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Daily sickness insurance: details on the policy in Switzerland

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Daily sickness insurance: details on the policy in Switzerland

Although daily sickness benefit insurance in Switzerland is purely voluntary, many Swiss opt for this policy. In Switzerland, the OR, the so-called obligation law, is valid. However, the continued wages paid by the employee in the event of illness are often insufficient. 

This is where daily sickness benefit insurance comes into play. This policy covers full payment of wages even in the event of long-term incapacity.

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Financial security for sick people

Those who are temporarily unable to pursue their professional activity are often faced with a major problem. The self-employed have to use up their financial cushion. Housewives may have to look for paid care. 

Even employees who are entitled to continued payment of wages by the employer face problems. In the worst case, the incapacity to work lasts over such a long period that the entitlement to continued wages ceases to apply. 

In these and many other situations, daily sickness benefits promise financial security.

Benefits of daily sickness insurance

Daily subsistence insurance aims to secure the financing of one's own everyday life and lifestyle in the event of inability to work due to illness or an accident. In the event of illness, payment of up to 100 percent of the wages is in prospect. 

However, the type of insurance also has a significant impact on the respective conditions. Depending on the type of daily sickness benefit insurance, the sum insured can be paid out for up to two years. If you accept a longer waiting period for payment of the daily allowance due in the event of unemployment, this fact also has a positive effect on the amount of the premiums. 

Daily allowance insurance offers potential policyholders in Switzerland a high degree of flexibility. Depending on the amount of the daily sickness allowance and the waiting time, the policy offers extensive design options. However, this flexibility gives every policyholder the opportunity to adapt the conditions to individual requirements. The most important advantages at a glance:

    • financial security despite illness
    • Insurance conditions can be adjusted individually

No assumption of costs in the event of unemployment

Even if it may sound a bit strange at first, there is an agreement in the employment contract about a? Loss of insurance benefit? can have a serious impact on the use of daily sickness insurance. 

If an employee cancels or receives the termination, it is entirely possible to lose the insurance as a policyholder. A similar case occurs for the self-employed who are insolvent after a long illness, have to sell their business or have to give up. 

Potential policyholders avoid these risks by taking a close look at the insurance conditions. Because there are now many insurance law agreements in which details such as these are interpreted in favor of policyholders.

Special features of a daily sickness allowance for the self-employed

The self-employed also take advantage of completely different options. These policyholders are often free to individually determine the start of payment and the amount of the sum. As a rule, those affected have a right to receive the benefit from the 14th, 30th or 45th day of illness. 

All in all, the benefits should correspond approximately to the value that arises from the loss of earnings. Nevertheless, the self-employed benefit from a particularly large number of advantages. In addition to maintaining the usual standard of living, the policies also offer protection against incapacity to work in maternity. 

All of these advantages are reason enough to seriously consider taking out daily sickness benefit insurance. Ultimately, personal protection primarily serves a purpose, your own recovery. 

Swiss health insurance companies cover the costs necessary for physical and mental recovery. However, the healing process will certainly progress faster if those affected weigh in financial security during this difficult time.

Health reservations

If the insurance companies request a declaration of their current state of health when they join the policy, potential policyholders must also truthfully complete the document. 

If the potential policyholders do not disclose certain facts or provide the information incorrectly, there is no entitlement to insurance protection in the event of a benefit - on the premise that there is a connection between the medical cause and the benefit. 

In practice, however, most insurance companies increasingly offer so-called full insurance. This means that every worker can be admitted without a prior health check. 

If the companies offer this insurance option, there are no benefit restrictions for existing diseases. 

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Children's glasses: What costs does the health insurance cover?

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Children's glasses: What costs does the health insurance cover?

Many children rely on visual aids like glasses. Worldwide comparisons show that myopia is increasing rapidly everywhere. This development does not stop at children who are based in Switzerland either. 

But if you need visual aids like glasses, you have to expect relatively high costs. In Switzerland, it is entirely possible that health insurance companies support policyholders with financing. The insurance companies may even participate in the financing of contact lenses.

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The basic insurance includes a participation for visual aids for children

In general, the so-called basic insurance in Switzerland is obliged to provide visual aids for children and adolescents up to the age of 18. Disability insurance, IV. 

This policy covers the costs. This includes most medical services that are related to so-called birth defects. 

Since these services also include visual impairments, the insurance companies in this case bear the cost of visual aids up to the age of 20 without a deductible.

An annual share of CHF 180

In Switzerland, children and adolescents who rely on visual aids receive an annual share of CHF 180 from their basic health insurance for contact lenses or glasses. However, an annual ophthalmological prescription is required to bill the health insurance company for these costs. 

Those who meet these requirements will benefit from this amount paid by the insurance until they are 18 years of age. Experience has shown that insurance companies pay higher reimbursements for contact lenses or spectacle lenses if people even suffer from a particularly severe visual defect or a related illness.

 This case occurs among other things with the following diseases or under the following circumstances:

    • in diseases of the cornea
    • an adjustment necessary after an operation
    • in the event of a refractive change due to illness

In general, parents in Switzerland are well advised to have their children examined regularly for possible ametropia. After all, most visual defects require therapy as early as childhood so that visual acuity is not restricted in the future.

With basic insurance, the payment of a deductible is included

Experience has shown that parents still have to pay a deductible for the provision of contact lenses or glasses. If, however, parents have opted for a franchise for their children that is higher than zero francs, policyholders must assume the respective franchise amount and the deductible of 10 percent on their own. 

Insurance experts therefore advise you to generally opt for a franchise of zero francs. After all, the discount on a higher franchise is comparatively small.

Good supplementary insurance is often a sensible solution

It may also make sense for affected parents to save cash by taking out additional insurance. However, a look at the details is required, since the benefits for supplementary insurance vary considerably from one health insurance to another. 

This step is particularly worthwhile for children and adolescents who are permanently dependent on the support of a visual aid. Experience has shown that contact lenses and corrected glasses ultimately cost more than CHF 180 per year.

Is a franchise recommended for children?

Actually, the amount of the franchise does not affect the additional payment for the children's glasses. In general, experts in Swiss insurance law also suggest agreeing a franchise of CHF 0 for children and adolescents. 

The insurance specialists cite the reason that the prospects for a discount on a higher franchise in Switzerland are relatively slim. To make matters worse, children and adolescents need a medical consultation comparatively often. 

If adults are dependent on glasses and contact lenses, other regulations apply. The compulsory basic insurance valid for Switzerland only provides financial support for visual aids under certain conditions. 

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Family insurance: Free health insurance membership?

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Family insurance: Are there options for free health insurance membership?

Anyone who is already resident in Switzerland or would like to settle in the country is subject to compulsory health care insurance. For Swiss citizens, this means that every family member must take out basic insurance.

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There are no family insurance schemes in Switzerland

Around 90 health insurers are located across the country, from which policyholders can choose their favorite insurance company.

The range of services offered by individual health insurance companies is no different. But if you want to upgrade the basic package by taking out additional insurance, you should take a close look at individual offers.

In line with the German system of private health insurance, policyholders pay non-income-related head premiums, which however vary from canton to canton and from health insurance to health insurance. However, in contrast to the German health insurance system, there are no family insurance schemes in Switzerland.

Reduced contribution rates for children and adolescents

Children and adolescents up to the age of 18 still have an advantage. In Switzerland, reduced contribution rates apply to certain groups of people. The following policyholders benefit from these regulations

    • children
    • youth
    • young adults
    • Low income people

A sample calculation provides information

A breakdown of the costs required for health insurance in Switzerland may seem confusing at first. But a look at the details reveals that this composition is still clearly subdivided. 

In general, insured people usually have to pay part of the treatment costs. The general contributions for health insurance are comparatively low. However, the cost contribution is also added to these costs, which in turn is calculated from a deductible of the invoice amount of 10 percent and the ordinary franchise. 

This model can be quickly explained using this calculation example.

There is no proper franchise for children and young people

In this example, policyholders have to pay a monthly contribution of 250 euros for the health insurance. The annual franchise is added to this, which in this example is CHF 300 per year for adults. 

This is where family-friendly Swiss politics comes into play. Because children and adolescents up to the age of 18 do not have to pay a regular franchise in Switzerland. This is offset by the deductible, which amounts to ten percent of the annual treatment costs. 

If treatment costs totaling CHF 2,000 have been incurred in the course of a year, the sum of the ordinary franchise is subtracted from the invoice amount. In addition, 10 percent of the deductible of the remaining 1,700 francs will be charged by the health insurance company. 

Based on this, a policyholder would only pay CHF 470 of the entire treatment fee, plus the monthly health insurance contributions. Accordingly, the maximum deductible is CHF 700 per year. 

For children and adolescents up to the age of 18, the share is reduced to CHF 350. If you want, you can also increase the proportion of the ordinary franchise in order to minimize the deductible if necessary.

Financial benefits for younger people

This example illustrates that there is no family insurance in Switzerland like in Germany. Nevertheless, children, adolescents and young adults benefit from some advantages that the Swiss health system offers them. 

Are there options for free health insurance membership? These options do not exist in Switzerland. Nevertheless, younger people are comparatively little asked to pay.

How children and young people join the health insurance system

Children up to the age of 18 are automatically covered by basic insurance after their birth. After the birth of a child, parents are obliged to register the newborn with a health insurance company no later than three months after the birth. 

When deciding for or against health insurance, potential policyholders are free to choose. The benefits of this basic insurance for children, adolescents and adults in the basic insurance are identical for all health insurance companies. 

However, the amount of the premiums differs significantly from provider to provider. If in doubt, it is advisable to compare offers from different providers online. 

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