Basic insurance

What is the basic insurance?

Basic insurance (KVG) is health insurance with the same benefits from all health insurance companies. Basic insurance covers the costs of doctor visits, medication, hospital stays and pregnancy. The benefits of basic insurance are required by law and are the same for all health insurance companies.

How does the health system work?

The Swiss healthcare system in Switzerland is highly developed and offers good care. The private health insurance companies offer services for the health system in Switzerland. All health insurance companies have different premiums and can vary depending on age and place of residence. Other factors for the premiums are deductible and deductible. The higher the deductible, the lower the premiums. The deductible is the amount that a person pays themselves per year before the health insurance pays its benefits. The deductible is the additional amount that customers pay after the deductible has been reached. However, the amount is limited to 10% to 700 Swiss francs per year. On Checkall.ch you can compare the various health insurance companies and take out a contract directly online.

What basic insurance models are there?

There are 4 different basic insurance models in Switzerland. The basic insurance models differ mainly in terms of the restrictions and conditions of the insurance benefits and the amount of the premiums. The choice of the right model depends on the individual needs, preferences and financial possibilities of the insured. You can choose from the following basic insurance models:

Free doctor model (standard model)

With the free doctor model (standard model), the insured have the freedom to choose any doctor or hospital in Switzerland. Insureds are not tied to any particular network of healthcare providers. Under the free choice of doctor model, the insured choose their medical care freely. Insureds do not need to see a GP or go through a referral process to get to a specialist or hospital. However, the premiums for this model are higher than for other models.

HMO Model

With the HMO model, the insured must consult a general practitioner in the same network. The GPs are part of a network of health care providers that work with health insurance. For the HMO model, the health insurance companies offer lower premiums than the free doctor model (standard model).

Family doctor model:

With the family doctor model, the insured choose their family doctor themselves. In the event of a complaint, the insured are obliged to see their family doctor before going to a specialist or hospital. The family doctor acts as the first point of contact and coordinates every treatment and, if necessary, refers you to a specialist practice or to the hospital. The family doctor model offers lower premiums than the free doctor model (standard model).

Telemedicine:

Telemedicine in the basic insurance model refers to the use of telecommunications and information technologies. The medical diagnoses, consultations and treatments are carried out directly with a doctor through telecommunications and information technologies. Telemedicine enables doctors to remotely access medical data such as images of injuries or readings from medical devices in order to make diagnoses or provide advice. Insured persons can thus access medical assistance more quickly and easily, especially in rural areas or with restricted mobility.

What are the most important benefits of basic insurance?

• Medical treatment:

  Basic insurance (KVG) covers the costs of medical treatment, consultations, examinations and operations. This also applies to outpatient treatments that are carried out in a doctor's practice or in an outpatient surgery center.

• Hospital stay in Switzerland:

  The basic insurance (KVG) covers the hospital stay in hospitals recognized in Switzerland according to the cantonal hospital list. This also includes operations and stays in the hospital in the intensive care units.

• Medication:

  The basic insurance (KVG) covers the costs of medication that is subject to statutory health insurance. This list contains medicines that are considered particularly effective or essential for the treatment of certain diseases. Medicines that are not covered by health insurance are covered by supplementary insurance.

• Transports:

  Medically necessary transports are covered by basic insurance (KVG). In principle, transport must be medically necessary in order to be covered by basic insurance. This can be transport by ambulance or a specially equipped vehicle.

• Pregnancy and Childbirth:

  Basic insurance (KVG) in Switzerland covers the costs associated with pregnancy and childbirth. As part of prenatal care, at least two ultrasound scans are usually performed to monitor the health of the fetus. These ultrasound examinations are included in basic insurance.

• Abroad:

  Basic insurance (KVG) covers acute, emergency outpatient and inpatient treatment abroad up to a maximum of twice the amount according to the Swiss tariff. In addition, there are certain countries in which basic insurance does not offer reimbursement for medical treatment abroad. It is therefore important to find out about the exact conditions and restrictions to ensure that you are adequately covered for treatment abroad.

Are there certain requirements for inclusion in Swiss basic insurance?

All people living in Switzerland must be included in the Swiss basic insurance (KVG). There is an obligation to be included in the Swiss basic insurance. You can easily change your basic insurance every year.

How to choose a health insurance company in Switzerland?

Choosing a health insurance company in Switzerland is a bit confusing due to the different insurance providers and tariffs. Compare all insurance companies to find the right health insurance company for your criteria. Here are some criteria that can help in choosing the right health insurance company:

• Tariff models:

  The best health insurance companies are characterized by a selection of different tariff models. The different tariff models are free doctor model (standard model), family doctor model, HMO model, family doctor model, telemedicine. Providers who only offer one tariff model are not recommended. In financially weak times, there is no need to reduce the premium with another tariff model. For a suitable model, you have to switch health insurance companies to another provider.

• Health insurance comparison:

  The premiums for basic insurance (KVG) are different for all health insurance companies. Compare premiums from different providers to find the cheapest option. On Checkall.ch you can compare the best health insurance companies, take out online contracts or order an offer.

• Additional services:

  Some health insurance companies offer additional services such as alternative medicine, fitness subscriptions or room selection in the hospital. All health insurance companies have various additional services. If you are interested in such services, look for a provider that offers them.

• Customer service:

  A good customer service of a health insurance company can help you with questions or problems. Find out which service channels the health insurance companies offer and how quickly they respond to inquiries.

How do I change basic insurance?

You can change your basic insurance (KVG) annually by November 30th at the latest during office hours with your previous health insurance company. Cancel your previous basic insurance with your current health insurance company. Create a cancellation template with our cancellation tool.

The termination template allows you to receive a completed letter of termination as a PDF. You must send the letter of termination to your health insurance company by e-mail or post. Your old health insurance company will send you a cancellation confirmation, which you must present to the new health insurance company. As soon as your new health insurance company has accepted the application for basic insurance, you will be deregistered from your old health insurance company and registered with the new health insurance company.

Are family members insured under the same basic insurance?

In Switzerland, family members do not have the same basic insurance (KVG). Each family member must take out basic insurance separately with a health insurance company. However, there is the possibility as a family to take out basic insurance with the same health insurance company. Many health insurance companies offer family discounts, in which the premiums are reduced if several family members are insured with the same health insurance company. It is therefore advisable to inquire about the specific offers for families with different health insurance companies and to compare them to find the best offer.

Are dental services covered by basic insurance?

Basic insurance (KVG) only covers dental treatment in the event of a serious illness, such as a disease of the masticatory system. Ordinary treatments such as teeth whitening, cosmetic corrections, root canal treatments, implants, etc. are not covered by basic insurance. It is therefore important to find out in advance from the health insurance company which dental treatments are covered by basic insurance and which conditions must be met.

How does basic insurance cover emergency care and hospitalization?

In the event of a medical emergency and hospital stay, the costs for the necessary treatment are covered by basic insurance. For an inpatient stay in hospital, basic insurance covers the costs of general care, accommodation in a shared room (general ward) and medical services, examinations and operations. The costs for single rooms (private ward), on the other hand, are not covered by basic insurance.

How does basic insurance cover emergency care and hospitalization?

Basic insurance (KVG) covers some complementary therapies. These treatment methods for complementary therapies must be carried out by a recognized therapist. The 5 treatment methods are:

• Acupuncture
• Anthroposophic medicine
• Traditional Chinese Medicine (TCM)
• homeopathy
• Physiotherapist (herbal medicine)

How do non-Swiss or short-term visitors access healthcare services in Switzerland?

Non-Swiss or short-term visitors gain access to health services through travel health insurance. It is therefore important to take out travel health insurance before entering Switzerland. It is not possible for a non-Swiss person without a residence permit in Switzerland or a short-term visitor to take out basic insurance.

Do foreigners or short-term residents have to take out basic insurance?:

Non-Swiss or short-term visitors gain access to health services through travel health insurance. It is therefore important to take out travel health insurance before entering Switzerland. It is not possible for a non-Swiss person without a residence permit in Switzerland or a short-term visitor to take out basic insurance.

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