An ounce of prevention is worth a pound of cure. Most people have heard the old adage at least once. Swiss health insurance providers incorporate its logic in their insurance models, to some extent, by paying out benefits towards the costs preventative measures like inoculations and medical examinations.
Basic compulsory health insurance does not cover (anywhere near) all possible preventative examinations and vaccinations, and that is where supplementary health insurance comes into play: some supplemental policies provide benefits towards the cost of checkups and inoculations which are not covered by compulsory health insurance.
Preventative care and vaccinations: what is covered by compulsory Swiss health insurance?
- Swiss compulsory health insurance covers a range of vaccinations, including those against tetanus, chickenpox, whooping cough, polio, diphtheria, hepatitis B and tick-born encephalitis. The guidelines for which vaccinations are covered are laid out in the Swiss inoculation plan, which can be accessed on the website of the Swiss Federal Office of Public Health.
- Flu shots are covered when the policyholder is at least 65 years old or belongs to a high-risk group. If your medical condition leaves you vulnerable to complications resulting from influenza, then necessary flu inoculations will be covered.
- Your policy’s deductible and coinsurance generally apply. However, certain inoculations do not require a deductible copayment. Example: Cervical cancer inoculations for women younger than 26 are fully covered by compulsory health insurance, when they are performed as part of a cantonal health program.
- Treatments aimed at preventing certain types of cancer are covered by basic health insurance if your family has a history of cancer. Examples: Skin cancer, stomach cancer and breast cancer screening.
- One breast cancer screening every two years is covered for women aged 50 and older, regardless of whether or not your family has a history of cancer.
- Gynecological checkups for women: One preventative general gynecological examination every three years is covered, even when no irregularities have been found in previous gynecological checkups. In the event that problems are found, your basic health insurance covers all further examinations and treatment.
- If you aren’t sure whether or not a preventative examination or inoculation is covered, just ask your doctor. They should be able to clarify this.
Preventative care and vaccinations: what is covered by supplementary Swiss health insurance?
- Checkups: Supplementary health insurance generally covers preventative examinations, whether they are actually necessary or not.
- Preventative vaccinations or prophylactics applied ahead of a trip abroad, such as those against malaria or yellow fever, are not covered by basic health insurance but are covered by some supplemental health insurance policies.
- A comparison of optional health insurance coverage can help you find the differences in the examination and vaccination coverage provided by different insurers. Depending on the policy you have, you may get anywhere from 50 to 90 percent of the costs covered. Most insurance providers place caps on the maximum benefit they pay towards preventative measures, and these caps range from 200 to 1000 francs depending on the policy.
- Practical tip: Select the “vaccinations” and “preventative examinations” criteria when using the supplemental health insurance comparison to find, filter and sort policies based on these benefits.
- Some supplementary policies also cover preventative training sessions and gym memberships.
- Currently, these insurance policies provide some of the highest coverage for preventative examinations: Sanitas Classic (80%, maximum 1'000 francs per year), Helsana Completa (90%, maximum 750 francs per year), Concordia Natura (90%, maximum 500 francs per year).
- Policies from these insurers currently offer some of the most attractive inoculation benefits: Helsana Completa, KPT-Versicherungen, Concordia-Versicherungen, CSS myFlex Balance & Premium, Atupri Mivita Reala & Atupri Mivita Extensa, Sanagate Optima,Groupe Mutuel Bonus.
The moneyland.ch team