You’ve newly arrived in Switzerland, concluded your basic health insurance on time, and started to settle in. Yet the first time you have actual healthcare expenses, you get stiffed with a high bill and rightfully ask yourself “how is THIS not covered by basic insurance?”.
Truth is that basic health insurance only covers, well, the basics. Expat Services Switzerland helps you avoid any nasty surprises the next time you step into a hospital. Here are 10 things NOT covered by your basic health insurance (and what to do about it).
Expats are most often surprised to learn that basic insurance doesn’t cover dental care such as cleanings, fillings, or orthodontics. Only serious conditions affecting the jaw or teeth due to an accident, or a severe illness are covered. Dental treatments in Switzerland can easily amount to several thousand francs, so supplementary dental insurance can be a valuable addition. Note that you need to pass a dental health check to apply for the insurance in the first place.
If you prefer the comfort of a private or semi-private hospital room rather than sharing with several patients, you’re out of luck. Basic insurance only covers the costs for a shared room in a public hospital ward, which might not offer the level of privacy and convenience some expats expect.
Basic insurance covers a limited number of alternative therapies, like acupuncture or traditional Chinese medicine, and only when performed by certified professionals. Many popular alternative treatments and wellness therapies are excluded, so if you rely on these, supplementary insurance is essential.
Regular eye exams, glasses, contact lenses, and hearing aids are not included in basic insurance. The costs for high-quality corrective devices and frequent prescriptions add up quickly.
There is one exception: glasses for children under the age of 18 are covered, up to CHF 180 per year.
Procedures deemed elective or non-essential by your basic insurance provider, such as cosmetic surgery, are not covered. If you anticipate the need for such procedures, additional coverage will be necessary.
Basic health insurance mainly covers standard medical treatment near your place of residence or place of work. Only emergencies are covered abroad. If you’re looking to get treated by a doctor outside of Switzerland, you’d need additional coverage.
Furthermore, if you actually do have an emergency abroad, your basic health insurance won't cover all expenses for transportation & treatment. Even worse, you will likely have to pay the entire sum upfront first, only then will the insurance company reimburse you. This isn't the case with supplementary insurance cover, where the insurer stands in direct communication with the hospital, so this is a must if you travel frequently or plan to visit your home country.
Access to certain specialized therapies and treatments, such as advanced cancer treatments or new experimental drugs, is often restricted under basic insurance. Medications that aren’t on the list of specialties aren’t covered either.
Basic insurance generally doesn’t cover gym memberships, fitness programs, or preventative health measures like wellness checks or vaccinations not mandated by Swiss law. Supplementary plans may offer reimbursements or incentives for maintaining a healthy lifestyle.
While basic insurance covers a limited number of psychotherapy sessions, long-term treatment, counseling, or access to private mental health facilities are often not covered, which is crucial for those who might need more extensive mental health support.
Basic insurance provides limited coverage for home nursing care and rehabilitation services. For more extensive or long-term home care needs, such as those required after major surgeries or during chronic illness management, supplementary insurance can fill the gap.
Switzerland operates under a social health care system, which means basic health insurance can only cover services deemed essential and cost-effective. According to Swiss law, those with basic insurance are entitled to treatments that are “useful, appropriate, and economical.” So if you can still function well enough without new glasses or an elective procedure, you’re “on your own,” so to speak.
Good news – expats can cover these services by concluding a supplementary insurance option. These optional insurance packages are highly varied, affordable, and tailored to your specific needs. Here’s how to proceed:
Supplementary health insurance offers too many benefits to pass up. The coverage is essential to achieve proper peace of mind for your new life in Switzerland. Contact us today to secure your future against unwanted surprises!
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