State health insurance in Switzerland is funded according to cantons, rather than by national social insurance contributions. As an expat, you will need to register with the system within three months of arriving in the country. Unless you are exempt (if you are a student, for example, or a cross-border worker) you will be automatically signed up to a provider, possibly at a higher premium, if you do not register yourself.

Since health insurance varies from canton to canton, there is no centralised system in operation. In some regions your insurance company will pay your healthcare provider and send you a bill for 10% of the cost. In others, you will need to pay out of pocket and claim 90% of the cost back from your insurance company.

Once you are registered, you will be issued with a health insurance card.

You can also take out private cover. If you need hospital treatment and you do not have insurance, you will be asked to make a deposit of up to CHF 10K (around €9K).

If you are from an EU member state, you will be able to use your EHIC card.

Everyone who pays into the state-approved insurance system will be eligible to access Swiss healthcare.

You are responsible for registering with the Swiss health insurance system. You will need to register for a Swiss residence permit first, or sign up with your local commune.

You can then choose which local health insurer you would like to register with, and ask for a registration form. You will need to send them your visa or residence permit; your passport; and proof of your address along with the form.

Once you are registered, deductions will be taken directly out of your salary.

Insurers are not allowed to turn any applicant down.

The KVG (Krankenversicherungsgesetz or Health Insurance Act) ensures that the providers of state health insurance provide identical cover for illness, accidents and emergencies.

Coverage by the Swiss state health insurance system includes the following:

• doctors’ visits
• check-ups
• hospital visits
• maternity care
• medical devices
• medication
• oncological screenings
• psychiatric care
• rehab
• transport
• vaccinations

You can also take out supplementary insurance to cover the following:

• dentistry
• enhanced hospital care
• alternative medicine (if conducted by a licensed practitioner)
• prenatal care
• travel insurance
• loss of earnings and lump sum payments if you are unable to work

If you are planning on climbing or walking in Switzerland, you should check whether your policy covers mountain rescue.

As an expat retiree, you will need to demonstrate proof of valid health insurance before you can apply for your residency permit. Once you have your permit, you must sign up to the state-approved system within three months of your arrival in the country, and must make monthly contributions to continue to be able to access the healthcare system.

You will be covered under compulsory medical insurance unless you are exempt – for example, if you have a short-term residence permit; if you are an employed student from certain EU member states and have insurance from your home country; or if your existing insurance provides more extensive cover than the local Swiss version.

To apply for exemption you will need to contact your local canton office and supply them with the following:

• copy of your residence permit
• copy of your existing insurance policy
• copy of confirmation of enrolment or confirmation of education
• copy of your internship contract/employment contract

Usually, state-approved insurance policies will not include your dependants and you will need to arrange separate cover for family members. Check with the health insurance provider in your local canton to determine if you can register family members with the local scheme or whether you will need to take out private cover for them. If you are able to sign your dependants up with a state scheme, you should not have to pay the standard deductible for your children.

The state health insurance system covers only emergency surgery caused by serious jaw or mouth disorders or diseases. Otherwise you will need to take out private cover or supplementary insurance for any dental treatment.

Monthly premiums will depend on your insurer and your canton, since the system is not centralized, but on average you will be paying CHF 300 per month. Your premium will be calculated according to your personal risk profile, not your income.

The standard deductible is CHF 300 per annum. Most costs over this will be paid by national insurance, but you must still contribute a further 10%, capped at CHF700. Paying a higher deductible will affect the rate of your premium.

Some expats also take out private health insurance to top up basic national plans and to ensure speed of access to diagnosis and healthcare.

Private health insurance will cover the basics as well as more advanced care and treatment that is not covered by the national plan: for example, dental treatment and alternative therapies.

Since all healthcare in Switzerland is essentially run by private providers, albeit regulated, the costs are as listed above.

For those seeking international private medical insurance (iPMI) cover for multiple countries including Switzerland, numerous variables can have an impact on the cost.

The most important variables are:

• age (the higher the more expensive)
• area of cover (i.e. in addition to Switzerland, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
• product choice (higher end insurance products are more expensive)

Other variables include:

• deductibles
• co-insurance
• payment frequency
• gender
• nationality
• country of residence

As so many variables have an effect on the cost of international private medical insurance in Switzerland it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

The big international providers, as well as local insurers, cover Switzerland:

• Agrisano
• Atupri
• Assura
• AXA
• Cigna Global
• Concordia
• ÖKK
• Pacific Prime
• Sanitas
• Swica

Krankenversicherungsgesetz/KVG - Health Insurance Act