Direct contact to the Helsana Group

End of the year: focus on health insurance premiums

Jahreswechsel

As we get closer to the end of the year, the topic of health insurance premiums comes to the fore. You do, however, have various savings options. Take this opportunity to benefit from reduced premiums. We are also committed to achieving lower costs. Find out more about our cost savings efforts. We will be happy to advise you in person.

Insurance costs and premiums

The healthcare system in Switzerland has the advantage of services that are highly available nationwide, with up-to-date technical facilities and extremely well-educated staff, making it one of the best healthcare systems in the world. This is primarily financed by means of insurance premiums. Lawmakers, supervisory authorities and health insurers regularly ensure that this is the case by making carefully balanced adjustments.

Why are insurance costs rising?

Demographics – population growth and the growing share of older people – and medical advances play a role as regards the growth in costs. The main reason for the growth in costs, though, is volume growth and the expansion of the benefits catalogue together with the policyholders' entitlement attitudes.

Medical and technological advances continually result in new services. New medications often cost several times more than their predecessors. The often rash consumer behaviour in the supply-induced healthcare market (expansion of services by doctors) is continually driving the growth in services.

Furthermore, heavy restrictions have been placed on competition among health insurers, which means that they have little room for manoeuvre in determining the amount of premiums. In the case of basic insurance, they are obliged to reimburse the costs of the insured benefits in full. As a result, there is not much incentive to seek less costly treatments.

Health insurers have very little influence on the development of premiums. However, this does not prevent us from striving to achieve lower healthcare costs within the scope of our capabilities.

Where do health insurance premiums go?

In 2014, basic insurance customers in Switzerland paid a total of CHF 25.8 billion in health insurance premiums. By far the largest part of this sum served to finance medical services worth CHF 28.6 billion.

Most of the money was used for inpatient hospital treatment, outpatient treatment in doctors' practices, and medications. This was followed by outpatient hospital treatment and nursing home costs. The cost sharing of insured persons in the form of deductibles, excesses and cost contributions to hospital stays amounted to a total of CHF 4 billion.

The difference between the premium income and costs was financed through additional sources, such as investments of CHF 734 million.

Please bear in mind that health insurers do not make any profit from basic insurance. Surpluses are put in reserves.

Overview of the healthcare cost breakdown

Prämienaufteilung Source: FOPH – compulsory health insurance statistics for 2014

How are the prices of medications developing?

Around 17% of the benefits paid under basic insurance are used for medications. This high proportion is due to the above-average price of medications in Switzerland, among other factors. This will not change unless a fundamental system shift is considered.

Who is responsible for determining the prices of medications in Switzerland? To what extent does the pharmaceutical industry influence the development of prices? Why are generic medications also more expensive in Switzerland than elsewhere?

You can read the answers to these and other key questions related to the pricing of medications in our article.

How do you have to participate in the costs?

In the health insurance system in Switzerland, insured persons participate in the costs of medical services, thus helping to moderate health insurance premiums.

This cost participation consists of three components:

The deductible

This is the maximum amount you are willing to pay out-of-pocket for medical services. You can select from among six different levels. The higher the selected deductible, the lower your insurance premium.

The excess

The excess is a cost participation component prescribed by law. It becomes applicable after the selected deductible has been reached and may amount to no more than CHF 700 per calendar year.

The hospital cost contribution

The hospital cost contribution is also prescribed by law. Starting from age 26, adults pay CHF 15 per day for each hospital stay.

More information on your cost participation

Save on your health insurance premiums now

Benefit from premium reductions. You have various options for reducing your health insurance premiums for the coming year. You can save on premiums both for basic insurance and for your supplementary insurance policies. Our savings tips will show you how it works. Please communicate your preferences in a timely manner before the end of the year so that we can adjust your policy.

Savings tips for basic insurance
Increase the annual deductible

The statutorily prescribed annual deductible is CHF 300. You can select a higher deductible and greatly lower your health insurance premiums through a higher cost participation. Learn more about premium savings via the deductible.

Select an insurance model with a premium reduction

Under a different insurance model, you can benefit from premium discounts of 6%, 12% or 15% under basic insurance. Before visiting a doctor in the event of health-related questions, you first consult a telephone advisory hotline or your general practitioner or a group practice. Learn more about premium savings via alternative models.

Prevent redundancies in accident insurance

If you are employed by the same employer for at least eight hours per week, you are automatically insured against occupational and non-occupational accidents. The exclusion of accident insurance under basic insurance reduces your premiums by 7%. Learn more about premium savings via accident insurance.

Apply for a premium reduction

Check whether your financial circumstances entitle you to financial support. The conditions and amount of such financial support differ from canton to canton. Learn more about premium savings via premium reductions.

Apply for supplementary benefits

If your AHV or IV pension is not sufficient to provide an adequate living standard, you may under certain circumstances be entitled to supplementary benefits. These also include premium reductions. Learn more about premium savings via supplementary benefits.

Find out more details about additional health insurance savings options.
Savings tips for supplementary insurance
Take out a long-term policy

Customer loyalty should be rewarded. With a three- or five-year policy, you benefit from a premium discount of 3% or 5%, respectively. Learn more about premium savings via long-term policies.

Increase your cost participation

You can take out some hospital insurance policies with a deductible. Depending on the amount of your voluntary cost participation, you can benefit from a discount of 15% to 35%. Learn more about premium savings via hospital deductibles.

Prevent redundancies in accident insurance

If you are insured against accidents through your employer, you do not need to take out private accident insurance, thus reducing your premium by 10%. Learn more about premium savings via accident insurance.

Find out more details about additional supplementary insurance savings options.

Our commitment to lower healthcare costs

As one of the largest health insurers in Switzerland, we play our part in helping to promote affordable healthcare. We contribute substantially to cost reductions by means of various services. This helps prevent insurance premium increases and thus benefits all insured persons.

Individual Case Management always on your side

Should you require outpatient or inpatient care, we will provide you with professional and empathic advice and assistance on your path to recovery. With active support for hospital admittance, treatment and therapy programmes and rehabilitation, we strive to ensure that your case is handled purposefully, without administrative hassles or redundancies. This allows you to make cost savings and benefit from consistently high-quality treatment. Learn more about Individual Case Management at Helsana.

Returning to work with Case Management

If an illness or accident prevents you from working for a long time, you find yourself in a difficult life situation. Not only has your health been affected, you are also suddenly confronted with professional, legal, social and financial questions. The situation can quickly become complicated due to the numerous parties involved, such as doctors, employers, various insurers and administrative offices. This is where the Helsana Case Manager steps in. The Case Manager is familiar with the healthcare and social system in Switzerland, as well as the relevant offers and points of contact, and is able to coordinate the necessary measures and processes. This person overcomes bureaucratic hurdles and helps you to return to work as quickly and smoothly as possible. Helsana Case Management therefore benefits all participants. It takes the pressure off patients and employees and prevents costs from getting out of hand. Learn how people in this situation have managed to get back on their feet thanks to Helsana Case Management: getting back to health, moving forward with life.

Joint purchases to get a better deal

We created the HSK Purchasing Cooperative in cooperation with two other health insurers. The joint purchase of medical services creates advantageous conditions for the companies involved, without diminishing quality. The resulting cost savings contribute directly to keeping premium increases in check. Learn more about the HSK Purchasing Cooperative.

Price advantage with mail-order pharmacies

As a Helsana customer, you can get medicines at a lower cost through four Swiss mail-order pharmacies. This has two advantages at once: you benefit personally while also contributing to lower healthcare costs. You make your order quickly and easily online. The postal service delivers your medications directly to your home. Shipping is free for prescription products. If necessary, you can benefit from confidential telephone advice. Choose generic products whenever possible. Their effect is the same as that of brand-name medications, but they cost much less. Learn more about the offerings of the mail-order pharmacies recommended by Helsana.

Knowledge for smart decisions

The range of modern medical services on offer is varied and complex. It is difficult for laypeople to assess the potential benefits and drawbacks of medical treatments and therapies. Cost is always an additional factor when making decisions. The more you know about medical services, the easier it is to decide if they are appropriate. We are therefore committed to providing objective, scientifically supported information to which we grant you direct access.

Committed to our customers

Competent advice over the phone

Your regional customer care team will be happy to answer questions on all aspects of your health insurance from Monday to Friday, 8 a.m. to 6 p.m. You can find this telephone number in your policy. You can of course still reach us on our central telephone number 0844 80 81 82.

Personal advice in the sales office

Would you prefer a personal consultation? Then visit one of our sales offices.

Sales offices

Secure communication via the customer portal myHelsana

Are you already using our myHelsana customer portal? If so, you can send your questions directly as a portal message. Would you like to register for myHelsana?

myHelsana

Calculate personal premium and request a quote

Start your personal premium calculation for the compulsory basic insurance and any other supplementary insurance you are interested in.

Premium calculator