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Health insurance

Who has health insurance? How can you save money on premiums? What costs are covered by accident insurance? You can find answers to these and other questions in the section “Health Insurance”.

You can listen to brief introductory information in your language here:

+ comparis.ch - Basic insurance benefits
+ comparis.ch - Health insurance costs
+ ch.ch - Health insurance ch.ch
+ www.krankenkassen-center.ch/
+ www.healthinsuranceswiss.com/
+ health insurance (8 languages)

Frequently asked questions
Every person who is a resident of Switzerland is obliged to have health insurance. After moving to Switzerland, you have three months to obtain your health insurance. The so-called basic coverage (Grundversicherung) is mandatory. Insured persons can select the company of their choice. Routine dental treatments are not covered by the basic insurance.

You can also purchase optional supplementary insurance, which will increase the cost of your premiums. This insurance covers additional services such as dental treatments or the comfort of a private room in the hospital.

Accident insurance is included in the health insurance. Employed persons, however, are covered for accidents through their employer.

+ comparis.ch: You can find a listing of all treatments covered by the basic health insurance here.
+ Swiss Health Directory: This helps migrants orient themselves in regard to the Swiss health-care system. It is available in a number of different languages.
Health Insurance
Costs vary depending upon the insurance company and type of coverage. The insured person must pay a health-insurance premium every month.

You can choose your insurance type yourself: for example, your premiums will be lower if you opt for a policy without free choice of physicians. This means that you always have to consult a certain family physician or HMO (health-care center) first.

Ask your insurance provider for more detailed information – it is worthwhile to compare!

You can compare the services and prices of the individual health insurance companies based on your personal needs here:
+ comparis.ch
In addition to the monthly premiums, you will have to pay part of the cost of your treatments yourself. This is called the deductible portion (Franchise). You can choose the deductible amount yourself: the lowest is 300 Francs, the highest 2,500 Francs. This means that if you choose the highest deductible, you have to pay all medical costs up to 2,500 Francs yourself, but your premiums will be lower. With a lower deductible, such as 300 Francs, your monthly premiums will be higher, but the medical costs above 300 Francs will be covered.

If your medical expenses exceed the deductible amount during a calendar year, you still have to pay 10 percent of the additional costs; this is called the co-pay (Selbstbehalt). By law, the co-pay may not exceed 700 Francs per year.

Expenses for pregnancy and childbirth are covered in full from the beginning by the health insurance.
After a doctor’s appointment you will receive a bill, which you need to pay yourself. A copy of the bill is enclosed (reimbursement copy, Rückforderungsbeleg), which you then send to your health-insurance provider for reimbursement.

A hospital bill will be sent either to your home or to your health insurer, and is usually paid directly by the insurance. The insurer or the hospital will send you a separate bill for incidental charges you have to pay yourself (co-pay, food fee).
Health-insurance premiums can strain the household budget. Persons with low incomes are entitled to premium reductions from the canton, which means that the canton pays for part of the health insurance premium.

If you are entitled to a reduction, you will automatically be notified by the Lucerne Compensation Office (Ausgleichskasse Luzern). In order to qualify, you must send in a form by the due date every year.

You can obtain further information from the Ausgleichskasse for the city of Lucerne.

Ausgleichskasse Luzern
Würzenbachstrasse 8, Postfach, 6000 Luzern 15
Telephone: +41 (0)41 375 05 05, Telefax: +41 (0)41 375 05 00
Web: www.ahvluzern.ch

Patients with low incomes can arrange to pay most medical and hospital bills in installments. Your doctor can give you more information in this regard.
The accident insurance pays the costs of medical treatment after an accident, and in case of temporary inability to work also pays a daily allowance (Taggeld) to compensate for lost income. If long-term disability or death results, pension benefits are paid.
  • If you work for eight hours or more per week for one employer, you are covered for all accidents at work and during your free time.
  • If you work fewer than eight hours per week for one employer, then you are only covered for accidents at work and on the way to and from work. You need to obtain accident insurance from your health insurer to cover non-work-related accidents.
  • Unemployed persons who are entitled to unemployment compensation have mandatory accident insurance.

Non-working persons such as housewives and –husbands, children, students, retired persons, or long-term unemployed persons are not insured, and are required to obtain accident insurance from their health insurer.

  • If you have an accident: report the accident to your employer or your health insurer immediately. You can obtain the proper form from either of them.

The abbreviation IV stands for Invalidenversicherung (disability insurance). This is another important type of social insurance like the AHV (social security pension). A person is considered disabled when he or she is unable to work permanently or for an extended period (at least one year) due to physical, psychological, or mental health impairment.

The primary purpose of the IV is to reintegrate the affected person into the workforce. This is facilitated by a wide range of rehabilitative measures. If this objective cannot be achieved, the IV will pay the insured person a disability pension.

Further information on disability insurance:
+ ch.ch

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