It's not so easy to navigate between the offers offered by the various caisses. We guide you through the legal framework and the options that allow you to pay less for the same quality of care.
Hello Doctor. I need your advice.
Maybe you have a primary care physician who, from father to son or mother to daughter, has been treating you and your family members for generations.
For the rest of us, the average person, finding a practice that still welcomes new patients can be a struggle.
When you manage to find a doctor, the administrative team will ask you a single question: 'Can I have your health insurance card?'. This precious key will allow you to schedule a consultation. Your contact details will be recorded, a photocopy of both sides of your documents will be made and your insura nce will now be informed of each visit and each intervention.
Depending on the type of coverage you have, your care will be reimbursed to a certain degree.
Do you have a choice in this matter?
No, 'every person domiciled in Switzerland must be insured for treatment in the event of illness, or be insured by his or her legal representative, within three months of taking up residence or being born in Switzerland'. The KVG determines the scope of application.
I can't hear well. Did you say La La Land?
No, the KVG or Federal Law on Health Insurance.
It is a hedge based on the pooling of risks. You pay an insurance premium that covers you but also finances the risk of illness incurred by the community. And vice versa.
A legal framework lays down certain regulations and obligations in this regard, on both sides. This is the KVG.
Basic coverage is guaranteed for anyone who wants it. A health insurance company cannot refuse or even ask you to fill out a prior health form (except for certain supplementary health insurance). There are different types of medical coverage to choose from.
Is there a special patient menu?
Yes, there's even a children's menu.
Depending on the health insurer, the cost of premiums depends on the age range. Some provide for two tranches, namely minor and major. Others add an extra slice, young adult or not.
Children have more favourable conditions in terms of premiums. For adults, the choice of the amount of your premium is directly linked to the deductible that would be applied as an out-of-pocket cost.
If you choose a low-cost premium, you may end up paying a higher deductible for treatment. As long as you're healthy, it's the smart choice. But germs, viruses and other diseases don't follow the same schedule as you...
In addition, you can choose between basic insurance, a formula with your family doctor (who must be recognised by your health insurance company), telemedicine and the healthcare network. Learn about these options as it impacts the cost of your premium.
The last choice to make is complementary insurance. This mainly includes the costs associated with your glasses, contact lenses and teeth. This financial burden is not to be underestimated!
A stitch in time saves nine
Depending on your means, your medical history, your family history... So it's a good idea to take the time to reflect.
Your choice will determine the amount of your spending on premiums and deductibles, depending on your state of health and the care provided.
When you reach a certain age, it may be smarter to pay higher premiums and reduce the cost of your deductible.
It still stings! Can I do otherwise?
The bill is high and you think your expenses are too high? Your health insurance is compulsory; Supplemental insurance is not (even if, as you can see, it will sting more when you have to treat a cavity or buy new glasses...).
However, it is possible to find a lower price.
How to compare before changing? My toe is visibly swollen. It's going to cost a lot of money and I want to make sure everything is taken care of as before!
First of all, it is useful to clarify that you have the right to change your health insurance provider. This is by 30 November at the latest. The date of receipt of your letter is decisive.
Also, if you have a family to cover, you don't have to all use the same health insurance. Check to see if your current fund is making a move to cover all members of your family; Some apply a discount as part of this.
What are the other criteria for comparison?
The price , of course. There's nothing stopping you from asking for quotes.
The refund period. This varies. Depending on the state of your cash flow, this may be important.
Transparency and clarity of the information provided. If the number is tempting but you don't understand anything about the terms and conditions, you might as well abstain.
Discounts applied on the basis of the number of people insured and on the basis of your payment method. It's often cheaper to pay your premium all at once or twice rather than every month.
Lately, the reputation of the brand. Comparison sites exist, quality indicators are available... Just ask current and former customers to get an idea of the coverage policy in place.
The quality of care!
You get used to it, but let's not lose sight of the quality of care provided in Switzerland. For or against the KVG, for or against downward or upward variations in premiums... There is no doubt that we all have a quality of care that is quite exceptional.
As always, it's all about finding a partner you can trust. There will be a price to pay, a deductible to honour, and sometimes the administrative burden on some funds can be heavy.
However, at the end of the day, if your care is widely covered and you confidently enter a practice, clinic, hospital... Isn't it worth it?
While waiting for your comparison and final choice, we wish you all, on behalf of the Milenia family, very good health! The KVG will cover you in the event of a health problem; We're here for everything else!
