Your Health Insurance in 2023

I have been living in Switzerland for the past 14 years, and so far personal experience with any Health insurance have been just terrible. Paying yearly around 3500 CHF for the health insurance and needing to further pay all the bills until 2500 CHF then another 10% on top and after with all that have to ask permission every time i need to visit a doctor by phone seems stone age for me. It seems so complicated and customer unfriendly that (thanks god he permits) so far my way against it was to just get cheapest cover with 0 additional products insurance, and never visit a doctor. Period.

Well I am getting close to 30, married with a small kid, so my strategy start to show weaknesses more often then not.

I got the maximum coverage for my kid in CSS with 0 franchise, as its quite cheap and though that now the freedom of visiting any doctor and doing any tests we would like, has finally arrived. Famous Swiss Welfare System will reveal its full potential! But NO! to get even a blood test for our new born, or some specialist checkups outside of spectrum of our general paediatrician knowledge proved to be a real fight. Our GP would just refuse to prescribe any external visits when in other countries it is a must (Eye checkup, bones checkup, allergies check etc, even a simple blood test) and I feel like it is just because she knows that she will get destroyed by the insurance people for spending their money on something which was not life or death urgent. Well we have changed 3 paediatricians in the course of the first year of life of our son, and then just gave up. Don’t you think this system is broken ?

Here what I have came up with as a plan for 2023, curious to see if any of you have done something similar:

Get only mandatory cheapest coverage in KPT, had a law suit with them in the past which i have won, but hey they are cheapest this year, and I don’t mind getting my hands dirty again =) And then getting a full private medical insurance in Spain. You can get it even if you are not a resident, the maximum coverage with 0 Franchise costs 588 EUR a year (49 eur a month), if anything planned needed, tickets to Barcelona costs 30 EUR each way, and if something urgent needed I think they will even cover some of the costs in Switzerland.

This way when ever my wife needs to visit a doctor, do a blood test, or have pain somewhere, we can actually get full medical treatment without paying thousands of CHF before reaching the Franchise limit.

My posts are massive as always, sorry for that - but hopefully some of you will have patience to read it all =)

2 Likes

Either this is just for you and pretty expensive or for all 3 and pretty cheap (for Swiss standard). In my case the cheapest option it is 2’760 CHF/a/pers (adult, older than 25)

I would read the fine print closely. Was looking for something similar (although for different reason), and it was just not possible.

As long as the kid looks and has a healthy development, no real need ? I mean as long as the kid does not show some allergic reaction symptoms, why would you do an allergy test ?

On the other hand, I have the feeling that Switzerland has made the choice of nearly no prevention health care at all. The necessary check ups (to be defined, your list seems a bit over the top) which would actually save costs overall when detected early, but which are not done since insurees have to do it out of the pocket. As an example, I haven’t been to the doctor since 4 years, and it just does not seem not right. Especially knowing that in other countries such check-ups would be costing peanuts/be free and the health insurance would be much cheaper than here (even when considering purchase power). Most of us will not be able to tell as if this or this check-up makes sense. So having a catalogue of “free” check-ups in a predefined interval could actually save costs overall.

4 Likes

Just depends where you live, in VD the cheapest is around 3600 CHF / year.

2 Likes

Lol, where can I sign? :star_struck:

This model was your choice, you can have other more expensive models, where you can get treated wherever you want without asking for permission beforehand.

Why does the GP need to prescribe it? Can’t you just go to e.g. an eye doctor and make an appointment there?
I also need to ask why you want to do all these checks when your kid is healthy? In my experience the doctors here do all the checks that are needed for babies/small children.

3 Likes

I guessed so. Kind of still amazes me where the differences are coming from.

Different patient behaviour (going more often, going abroad to save costs, thus making it more expensive to maintain infrastructure) ? Different financing of healthcare (cantons are for instance financing part of hospitals) ? That would be actually worth a study, if not already done.

Was thinking the same :stuck_out_tongue:

The cost of labour or people just going too much to the doctor for nothing has to be the case no? Health insurances are obliged to offer basic health insurance without generating profits as per the federal law about health insurance.

Edit: Or people are just generally more healthy in cantons with lower premiums? Younger population and thus generally lower costs? I don’t think cross financing is the case though as more liberal cantons have lower premiums than social ones.

Well cost of labour should be approximately the same between Zurich/Aargau (low premiums I cited now) and Vaud cited before with its high premiums. I would even argue that Vaud has lower salaries than Zurich.

And if its going more often to the doctor, than it would be interesting to know why.

About having more healthy people, there is a risk assesment of each insurance clients pool. Insurances with a higher risk profile pool will get money with insurances having a lower risk profile pool. Not sure though if this applies across cantonal borders.

Vaud has a large and dispersed territory. I’d compare it more to Bern than Zürich. In Lausanne, without accident insurance and with a CHF 2500 copay, the cheepest yearly premium for an adult comes at about CHF 3800. In Bern, it’s around CHF 3730, so not that far away.

I’m no expert but the way healthcare is structured in the Canton/area probably has an impact on the amount of the premiums.

Basel Stadt is comparatively absolutely tiny, yet has one of the highest premiums too.
“Socialism scale” might also be playing a role. :thinking:

3 Likes

Health systems costs in switzerland are mainly driven by visitis in the hospitals emergencies. People coming form other countries have often the tendency to visit this emergencies more often. One of the reason is, that in their home country they unfortunately dont have good medicin available outside hospitals.

  • in cities you habe a bigger part people with migration background
  • in cities you have more hospitals

I personally will be changing from CSS to Concordia HMO model. My GP is in their HMO model, and they have the lowest price.

No experience with Concordia, but the savings per month (22.-/month) seems worth it.

With CSS, with the same model (actually the lowest price model), the cost increase would be around +50.-/month in my case. This is insane!

Yet, I love the CH system, since it is by far the cheapest health insurance I’ve ever had.

For comparison, the countries I’ve lived in previously:

  • Country 1: employer and employee pay 7.65% of salary each.
  • Country 2: employee pays 13.4 % from salary.

And then one gets “free” visits to the doctor.

I’m just adding the deductible + premium (2500 + 700 + 3500), accept that this amount is possibly gone each year, see how much percent of income that is, and enjoy the good deal.

Would you mind sharing the countries ? I have a doubt your numbers are correct or count in everything
Typing in 7.65% for healthinsurance gets me Austria as a country, and there the ratio is in total 7.65% shared equally between employee and employer. (I might have the wrong country), plus it is capped at a maximum.

page 4 of this document :
https://www.svs.at/cdscontent/load?contentid=10008.763170&version=1640851356

Furthermore, it is important to see if this amount is fully going to healthcare or not or if there are other sources, and what you get for it. Can you cover the full family with one salary ? Is it including hospital stays fully paid for or not ?

In the case of Switzerland, you forget that part of your taxes go into the healthcare system, especially in the financing of hospitals, as well as the accident insurance which is also paid through your paycheck (which might be different in other countries), and that actually a hospital stay or ambulance will not be fully covered through the basic health insurances etc.

Since I do not have the time to add everything up, here a report of the OECD how much we spend of the GDP in healthcare. Switzerland is 2nd in the OECD. How much this is due to inefficiencies, actual added value or not is up to debate and for studies. However, I think that most studies are too simplistic (the classic “just people going too much to the doctor because it is free”).

Not sure if the deal is still looking so good.

In the end, affordable healthcare is a key element for thriving economy and should have its cost. How they are shared between rich and poor, private persons and companies profiting from a healthy population etc. is difficult and I do not pretend I have an answer.

Personally I think that the deductible system is partially preventing people to go seek healthcare in time and we could save cost by being less on the self-responsibiltiy lane.

5 Likes

Right, Country 1 is Austria. You’re right, the percentage is 7.65% total, split between employer and employee. Income capped at 5670 Eur / Month (thus a max contribution of 433 Eur / Month)

Hi guys

Saw that a couple of you are with KPT. Guess the Win Win model?

How are your experiences with it?
Does one need to have a “Hausarzt” or will they assign / recommend someone in the area?

Family 2+1 with Assura atm. Next year premiums we got for whole family from Assura is something 15chf cheaper than all these online calculators.
Debating if it makes sense to switch to KPT for overall 200chf savings…

1 Like

Calculators don’t take into account the “Rückverteilung der Lenkungsabgaben auf CO2”, which amounts to CHF 5.10/month/person (at least for Assura), which makes up the CHF 15.3/month difference, which you refer to

Indeed, kpt.ch give also cheaper price, thus monthly diff is back to 30chf plus you can get extra 1% discount for full yearly payment.
Not bad for small hassle, but was wondering how much I do save per year playing all those “saving” games, 2k?, and how much do I need to increase my salary to stop caring…

2 Likes

You choose your “Hausarzt” yourself. There’s a list somewhere online which doctors you can choose. Personally I never had a doctor that was not in the list.

1 Like

The first step is to control expenses before considering salary increases.

I think the rational thing to do would be to imagine what you would do with that extra 2K at your disposal.

A family holiday, some good (gastronomic) restaurants, invest in material for a hobby (sports equipment, new bike, etc).

So yes, for 2K the effort is worth it (in my opinion). If we were talking about 20.- or 100.-, the discussion would be different, though…

1 Like