Semi-private or private health insurance

Hi everyone,

I’m considering taking a semi-private or a private supplementary health insurance and I’m trying to understand if that can be worth it or not. I’m still young, overall good health and would be able to afford it, but I also don’t like to waste money for nothing.

I’m not very interested in the additional comfort, but more in the potential difference of treatment.

A few questions for you:

  • Do you have it? What is your experience?
  • I’ve heard some anecdotes where there is a difference in care between general ward and these two insurances. Choosing the doctor of course, but also in terms of speed of treatment and in general consideration. Do you think it is plausible or not? I also heard the opposite feedback so not sure
  • Between semi-private and private, is the only difference the room, or may there be an additional difference of treatment?
  • There are even worldwide insurances. Are they worth it in case you need a special treatment not available in Switzerland, or is it too much overthinking?
  • If you have it, what is your premium strategy? Do you just go for the low one, or do you take the high one at around 5000CHF?

Thanks a lot, I’m really not sure what to do.

Many people including myself have private insurance when it comes to accident insurance payed by your employer (the difference in premium from general to private is very low compared to the health insurance). I had my Achilles torn apart last year and needed surgery. The accident happened on a Friday night and I was not able to contact anybody from my office. As I was not aware of the insurance company nor the coverage I had myself checked in the hospital on the general floor. I did not get the surgery done the entire weekend (to be fair it’s not life threatening) and needed to stay in a two person bed room which was ok as was the attendance. As soon as I could contact HR on Monday and they confirmed that I had private insurance I got the surgery within two hours (could have been also causality) and the room which I could stay afterwards for 3 more nights was bigger and nicer than any hotel that I have been in ever. The service was phenomenal including a check in every 30min.

That sad I’m not sure if you really get a different quality of the surgery, which at the end maybe is what you are in a hospital for.
Semi-private to me is somehow like the franchise in between 300-2500 CHF they are not a real option. Either you are in or out.

From my perspective you are paying for the comfort if you need to stay in. That sad if you are in your final moments you can always pay private out of your pocket (which my mom actually did when she had final stage cancer).

With regards to the world wide treatment I’m not sure if an insurance would really cover that, assuming it would be something really specialized and hence extremely expensive. But you never know there are obviously treatments that will not be available when you maybe need them in Switzerland but at the end it’s a numbers game (as anything that involves an insurance)

I hope something out of that is helpful for you.

Have a great day and hopefully you do not need the health insurance

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Thanks a lot for your insights. It is really helpful!

Most insurances also offer flexible hospital insurance where you can decide when checking into a hospital if you want general, semi-private or private. The monthly premium cost is somewhere between general and semi-private.

For example: Flexible choice of hospital ward - CONCORDIA

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Personally, I don’t see the need for extra hospital insurance, because the publically-funded hospitals covered by mandatory Swiss health insurance are excellent.

Nowadays there are few or no general wards in the old sense of the term (a large dorm with rows of beds). The general wards of most Swiss hospitals are now semi-private (2 people per room). So getting supplementary hospital insurance for semi-private wards only makes sense if it has additional coverage for private clinics and gives you the right to choose which of the hospital’s doctors you want to be treated by. The exact coverages vary between offers.

I would consider it a big luxury, and all the more so for a young person who is unlikely to need medical care in the first place.

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I wondered about this aswell and besides that, each basic medical insurance from every insurer has to cover the same medical costs.

For me personally the flexible option to choose which category I want when entering the hospital is about 250.- a year. So still a cost but not significant.

You might live in a more well off area then :sweat_smile:. At my closest hospital there are still four bed rooms for the general ward. Also when you are atleast semi-private you don’t get treated by an assistant doctor but from the chief doctor (Chefarzt). Or when my mother gave birth to me and my siblings it was not the doctor which was on shift. Instead they called the chief doctor to come and monitor the situation.

Would the treatment be the same with any other kind of doctor? Propably. But if you have the money and can buy a little bit more “security”, even if it’s just for your peace of mind, why not.

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Currently I have private hospitalization cover. There is a very small difference in premiums in my case (SWICA ~7 CHF/month difference ). Otherwise if the difference was bigger I would settle for semi-private.

I assume implications of only having basic could include - examples from Canton Geneva :

  1. Knee injury skiing - you might struggle to get treatment from the specialists at the private Hopital de la Tour.

I am not sure how it works is if you have an expensive basic insurance that allows free choice of Dr. I suspect in practise they may not accept you because the Drs only do their operations tin that hospital

  1. Emergency: I have been in an urgence room in HUG with 6 beds
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I’m wondering myself what to chose. I honestly would not want to be in a hospital room with 3+ strangers. My wife had to share after giving birth because there weren’t enough private rooms. She didn’t sleep, basically (ok special situation because of the newborns, but still).

Two things to consider:

Check your accident insurance via your employer. You might have private coverage for accidents already. No need to pay double and if you are young and healthy the most likely hospitalization reason is covered.

Choosing the chief medical officer can, but need not, be the superior option. Young doctors can be highly motivated and actually care for your case, whereas the chief might see you as boring, routine and lucrative. The right to choose your doctor might still be worth it, just saying, it doesn’t need to be the chief.

I’m tending towards a flex option right now, it limits my payments in case things go wrong, but is still vastly cheaper than opting for private straight away. Agreeing to the above sentiment that semi-private seems to be the worst option, it’s still expensive without giving you the full benefits.

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My impression is that supplementary insurance is something you pay for when you’re young and healthy and use when you’re older.

Once you start having issues, it’s too late to get it.

But yeah in practice it’s a luxury rather than a necessity, having the chief doctor treat you for a standard procedure isn’t a good allocation of (scarce) healthcare ressources. If you have a complicated case, the chief doctor will treat you regardless of insurance.

(At least for now, healthcare systems can degrade fairly quickly, see UK or France over a few decades)

So yeah it’s an (expensive) hedge on health system degrading and extra luxury if you need healthcare.

Disclosure: I pay a lot of money for supplementary that I never used, always thinking about dropping it but there’s also some sunken cost fallacy going on.

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Does anybody know if there is somehow an age trigger point to switch into a private insurance?
I understand that obviously once you have some health concerns it would be difficult to get into the private. However is that also the case with a certain age, that an insurance company would check your file and reject you because of your age?

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Age 61 is generally the age at which health insurance premiums peak, so it would be fair to say that age 61 is the age trigger. It may vary slightly between insurance providers, but that’s the general threshold.

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Thanks, that is interesting to know. statistically you have 15 years left after age 61 so, I think that would be my “strategy” to hopefully keep healthy until my late 50ies and try to get into private if there is a good provider. At the other hand who knows how our health system will look in 10+ years.

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I thought in CH people lived longer than 76…

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Thank you all for the contributions, I’m reading them carefully.

I’m getting more and more the feedback that there is actually a difference of care between standard, semiprivate and private. A part from choosing the doctor, it seems you have faster access to specialists and also probably exams. You could also have one person following your treatment in some cases and speak to the hospital.

Of course nothing extreme. You are treated generally very well also in standard, it is just a bit better.

Seeing this I’m probably going for one of the two, even though I understand it is a luxury. I still need to choose the franchise though. Not sure if the price increase for the 0CHF one is justified…

The premium for private insurance is ~200 fr per month. In case of RE, 60-70k CHF Net Worth needs to be set aside to pay for this assuming a 3.5% SWR

I prefer to delay RE to accumulate that amount. Staying healthy for as long as I can is high priority for me

Apparently Swiss people do get older but not better at math :joy::joy::joy: I should have sad 25 years and hence 86 (to the best of my knowledge)

It’s very hard to calculate the benefit of subscribing to one especially if you plan to retire to a neighbour country

I tried to actually calculate it for Switzerland using average numbers. Hospitalization rate in Zurich is about 11% (11 out of 100 people need to go to hospital per year), average stay is 5 days. Rounding down a little means I could expect to be hospitalized for 5 days per decade, so 20 days in the next 40 years. A switch to private costs about 1000 CHF per day (even though it can cost vastly less or more depending on hospital, 1000 is University Hospital Zurich).

Based on these numbers no supplementary policy is worthwhile, not even counting that you could invest the money not spend on insurance. That shouldn’t be surprising, given that insurers need to earn some money and if they loose on average they’d go bust.

But these numbers are terribly sensitive to even slight changes. 3-8 days more in hospital in the next 40 years and suddenly Flex insurances are worthwhile. Not counting immaterial benefits as being allocated private rooms on a preferential basis and the like. And of course there are the really scary cases, like rehabilitation for a month or longer, easily costing 50k and more.

So, it comes down to your risk aversion and how much you value excluding paying for those scary cases. Same with choosing the level of franchise. At 0 you include more standard cases. At 5000 or so you only include more scary cases.

Wouldn’t rehabilitation be paid by the basic insurance (90% after the franchise at least)?

For general ward yes I’d assume. The 50k is for the upgrade to (semi-)private. Always depending on full upgrade or just room upgrade and on canton, hospital and treatment. I got the number from Groupe Mutuel, they give the following examples for the benefit of their flex insurance: