Hospital Supplementary Insurance in Switzerland: Which Model Suits You?
Free choice of hospital and more comfort? A hospital supplementary insurance covers the gaps in basic insurance. Compando compares the four models, premiums and admission conditions.
1. Which hospital stays does basic insurance cover?
Mandatory basic insurance covers inpatient hospital treatments throughout Switzerland if the hospital is on the hospital list of the canton of residence. Insurer and canton of residence share the treatment costs:
Cost bearer | Share per stay |
|---|---|
Insurer | up to 45 % |
Canton of residence | around 55 % |
Insured | deductible + co-payment + CHF 15 per hospital day |
Where do additional costs arise without supplementary insurance?
In three cases, insured persons bear the costs themselves:
- Treatment in an extra-cantonal hospital without medical necessity: If the desired hospital is not on the hospital list of the canton of residence, basic insurance reimburses only the tariff of the canton of residence. You bear the difference yourself.
- Additional comfort: Semi-private or private ward, single or twin room and free choice of doctor do not belong to basic insurance, but to supplementary insurance.
- Hospital contribution CHF 15 per day: This statutory daily flat rate is also not covered by hospital supplementary insurance.
Basic insurance covers fully extra-cantonal only in case of emergencies, with medical necessity (with authorisation of the canton of residence) and at hospitals with insurer contract.
Hospital supplementary insurance for free hospital choice
A hospital supplementary insurance closes the gaps in extra-cantonal stays and provides more comfort in the hospital. The comparison of providers shows directly premiums and benefits of the four models.
2. Which hospital supplementary insurance products exist in Switzerland?
Hospital supplementary insurance extends the protection of basic insurance. In Switzerland, four models are available; all are subject to the Insurance Contract Act:
Who is accepted into a hospital supplementary insurance?
Unlike with basic insurance, insurers may reject applications for supplementary insurance or attach policy restrictions. Before taking out supplementary insurance, the insurer examines the risk profile via a health questionnaire. Criteria are age, gender and health history.
Three results are possible: young, healthy persons are usually accepted without policy restriction. More frequently, insurers issue a policy restriction and temporarily exclude certain pre-existing conditions. With serious chronic illnesses, a rejection of the application threatens. Children and adolescents have the best admission chances; from 55 years, new conclusion becomes more difficult.
Answer the health questionnaire truthfully. False information can under Art. 6 of the Insurance Contract Act lead to benefit refusal or contract dissolution. Terminate the existing supplementary insurance only after written acceptance confirmation of the new insurer.
3. Is a hospital supplementary insurance worthwhile?
A hospital supplementary insurance brings more flexibility in hospital choice and comfort during the stay. Which model is worthwhile depends on age, health and comfort wish.
The coverage "general ward whole Switzerland" is suitable for persons who want to be treated in an extra-cantonal hospital without medical necessity, or for insured persons in border regions with small hospital selection.
Semi-private and private are worthwhile with desire for free choice of doctor, twin or single room and more comfort. Semi-private suits families and plannable interventions, private suits persons with desire for chief physician treatment.
The Flex model is suitable for young or healthy persons with low risk of a hospital stay. The base premium is low; an upgrade to semi-private or private is possible if needed.
Trend: outpatient instead of inpatient
In recent years, many interventions are performed outpatient instead of inpatient. Insured persons leave the hospital the same day. Some insurers complement their hospital supplementary insurance with an outpatient component. Additionally, the comfort difference between the wards decreases because new hospital buildings frequently have only single or twin rooms. This changes the price-performance ratio for semi-private and private.
Which model suits you
With hospital supplementary insurance, premiums and benefits differ strongly between providers. The direct comparison shows the suitable model for your life situation.
4. Hospital supplementary insurance: advantages and disadvantages?
Model | Advantages | Disadvantages |
|---|---|---|
General ward whole Switzerland | Low premiums Extra-cantonal stays covered | No additional comfort Later upgrade expensive |
Semi-private | Twin room Free choice of doctor Partly medical second opinion Individual hotel services Partly flexible appointment choice | Mid-high premiums Change to single room expensive |
Private | Free choice of doctor incl. chief physician Partly medical second opinion Hotel services (meals, transfer) Partly flexible appointment choice | High premiums |
Flex | Upgrade to semi-private or private possible Manageable costs | Own contribution on upgrade (CHF 500 to 2'000) |
5. How can I save on hospital supplementary insurance?
When taking out a hospital supplementary insurance, you can lower the premium in several ways:
Hospital supplementary insurance by own needs
Needs around hospital, comfort and choice of doctor are individual. Because premiums and benefits differ between providers, a comparison pays off.
