If you're new to Switzerland, this might be the single most useful fact: basic insurance covers exactly the same things at every insurer, because the list of benefits is set by law. Nobody's basic insurance "covers more". Here's what's in it, and what isn't.
What basic insurance covers
- visits to your GP and to specialists
- hospital treatment in the general ward, in your canton of residence
- medicines on the official list
- maternity: pregnancy and birth, with no cost-sharing
- certain prevention and vaccinations
- medical emergencies, including limited cover abroad
- a defined selection of complementary medicine
What it doesn't cover
For these you need supplementary insurance, or you pay yourself:
- dental treatment, except after an accident or serious illness
- free choice of doctor and a private or semi-private hospital room
- glasses and contact lenses for adults (mostly)
- gym membership and wellness
- planned treatment abroad
How the costs work
You pay three things: the monthly premium, the annual franchise (you choose between CHF 300 and 2,500, lower for children), and after that a 10% co-payment up to a maximum of CHF 700 a year, or 350 for children. A higher franchise lowers your premium, so it pays off if you rarely see a doctor. The franchise calculator shows which level is cheapest for you.
The four models: how you reach a doctor
At the same insurer you can choose between models. They change nothing about your cover, only how you start a treatment, and a restricted model noticeably lowers your premium:
- Standard (free choice of doctor): you go to any doctor directly. The most expensive.
- Family doctor (GP) model: you have a set GP and see them first, and they refer you on. Around 15% cheaper.
- HMO: you go to a specific group practice first. Around 25% cheaper.
- Telmed: you first call a medical hotline that advises you and points you on. Around 20% cheaper.
For most people, especially if you're healthy, a restricted model is the easiest saving there is: same cover, lower premium. Free choice of doctor mainly pays off if you want to go straight to any specialist without a first step.
Identical at every insurer, only the price differs
Because the benefits are the same everywhere, insurers differ only in price, model and service, not in cover. Anyone who tells you their basic insurance "offers more" is selling you something. The only real decision you make here is to pay as little as possible for the same cover. How to switch insurer is in the switching guide.
billfox uses the official BAG data to find you the cheapest insurer for your profile, at identical cover. Supplementary insurance is then a separate, voluntary decision.