Overview of insurance products

Insurance models within the compulsory basic health insurance

Compare products >

BASIS compulsory health insurance (standard model)

The standard variant of compulsory health insurance offers you unrestricted access to the doctors of your choice (free choice of doctor in your canton of residence or place of employment). You decide for yourself who you would like to have treat you from your GP to a specialist or, for example, a chiropractor.

With the standard model, you enjoy the free choice of doctor and direct access to specialists at all times.

Calculate premium / request quote

Select your desired insurance cover. You can then request a quote or conclude the insurance directly online.

Premium calculator

How the statutory standard variant of compulsory health insurance works

Unlike with alternative insurance models, you enjoy the free choice of doctor at all times in your canton of residence or place of employment with the standard model. However, this health insurance does not offer a model-based discount on your basic insurance premium.

Insurance benefits

You receive the following insurance benefits after deduction of the statutory co-payment (deductible/excess/hospital cost contribution) with the standard model of compulsory health insurance.

Details about the co-payment >

Hospital stays in Switzerland General - canton of residence

Hospital stays

If you have opted for another insurance model, you will receive benefits only subject to the following conditions:

  • BeneFit PLUS Family Doctor option: The stay in hospital is prescribed by your GP or group practice.
  • BeneFit PLUS Telemedicine option: The stay in hospital is prescribed by a doctor at the Centre for Telemedicine.
  • PREMED-24: Before the stay in hospital, you contact the medical advice hotline to receive non-binding health advice.

You receive the costs of a stay in a general ward (multi-bed room) and medical treatment in accordance with the standard rate in your canton of residence.

Choice of hospital

You are free to choose among all the hospitals in Switzerland that are included on the cantonal hospital lists (“listed hospitals”), but receive no more than the costs specified by the tariff of your canton of residence.

Further information

Abroad EU/EFTA Member States: respective social rate / Other countries: double amount of the insured costs in Switzerland

Emergency treatment abroad (outpatient)

By virtue of the Swiss-EU Bilateral Agreement on the Free Movement of Persons, you have the same access to public healthcare (doctors, pharmacies, hospitals or ambulances) in EU/EFTA countries as the residents of the country you are in at that moment. In the event of a medical emergency you will therefore receive costs in accordance with the basic rate of the country in question.

In all other countries outside Switzerland you will receive the costs for outpatient emergency treatment up to double the amount that the same treatment would cost in Switzerland (rate of your canton of residence).

Emergency treatment abroad (inpatient)

By virtue of the Swiss-EU Bilateral Agreement on the Free Movement of Persons, you have the same access to public healthcare (doctors, pharmacies, hospitals or ambulances) in EU/EFTA countries as the residents of the country you are in at that moment. In the event of a medical emergency you will therefore receive costs in accordance with the basic rate of the country in question.

In all other countries outside Switzerland you will receive the costs for inpatient emergency treatment up to double the amount that the same treatment would cost in Switzerland (rate of your canton of residence).

Transport and rescue 50% up to CHF 500.–

Transport at home

You receive overall 50% of the costs, up to CHF 500 per calendar year, of scheduled transportation to a medical facility for medically necessary treatment at home.

This is on condition that you choose a recognised mode of transport, e.g. a vehicle operated by Spitex, a wheelchair-accessible taxi, a vehicle for disabled people or an ambulance.

Rescue at home

You can claim 50% of the costs up to CHF 5,000 per calendar year for rescue operations in Switzerland.

Medicines Medications on the specialities list

You receive the costs of medications prescribed by a doctor which are included on the specialities list.

Special case for points limitation:

Certain medications are divided into therapeutic groups. You receive the costs for a predetermined quantity from this group within 90 days. The doctor or pharmacist is required to inform you of this.

Further information

Outpatient treatment – conventional medicine According to the tariff in the canton of residence

Outpatient treatment

You receive the costs according to the tariff in your canton of residence for treatment by Federally certified doctors, chiropractors and medical support staff such as physiotherapists, occupational therapists, healthcare professionals, midwives, speech therapists, etc.

This is subject to the condition that the treatment has been prescribed by a doctor and is listed in the benefits catalogue of the basic insurance.

Further information

Outpatient treatment – complementary medicine Defined methods

Complementary (alternative medicine)

You receive contributions towards the costs of the following types of complementary medicine:

  • Anthroposophic medicine
  • Classical homoeopathy
  • Phytotherapy
  • Pharmacotherapy within traditional Chinese medicine (TCM)
  • Acupuncture

Please ensure that your doctor holds a recognised certificate of competence awarded by the Swiss Medical Association (FMH) for these methods.

The costs are refunded according to the tariff in the canton where the person lives or the tariff for his work location.

Prevention (preventive medical care) Costs for certain preventive measures

Check-ups

You receive the costs for specific examinations for the early detection of illnesses and for preventive measures (e.g. vaccinations) that are performed or prescribed by a doctor.

The costs of a gynaecological check-up are covered for women every three years. The costs of mammograms are covered subject to certain conditions. We would be happy to give you information on this by phone.

Medical aids and equipment According to list

You receive the costs of medically prescribed aids and apparatus, such as crutches, blood-sugar measuring devices, inhalation/respiration therapy equipment and compression stockings, up to the maximum amount specified by law.

This is on condition that the medical aids are listed in the aids and equipment list and that you obtain them from an authorised provider.

Further information

Maternity Examinations and consultations

Pregnancy

Check-ups and ultrasound examinations
  • In the event of a normal pregnancy, you are entitled to seven check-ups carried out by a doctor or by a midwife.
  • We will also reimburse you for two ultrasound examinations carried out by a doctor.
  • For a high-risk pregnancy, you will receive the costs of all necessary check-ups and ultrasound examinations.
Breastfeeding guidance
  • You receive 3 sessions of breastfeeding guidance from a midwife or specially trained nursing staff.
  • Breastfeeding guidance replaces the breastfeeding allowance. This was abolished with the 1996 revision of the Health Insurance Act.

Birth preparation

You receive CHF 150 per calendar year for

a) birth preparation courses run by the midwife for individuals or groups

or

b) a consultation with the midwife on the birth, the planning and organisation of the postnatal period at home and preparations for breastfeeding

Home birth

For a home birth, you can claim costs in accordance with the applicable rate or contract with the midwife.

Hospital stays

If you have opted for another insurance model, you will receive benefits only subject to the following conditions:

  • BeneFit PLUS Family Doctor option: The stay in hospital is prescribed by your GP or group practice.
  • BeneFit PLUS Telemedicine option: The stay in hospital is prescribed by a doctor at the Centre for Telemedicine.
  • PREMED-24: Before the stay in hospital, you contact the medical advice hotline to receive non-binding health advice.

You receive the costs of a stay in a general ward (multi-bed room) and medical treatment in accordance with the standard rate in your canton of residence.

Nursing care Cost contribution

Spitex

With home care, the care specialist determines your expected need for care with the direct time requirement. The specialist completes a relevant statement of requirements. We pay for the duration of care required based on the corresponding amount in francs specified by law.

You receive a contribution to the costs for Spitex at home (home nursing care), if prescribed by a doctor.

This is subject to the condition that the chosen Spitex organisation or healthcare professional is qualified and recognised.

Further information

Nursing home

You receive the costs according to the applicable tariff for inpatient care services in a nursing home. The tariff is based on the level of care needed, as determined on your admission.

We cannot assume boarding costs (room and board at the nursing home) from basic insurance.

Spa treatment CHF 10 per day

You receive CHF 10 per day for up to 21 days per calendar year for spa therapies at recognised therapeutic spas in Switzerland.

Conditions:

  • The spa treatment is medically certified as necessary.
  • The spa treatment has been prescribed by a doctor.
  • The spa treatment is carried out at a recognised therapeutic spa.

FAQs

Answers to frequently asked questions about the BASIS standard variant of compulsory health insurance:

What are the advantages of the standard model compared to the alternative insurance models?

With the standard version of basic insurance, you keep your options open at all times:

  • You are always free to choose and consult doctors within your canton of residence or place of employment.
  • You can go directly to a specialist of your choice, if needed.

By contrast, alternative insurance models come with certain restrictions and/or obligations.

Who can take out the BASIS standard model?

You can take out this insurance if you meet the following conditions:

  • You are officially resident in Switzerland, or
  • You are resident in an EU/EFTA country but are subject to Swiss health insurance legislation under a bilateral agreement, e.g. as a cross-border commuter.

Health insurers are obliged to accept all applicants irrespective of age and personal state of health without reservations.

How and when can I terminate this health insurance?

You can terminate the insurance on 31 December of each year and switch to another health insurance company in Switzerland, provided that you have no overdue premiums. There is a one-month notice period from notification of the premium for the following year.

If you have taken out a BASIS policy with the statutory minimum deductible of 300 francs (or without a deductible for children), you have the additional option of terminating it on 30 June with a notice period of three months, again provided there are no outstanding premiums..

Details about termination >

What deductibles are available?

Adults age 19 and over can either select the statutory minimum deductible of CHF 300 or one of five optional deductibles between CHF 500 and CHF 2,500. The higher your deductible, the lower your basic insurance premium.

There is no minimum deductible for children; however, by choosing the optional CHF 500 deductible for them, you can save on their premium too.

Details about the annual deductible >

Still not sure which deductible makes the most sense in your case? Our advisor will be happy to help you. Call us on 0844 80 81 82.

Different rules for cross-border commuters

For cross-border commuters from EU/EFTA countries, the statutory annual deductible for adults is also CHF 300 a year and there is no annual deductible for children up to the age of 18. However, cross-border commuters cannot be offered optional deductibles, i.e. they cannot opt for a higher deductible in return for a reduced premium.

How and when can I change my deductible?

You can increase or decrease your deductible on 1 January of the following year.

We must receive your notification regarding the change in deductible by no later than 31 December.

Change deductible >

Different rules for cross-border commuters

Cross-border commuters from EU/EFTA countries cannot be offered optional deductibles, i.e. they cannot opt for a higher deductible in return for a reduced premium.

Do I receive a premium reduction?

Those whose income and assets justify financial support are entitled to a premium reduction (PR). The premium reduction varies from canton to canton and often does not take effect until the policyholder has asked about it. So it is worth asking the competent office of the canton in which you live whether you are entitled to financial support for your health insurance.

Details about the premium reduction >

Is there a discount? How can I save on premiums?

There are several ways of saving on your premium for basic insurance.

Tips for saving on basic insurance premiums >

Why do I need basic insurance?

Under the Swiss Health Insurance Act (KVG), health insurance is compulsory for anyone living in Switzerland. It provides basic medical care in the event of illness, accidents and maternity, and is therefore known as basic health insurance.

The scope of benefits it covers is regulated by law. This means you receive exactly the same benefits from every health insurer in Switzerland.

Downloads

Popular supplements to basic insurance cover

Supplement your basic insurance cover with one or more supplementary insurance policies to close any gaps in coverage based on your needs.

Supplementary insurance at a glance >