For emergency medical assistance, call 144. This will put you through to the Ambulance service (G: Sanität-Notruf, F: Ambulance). Call 145 if the emergency involves poisoning. Note that 112 can be used throughout Europe for emergencies of any nature.

Swiss healthcare is considered on the whole to be very good but this does come at a cost to residents and health insurance is required for everyone. Healthcare is regulated at cantonal level and customer satisfaction with health services such as hospitals can vary from one canton to another. You will be required to take out a Swiss healthcare insurance policy within 3 months of your arrival in Switzerland. Foreign health cover, even if valid worldwide, is unlikely to be accepted by your local authorities as a replacement for a Swiss insurance scheme.

A wide range of treatments and therapies are available in Switzerland and, with a doctor's referral, you can obtain the treatment you require. This even includes spa retreats, if your doctor believes it to be necessary for your health, and acupuncture is also covered, although other alternative therapies are not.

As explained in the Health Insurance section, you will have an excess (Franchise) which you must pay, and only once you've reached this limit will the insurance company begin to contribute to your healthcare costs. Your deductible of 10% will apply once the insurance company start paying (e.g. once you've paid the annual excess), up to a maximum of CHF 700 for adults and CHF 350 for children. Although under most circumstances the insurance company will be billed and will settle costs directly, in other cases you may be expected to settle the bill. If you have exceeded the excess, you will then need to claim a refund for the insurance company's share at the end of the year, sending them copies of those bills you have paid yourself. If you haven't exceeded the excess and the insurance company were billed, they will then bill you. To ensure you and your insurance company agree on whether they are liable to pay your costs, send them a copy of each medical bill that you are asked to pay.

For accidents requiring emergency treatment, as opposed to illness and wellbeing issues, you are covered under a separate compulsory Accident Insurance (UVG) scheme. This is paid for via deductions from your salary. If you don't work, you can take out a supplemental accident insurance with your health insurance company. The accident and emergency (casualty) staff will need insurance details from you at time of treatment. If you are presented with bills or invoices, you can pass these to your employer. You will be liable for a percentage of ambulance costs but you can go to any hospital in an emergency.

Foreign visitors should always ensure they have private travel insurance. This includes EU/EFTA nationals, although they will be treated under the reciprocal European insurance scheme provided they carry a European Health Insurance Card (EHIC), which will reduce the costs that need to be reclaimed. Visitors with an EHIC will be treated on the same basis as Swiss residents, and will be expected to meet similar costs. Hospital treatment attracts an excess/deductible charge of CHF 92 for an adult for up to 30 days of treatment and is not refundable under the EHIC scheme but may be refunded by your private travel insurance. You will receive an invoice for the remaining charges and will need to submit this to the Gemeinsame Einrichtung KVG (www.kvg.org).

The Swiss are on average fit and healthy, with one of the highest life expectancies in the world, and obesity and related health issues are increasing at a slower rate than the US and the UK. An ageing population is likely to be one of the biggest challenges for the healthcare system. Smoking is widespread, with a higher percentage of smokers than many other countries, however a public smoking ban came into effect across Switzerland in 2010. How strictly it is enforced depends on the regulations of individual cantons. The Swiss have not universally embraced the ban and the rules are sometimes flouted in an otherwise law-abiding country.

Emergency counselling in times of crisis is available by dialling 143. Children and teens have their own support line, available by dialling 147. Your local doctor will also be a good first point of contact in times of distress and can refer you on to a psychiatrist, if required. There are also counselling services in Switzerland and some of these are able to offer support in English. If you do not have a local English-speaking counsellor, you can also consider counselling via phone. Some fluent English-speaking expats with appropriate qualifications offer counselling specifically for other expats.

Useful Resources

Gemeinsame Einrichtung KVG
Administration of emergency healthcare
http://www.kvg.org/en/default.htm
Gibelinstrasse 25, Postfach, CH-4503 Solothurn
Tel: +41 (0)32 625 30 30
Email: info@kvg.org

Caroline Garrod
English language counselling, face to face in Lugano, by phone to other areas
http://www.expatcounselling.com/
Tel: +41 (0)91 600 1873
Email: carolinegarrod@hotmail.com

Basel Therapy
English language counselling in the Basel area
http://baseltherapy.com/about-basel-therapy.html
Holbeinstrasse 42, 4051 Basel
Tel: +41 (0)799 628 462
Email: tony@boltonmoody.com

Geneva Counselling (Johanna Mulvaney)
Counselling in English, French or Swedish
http://www.genevacounselling.com/
69, Rue du Rhone (5th floor), 1207 Geneva
Tel: +41 (0)78 805 73 74
Email: johanna@genevacounselling.com