of medicines which are covered by their outpatient insurance.

Costs which are covered by some supplementary outpatient insurance offers:

• Alternative medicine

Many offers include additional insurance benefits for alternative medicine, but how much of the cost is covered varies between offers. You can find more information in the guide to health insurance coverage for alternative therapies.

• Ambulances

Most – but not all – Swiss supplemental health insurance offers cover ambulance costs both in Switzerland and abroad, up to certain limits. This extends the low ambulance cover from mandatory health insurance.

• Check-ups

Benefits covering routine medical examinations are common. Some are limited to gynecological examinations, while others also cover general examinations. Offers which include this coverage typically have annual limits on the amount you can claim. The least favorable offers in this regard only cover one examination every 3 years, while the most favorable cover up to 90 percent of check-up bills, with no limit on the amount you can claim each year.

• Childbirth

Swiss mandatory health insurance coverage already includes basic benefits for pregnancy and childbirth. Many supplemental insurance offers have additional benefits for ultrasounds, birthing classes, and fitness training. Some pay out a flat benefit to mothers who nurse their babies in order to encourage breastfeeding.

• Dental work

Most outpatient insurance policies do not cover dental work. Some include limited coverage for dentist and dental hygienist bills (50 percent of costs, maximum 100 francs per year, for example). Some cover part of the costs of dental surgery, such as removal of wisdom teeth. The dental benefits included in some offers only apply to children and teenagers, but there are a few which cover dental work for adults as well. Many health insurance providers also offer specialized dental insurance. You can get more information in the guide to dental insurance in Switzerland.

• Dietary consultation

Some offers insure the costs of dietary consultation prescribed by a doctor, when these are not covered by mandatory health insurance. Limits on how many consultations fall under the insurance coverage vary between offers.

• Glasses and contact lenses

Health insurance coverage for glasses and eyeglasses is included in many offers. Some also cover visual training. How much of the cost is covered varies between the offers. You can find detailed information about coverage for glasses and contact lenses on the information pages of products in the supplemental health insurance comparison.

• Gym memberships

Some insurers include health and wellbeing benefits in their complementary health insurance offers, or let you add an optional rider with this coverage. These benefits are meant to promote good health, and may cover gym memberships, yoga courses, and climbing center subscriptions, among other things.

• Home-based care

Doctor-prescribed home-based medical care is covered by some complementary insurance offers. Some cover the cost of household help when you are too ill to do the housework, up to certain limits (50 francs per day for up to 30 days, for example). A handful cover the cost of childcare when you are physically unable to care for your kids. Some cover tutoring for children who are unable to attend school while recovering from an illness or accident.

• Legal expenses

Legal insurance coverage for costs arising from legal disputes between medical service providers and you as a patient is included in some Swiss supplemental health insurance offers. The coverage only applies to emergency medical care outside of Switzerland while traveling. If you already have a dedicated legal insurance policy, then this risk may already be covered. You can use the filters in the interactive legal insurance comparison to find out if your insurance covers patient law.

• Medical emergencies outside of Switzerland

Most offers either cover medical emergencies during travel outside of Switzerland, or let you add travel insurance for medical emergencies. In every case, only medical emergencies are covered, and not routine medical care or examinations. 

There are limits on how much travel is covered (up to 60 days per trip or 120 days per year, for example). Typically, supplemental insurance covers the outpatient and hospital expenses which exceed the costs paid by mandatory health insurance and accident insurance. Some offers limit coverage to a maximum sum insured.

• Orthodontics

Many Swiss supplemental health insurance offers cover part of the cost of braces and other orthodontic procedures. This coverage generally only applies up to the age of 18, 20, or 25, depending on the insurance offer. The most favorable offers in this regard cover 80 percent of the cost, up to a maximum of 10,000 francs per year. The supplementary health insurance comparison lets you filter and sort offers based on their coverage for tooth misalignment treatments. You can find out more in the guide to health insurance dental coverage for children.

• Otoplasty (ear corrections)

Cosmetic surgery to correct ear deformities is covered by some policies, with the most favorable offers covering up to 90 percent of this cost.

• Personal medical equipment

Equipment like glucose monitoring devices, hearing aids, wheelchairs, and others are covered by mandatory health insurance if they are on the list of eligible medical aids published by the Federal Office of Public Health (FOPH). Some supplemental outpatient insurance offers cover medical aids which are not covered by mandatory health insurance, if they are on the insurance company’s own curated list.

• Search and rescue

Most supplemental health insurance offers pay part of the cost of search and rescue operations in Switzerland and abroad. Coverage varies broadly between offers. The same insurance policy may have a lower limit for Switzerland and a higher limit for search and rescue outside of the country. Some offers have a lower limit for search operations and a higher cap for rescue operations. You can filter and sort offers based on their search and rescue coverage using the supplemental health insurance comparison. Details are available on the product information pages. To find out how you are already covered, and whether or not you need additional insurance, consult the guide to Swiss insurance for ambulance transportation, search, and rescue.

• Spas and convalescent therapy

A number of offers cover spa and thermal bath therapies which are prescribed by a doctor. This adds to the spa coverage from mandatory health insurance. Some supplemental health insurance offers cover part of the cost of spa and thermal bath visits or yearly entry passes. In this case, these benefits are normally included in the same health and wellbeing allowances which cover gym memberships.

• Sterilization

Vasectomies are covered by many complementary insurance offers. Coverage ranges between just 300 francs at the bottom end to 90 percent with no limit. You can easily find the insurance policies with the highest vasectomy coverage using the filter and sort tools in the supplemental health insurance comparison.

• Transplants

Some offers specifically exclude transplants (organ or bone marrow transplants, for example), while others cover these medical procedures. If this is important to you, make sure to check the terms and conditions to find out if transplants are insured before signing up for a supplemental health insurance offer.

• Vaccinations

The vast majority of offers cover the cost of vaccinations. Depending on the offer, the insurance pays between 75 and 90 percent of the cost. Some offers have an annual limit on vaccination benefits, and these limits range between 100 and 1000 francs per year. Some have no limits at all. You can find more on this topic in the guide to Swiss health insurance cover for vaccinations and preventative care.

Costs which are never covered by supplementary outpatient insurance:

• Hospital stays in Switzerland

Many supplemental outpatient insurance offers cover the cost of stays at hospitals outside of Switzerland for medical emergencies while traveling, but hospital stays in Switzerland are not covered. If you want to extend the hospital coverage from mandatory health insurance, you can get complementary general ward insurance, semi-private ward insurance, or private ward insurance. You can easily find the most affordable offer for your specific needs using the interactive supplemental hospital insurance comparison.

Situations which are not always covered:

• Accidents

Supplemental health insurance policies generally cover medical costs resulting from either accidents or illness. But some give you the option of excluding accident cover to lower your insurance premium.

• Earthquakes

Medical costs arising from earthquakes are generally not covered.

• High-risk activities

Medical expenses which result from your engaging in high-risk ventures – including many extreme sports – are generally excluded from supplementary health insurance cover. However, there are a handful of exceptional offers which do cover medical bills in this case, but only up to a certain limit (250,000 francs, for example). You can learn more about how high-risk ventures are defined in the Swiss guide to insuring extreme sports.

• Pandemics

Some supplemental health insurance offers do not pay out benefits if the illness you are hit with has been declared an epidemic or pandemic. However, there are many offers that do not have this exclusion, so if pandemic coverage is important to you, make sure to review the exclusions listed in an offer’s terms and conditions before you sign up.

• Radioactivity

The cost of getting treated for conditions which result from exposure to radioactivity are generally not covered.

• War

Claims resulting from war or war-like events are always generally excluded from supplementary health insurance coverage.

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