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Basic insurance for maternity

What you should know about the benefits of basic insurance for motherhood in Switzerland

We will provide you with detailed information about the benefits that compulsory health insurance in Switzerland provides during maternity.

Are you really looking forward to the new life that will soon grow in you and can't wait to finally hold your little darling in your arms? 

Perhaps you are planning to start a family soon and want to build a future in Switzerland? 

The most important thing that you as an expectant parent are interested in during pregnancy is undoubtedly mothers and babies health protection during maternity. Here you will find helpful tips that will take away your worries and allow you to enjoy your child with ease. 

We will provide you with detailed information about the benefits that compulsory health insurance in Switzerland provides during maternity.

Basic insurance in Switzerland covers the most important costs in maternity.

Switzerland saw a steady rise in the birth rate between 2007 and 2017. This is mainly due to the stable economic situation of the attractive region and also to the child and mother-friendly basic insurance, which pays for the crucial and necessary examinations and treatments during motherhood. 

Because everyone in Switzerland has to show this compulsory health insurance for stays of three months or more, future small residents will also receive the best medical care from the time they come into being and also after birth. 

The basic insurance fundamentally covers the necessary special maternity benefits.

These include the treatments and preventive services performed by midwives or doctors:

- Check-ups during and after pregnancy such as:

Ultrasound examinations, prenatal cardiotographies, the first-trimester test, the non-invasive prenal test, advised amniotic fluid tests and the placenta examination.

- Treatments for diseases:

From the 13th week of pregnancy and 8 weeks after the birth, the basic insurance covers all costs that you incur due to illnesses or complications. Before the 12th week of pregnancy, the rules of your supplementary insurance or health insurance apply.

- Birth preparation courses carried out by midwives or a specialist institution.

Tips: 

- You do not have to prepare for birth alone, because the basic insurance makes a contribution of CHF 150 for individual and group courses.

- The stay in hospital during and after birth is also paid for by the compulsory health insurance for mother and child.

- For the birthplace and hospital resident in your canton, your health insurance company will cover the entire costs of the birth, including medical care afterwards. 

This includes the absolute assumption of costs without franchise, a deductible or a hospital contribution. 

If you decide to go to another hospital that is not in your canton of residence, it is advisable to agree with your health insurer beforehand what is paid and what is not.

Important:

If your little darling has an illness regardless of birth, the child's health insurance automatically pays for the necessary treatments from the first day, taking the deductible into account.

Good to know

Even after birth, basic insurance covers coverage for mother and child. For example, young mothers benefit from home care offered by midwives up to 56 days after birth. Unless otherwise prescribed by a doctor, this consultation includes up to ten appointments. In addition, the services for pregnant women provide the following treatments and advice after childbirth: 

    1. a check-up (six to ten weeks after delivery)
    2. three breastfeeding consultations by a breastfeeding consultant or midwife

A small tip on the side: In Switzerland there is no relevant case law for the case of a desired Caesarean section. Those who want to be on the safe side can choose the deepest franchise with CHF 300. In this case, the costs remain as low as possible if the health insurance companies do not completely cover the costs for a Caesarean section. 

Conclusion

Switzerland ensures good basic care for all pregnant women and their newborns. In addition, the various health insurance companies of course also offer modern and progressive additional benefits and insurance, which, depending on your individual needs, offer supplementary benefits during maternity.

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How and when can I cancel my basic insurance in Switzerland?

When and how can I cancel my Swiss basic insurance?

In principle, you can cancel the Swiss basic insurance annually without any problems or disadvantages.

If you are looking for a high-quality health insurance comparison have opted for health insurance from a health insurance company in Switzerland, you have all options.

The mandatory Basic insurance Switzerland is regulated by law and the premiums of the health insurers are officially approved.

Every health insurance company has to inform each customer clearly and openly about its services and premiums, which is why there are some advantages for you that you can use for a final decision or a change. In this blog you will find out when and how you can advantageously terminate your basic insurance in Switzerland.

In principle, you can cancel your basic insurance in Switzerland annually without any problems or disadvantages.

Tip: You can send a sample letter here Download.

Every year in October at the latest, the health insurance companies usually quantify your new premiums for the next year. You have until November 30th to cancel your old basic insurance and switch to another fund. 

The change to the new health insurance company generally takes place on January 1st of the following year. Regardless of the franchise levels, from GP model or Telmed model and the premiums, this rule applies to everyone, regardless of whether they have bonus insurance or not.

You should therefore calmly wait for the annual premium notification from the health insurance companies in Switzerland and include the result in an efficient health insurance comparison.

Anyone who has taken out basic insurance with a franchise can also terminate every six months.

If you pay a franchise starting at CHF 300 in addition to the basic insurance premiums, you can change your health insurance every six months until the end of June. However, this only applies to contractors who are not insured according to the family doctor model and the Telmed model. 

Tip: The old health insurance company must have given notice of termination by the end of March in order for the change to work smoothly.

If your health insurance company increases the premium during a current calendar year, you also benefit from an additional right of termination. This also applies if your basic insurance is anchored in one of the models.

A seamless change of health insurance is not a problem in Switzerland.

If you want to terminate your previous health insurance company in Switzerland as soon as possible, make sure that the date on which the notification of termination was received by the health insurance company is decisive. The notice of termination must therefore reach the health insurance company on the last working day before the start of the notice period. 

It is not the postmark with the date of sending that counts, but the timely receipt of the letter. Therefore, you should include all working days and also Sundays and public holidays in the submission deadline. 

Your new health insurance company must then send a message to the old insurance company in good time and pay the difference in the contributions if you fail to do so. This is how Switzerland successfully counteracts an interruption in the insurance relationship.

Bonus insurance special case

A special case occurs if you have taken out a bonus package for the basic policy with your previous health insurance. You can only terminate this so-called bonus insurance after a maximum of five years after the conclusion of the contract at the end of a calendar year. 

Please also note that you have to observe a three-month deadline for this termination. In the case of an announced premium increase, the shortened notice period is one month. In this case, however, the regulation with a five-year contract has priority. 

Therefore, you might want to think about the extent to which this insurance model might even be suitable for you due to the longer cancellation periods when you take out the bonus insurance. 

Conclusion

In Switzerland, you have the advantage that health insurance companies work openly and competitively to retain customers. As a rule, you yourself can decide annually which advantages and which cash register are attractive and lucrative for you.

A well-founded health insurance comparison makes perfect sense. So take your time between November and December to make the selection for your health insurance company. Find out here whether your health insurance company has one Work accident pays!

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Franchise and deductible: the cost sharing of the insured

Franchise and deductible: the cost sharing of the insured

All insured persons must bear part of the costs they incur. The scope of theThis mandatory cost sharing is set out in the law.

First there is the ordinary, legally prescribed annual deductible of CHF 300.

The franchise is a fixed annual amount and therefore a base fee that all adults aged 19 and over have to pay for their own healing costs each year.

The annual deductible applies to all services that are paid for from basic insurance, i.e. for doctor and hospital bills, medication, glasses, nursing home and Spitex bills as well as for gynecological preventive medical examinations, but also for r Accident treatment if no compulsory accident insurance pays.

Tip: Children up to the age of 18 do not have to pay a franchise (parents can, however, voluntarily conclude a franchise for their children).

The rules of the deductible

In addition to the annual deductible, there is a deductible of 10 percent, which is also required by law, also for children.

This means: If the insured has already paid off his franchise in the calendar year in question, he must continue to take over 10 percent of each invoice himself (in exceptional cases 20 percent).

This deductible is open to adults over 19 limited to a maximum of 700 francs per calendar year (350 children per year).

Three examples

Example 1: If you go to the doctor once a year and receive an invoice for CHF 290, you pay everything yourself.

Example 2: Anyone who presents a single medical bill of CHF 400 per year will receive a refund of CHF 90 rather than CHF 100 (400th minus annual deductible, 300th minus 10 percent deductible, based on the remaining amount).

Example 3: If the medical costs are CHF 2,000 per calendar year, you pay an annual deductible of CHF 300, plus a deductible of CHF 170 (10 percent of € 1,700). This results in a total cost sharing of CHF 470. The rest of CHF 1,530 is covered by health insurance.

Exceptions in the overview

All services in the event of maternity or for certain measures of medical prevention are exempt from paying the franchise fees and the deductible. In the context of inpatient treatment in a hospital, there is also a cost contribution of CHF 15 per day as hospital amount. Children up to the age of 18, trainees up to the age of 25 and expectant mothers for medical services during maternity are also exempt from paying the amounts. 

Franchise and deductible: the intention

In addition to the premiums, the franchise and deductible model has proven itself as an additional financing instrument for social health insurance. The primary aim of this is to support policyholders' personal responsibility and cost awareness. 

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In the military: do not pay basic insurance premiums

In the military: do not pay basic insurance premiums

Recruits and other service providers do not have to pay basic insurance premiums during the military period.

The premium exemption applies to people who have been on duty for more than 60 consecutive days. This applies to military and civilian service and also to civil defense.

These people are now subject to military insurance, so any bills must be submitted there.

Those affected must send the marching order to the health insurance company at least eight weeks before taking up duty.

Those who send in the marching order too late cause unnecessary trouble for the health insurance company. It will then offset wrongly paid premiums later (after the end of duty) with the new premium invoices (or refund them beforehand if necessary).

If the persons obliged to work are indented, they must request confirmation from the responsible army office (usually from the school command) that they are indented. They have to shoot the health insurance companycick? otherwise it will continue to send premium bills.

Only whole monthly premiums are taken into account for the premium exemption. If the service begins before the 15th of a month, the premium exemption applies from this month, otherwise from the following.

Overview of further information

If you do your military or civilian service in Switzerland, you cannot suspend additional insurance in addition to basic insurance. These policies just keep going during the military period. During this period, policyholders are obliged to continue paying the premium during the service. 

Anyone who has additionally opted for semi-private hospital coverage can of course also take advantage of this insurance if they are hospitalized. 

Conversely, this means that military insurance covers the costs of basic insurance. During a hospital stay, however, the general hospital department pays the costs. 

If you want to avoid any follow-up costs that may arise, you are well advised to find out about insurance coverage from the health insurance company in advance. 

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No cost sharing with motherhood!

No cost sharing with motherhood!

In the case of maternity benefits, the compulsory basic insurance does not include a franchise, deductible or CHF 15 per hospital day.

Maternity includes not only birth, but also preventive checkups and other benefits related to pregnancy.

Tip: The health insurance companies do not always notice on the basis of the invoice received that this is treatment in connection with maternity. Therefore, expressly ask the doctor and the hospital to put the note "motherhood" on the respective invoices.

In the case of pregnancy complications, the cost sharing in basic insurance has also not been owed since March 2014. Up until this point, complications were considered to be a disease, and the woman had to share the costs with the usual deductible and deductible.

This applied, for example, to compression stockings, hospitalization to prevent premature birth, physiotherapy due to back problems, treatment of gestational diabetes, medication to treat an infection, further operations or psychotherapy for depression after childbirth.

The following now applies to medical complications: From the 13th week of pregnancy to 8 weeks after birth, women generally no longer have to share in the costs of maternity. This is true even if the pregnant woman has the flu.

In the case of an unpunished abortion, however, the cost sharing is still owed.

But women shouldn't forget: If you have semi-privately or privately arranged a voluntary franchise in the supplementary hospital insurance, you must also pay this if you are a mother!

Special services provided by health insurance companies

In addition to the costs already mentioned, health insurance companies also assume all the necessary financial resources for the following medical services: 

    • Check-ups during normal pregnancy: seven exams and two ultrasound checks
    • Check-ups during pregnancy at risk: Assumption of costs from as many examinations and ultrasound checks as the doctor orders for medical reasons
    • Birth preparation courses: Insurance bears a share of CHF 150:
    • Childbirth and obstetrics by a doctor, midwife: Pregnant women are free to decide whether they want to give birth to their child in an acute hospital, at home or in an inpatient nursing facility; Service includes several midwife searches up to 56 days after birth
    • Breastfeeding advice: reduced to three sessions; Implementation is imperative for nurses trained in breastfeeding counseling 

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Which health insurance company offers the most family discount?

Which health insurance company offers the most family discount?

Children have lower premiums and young adults between 19 and 25 years receive a discount from many health insurance companies. Here you will find the Overview.

In principle, all health insurance companies offer a reduced premium for children up to the age of 18. At some health insurance companies, families with many children also benefit from the fact that the third and every additional child benefits from a family discount.

The health insurance companies may give a discount on premiums to young adults between the ages of 19 and 25 (but they do not have to). It does not matter whether young adults are still in training or not. The discount is allocated automatically, an application is not required.

The switch from child to youth practice takes place on January 1 after the child has celebrated its 18th birthday. The following change to adult practice takes place on January 1 after the person celebrates his 25th birthday.

But just: The discount is voluntary and varies from cash register to cash register. It ranges between 0 and 20 percent, and health insurance companies have steadily and markedly shut it down in recent years. More and more health insurance companies are canceling the discount for young people completely.

Tip for teenagers: If you switch to a cash desk with a large youth discount, there is a striking premium jump if the cash register is no longer allowed to give the discount as soon as you turn 26. But that doesn't matter, because the basic insurance can be changed every year.

Register your child with the health insurance company: how it works

Young parents should have registered their child with a health insurance company no later than three months after birth. However, mothers and fathers are well advised to complete the registration before the birth. All you have to do is inform the health insurance company of the name and date of birth of the offspring after the birth. 

In addition, you can also opt for supplementary insurance without a health check before the birth. The following conditions apply to basic insurance for children and adolescents: 

    • Birthday is automatically considered to be the start of insurance
    • Health insurance providers are freely selectable
    • Benefits are the same for all health insurers
    • Health insurance can be changed at the end of the year 

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Overview of family discounts

Here you will find an overview of the family discounts which health insurance companies grant for your children.

health insurance
Children's discount OKP
Youth discount OKP
Special promotions and regulations
SWICA
75%
12%
To the premium calculator
Helsana
75%
10%
90% child discount OKP from the 3rd child: In the OKP 90% child discount is granted from the 3rd child (0-18 years) in a family.
Progres
75%
10%
CSS
78%
8%
Family discount: Premium discount on various additional insurance policies if the legal guardian and the child / young person live together in one household and are insured with CSS: up to 100% discount for children and young people up to the age of 20.
Concordia
72-78%
3-6%
From the 3rd child: 88% premium discount in basic insurance.
Visana
76-78%
3-12%
Up to 90% child discount in OKP for every third and additional child insured with Viana.
Assura
73-79%
0%
From the age of 26, Assura guarantees lifelong maintenance of the entry age for supplementary insurance.
Sanitas
75%
10%
From the 2nd child 80% discount. Prerequisite: The children are insured with the same insurance provider.
Compact
75%
0%
From the 2nd child 80% discount. Prerequisite: The children are insured with the same insurance provider.
Group Mutuel
72-78%
6%
Family Discount: Global classic underage children receive a 40% discount
KPT
79%
8%
Family discount: From the 3rd child, the oldest child receives nursing plus or nursing comfort and / or hospital cost insurance for the general ward free of charge.
ÖKK
75-78%
0-8%
Family discount: For ÖKK FAMILY and ÖKK FAMILY FLEX children up to 18 years get 50% and teenagers from 19-15 years 20% discount.
Agrisano
78%
The first two children and adolescents (up to 18 years) receive a 78% premium reduction compared to the adult premiums.
Aquilana
75%
20%
75% lower premiums for the first and second child (up to the age of 18). Young adults (ages 19 and 25) receive a lower premium than older insured persons (adults). The discount is 20%.

Information without guarantee - status: February 2019

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Does the health insurance company pay the fitness subscription?

Does the health insurance company pay the fitness subscription?

Compulsory basic insurance does not pay for the cost of a fitness center subscription. 

However, some health insurers pay a modest contribution (usually 200 to 800 francs per year) from one of the small ones supplementary. 

Usually, at least a half-year or even an annual subscription is a prerequisite for the reimbursement of costs.

Health insurance companies often also pay for special courses such as aerobics, back exercises, pregnancy exercises, post-exercise exercises or pelvic floor exercises. 

The cash register is so small that it is not worth insuring this addition solely because of the fitness center contribution. 

Tip: Ask your health insurance provider whether your center is recognized. Request a list of those fitness centers that have been checked and approved by your health insurance company. Quite a few tills only pay for studios that have the so-called Quaitop belt seal.

Conclusion

There are several insurance companies that cover a more or less large part of the cost of a subscription to the gym. However, in most cases it is not possible to adapt the service package to individual circumstances. Anyone who books a complete package with additional insurance may pay for services that are not required at all. 

It is therefore particularly important to take a close look at the service packages of individual health insurance companies and compare them with one another. But not only the benefits vary from health insurance to health insurance. You should be yours Cancel health insurance if you are in Switzerland to compare. The premiums also differ. As a result, it only makes sense in very few cases to make the choice of a suitable supplementary insurance dependent on the fitness subscription offered.

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Health promotion contributions from health insurance companies

Here you can see an overview of all health insurances in Switzerland, which prevention contributions from supplementary insurances make to the costs of an annual fitness subscription.

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Information without guarantee - status: August 2018

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What health insurers are there in Switzerland?

What health insurers are there in Switzerland?

Here you will find the complete list of approved health insurers in Switzerland. Every person residing in Switzerland, whether Swiss or foreign, must take out insurance at the latest three months after taking up residence.

Free choice of cash register - also for the sick, the elderly and pregnant women

In the compulsory basic insurance, the insured have free choice of health insurance. Everyone is allowed to leave their health insurance company in compliance with the notice period and to join any new insurance fund, even in old age.

Tip 1: The new health insurance fund must include prospective customers in the basic insurance, even if they are sick or older, under treatment or in hospital. The cash registers are also not allowed to reject pregnant women.

Tip 2: Parents must have their children insured no later than three months after the birth. It is possible to register before the birth.

Tip 3: Health check: In basic insurance, health insurance companies are not allowed to require a health check or make health reservations. If you only want basic insurance, you don't have to answer the health questions.

Conclusion

Switzerland has a nationwide health care concept. Therefore, potential policyholders are free to choose the appropriate compulsory basic insurance from more than 50 private insurance companies. 

However, insured persons should bear in mind when searching that some of these companies operate throughout the country, while others only operate in isolated regions. In general, therefore, policyholders can only select one provider that is active in their own canton of residence. 

If you are looking for the best option for your own interests, you should pay attention to the premium amount. On the other hand, customer satisfaction plays a crucial role. This customer satisfaction is regularly discussed in customer surveys. 

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The complete list of approved health insurers in Switzerland

health insurance
Number of insured
CSS
939.684
Assura
927.345
Helsana
782.799
Swica
594.133
Concordia
524.273
Visana
456.492
Sanitas
350.824
KPT
389.623
Mutuel
386.486
Progrès
194.538
intras
166.696
Atupri
163.955
ÖKK
143.721
EGK
140.607
Vivao Sympany
137.092
Sansan
132.997
Wincare
130.431
Philos
100.705
Agrisano
91.947
Avenir
90.126
SKBH
69.429
Caisse-maladie et accidents Universa
67.635
La Caisse Vaudoise (Groupe Mutuel)
63.519
avanex
61.952
Caisse-maladie Hermes
61.521
Provita Gesundheitsversicherung AG
56.739
Supra Caisse-maladie
44.825
innova health insurance AG
40.818
Arcosana AG
40.783
Xundheit
36.598
Aerosana insurance
33.969
Kolping Krankenkasse AG
33.241
Aquilana insurance
32.419
Sumiswalder health and accident insurance
21.548
panorama
21.380
Carena Switzerland
21.123
Auxilia Assurance-maladie SA
19.417
Vivao Sympany Switzerland AG
18.945
Easy Sana
17.794
KLuG health insurance
16.368
Health insurance Lucerne hinterland
15.660
sodalis health insurer
14.770
SLKK
13.681
Galen
11.383
Moove Sympany AG
10.830
Avantis-Assureur maladie
10.722
rhenusana
9.239
Health insurance of the Goms region
8.458
Caisse-maladie de Troistorrents
8.257
sme insurance
7.433
Fondation AMB
7.220
Steffisburg Health Insurance Cooperative
7.081
Cervino health insurance
7.008
Health insurance Malters AG
6.944
vita surselva
6.302
sana24 AG
5.951
Birchmeier health insurance
5.474
SanaTop Insurance AG
5.365
Wädenswil Health Insurance Foundation
4.830
Publisana health insurance
4.750
Caisse-maladie de la vallée d.Entremont
4.633
Cooperative health insurance Elm
3.968
Health insurance company Visperterminen
3.004
Foundation CMP Lumnezia I
2.720
Lötschental health insurance
2.696
Health insurance Flaachtal AG
2.491
sanaval's health fund
2.429
Schattenberge health insurance
2.279
Daily allowance artists
2.204
Caisse-maladie EOS
2.046
innova Wallis AG
1.514
Stalden health insurance
1.486
Health insurance company Embd
1.408
Fondation Natura Assurances
1.276
Stoffel health insurance
1.222
Commercial health insurance
1.055
Staldenried health insurance
813
Luchsingen-Hätzingen health insurance
787
Simplon health insurance
583
Turbenthal health insurance
435
Zeneggen health insurance
209
Gondo / Zwischenbergen health insurance
98
vivacare AG
86

Information without guarantee - as of May 1, 2018 (BAG)

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How do I change my health insurance?

How do I change my health insurance?

You can find the most important tips for changing basic insurance at neotralo.ch

If you not only want to take care of the premium savings options, but also want to look for a cheaper health insurance fund, you can do this every year in the basic insurance: the scope of benefits is the same everywhere, the health insurance funds have to accept every person without reservation and without a waiting period. No matter if she is old, pregnant or sick.

Such a change can be worthwhile: in a number of cases, individuals can easily save CHF 1,000 a year by changing their basic insurance.

Change in premium increase during the year: It may happen that the health insurance company increases the premium during the calendar year. This also results in a right of termination. No matter which model you are insured with!

The date of receipt applies: The date of receipt applies to all cancellations by the health insurance company. The notice of termination must therefore have reached the health insurance company on the last working day before the start of the notice period.

So it is not the postmark with the date of sending that counts, but the timely arrival at the health insurance company.

Tip: Send registered cancellations and in good time. Keep in mind that the last day of the month can fall on a Sunday or public holiday on which the health insurance company does not collect any mail. (In the case of voluntary supplementary insurance, compliance with the time limit depends on the wording of the relevant regulations of the health insurance company.)

Insured without confirmation: If you are in writing and awritten at a cash register, you are insured even without confirmation.

A message from the cash register is required: The insurance relationship with the old health insurance company is only officially terminated when the new health insurance company informs the previous one that the new customer is ver without interruption of the insurance coverageis secured. So say the law.

The new health insurance company must therefore report to your previous one that you are now insured with it. The new till sends this Meltoo late, the change will take place on February 1st.

No change in the case of premium outstanding: A change of fund is only possible if you do not owe the previous fund on December 31, no premiums or cost sharing, and also no default interest and debt collection costs.

Here's how to do it:

1. Find out which health insurance company offers compulsory basic insurance at your place of residence.

2. Cancel the basic insurance registered at your current health insurance fund. The notice of cancellation must be received by the cash register no later than November 30 or the last working day in November.

3. Register in writing and registered with the health insurance of your choice for the next year (sample letter download).

Tip: If you cancel the basic insurance with your health insurance company, but want to keep the additional insurance, make sure that you only cancel the basic insurance in your registered letter and not the entire policy!

If you do so, the new health insurance fund must not refuse you entry into the basic insurance. Even if you have never previously requested or received an offer.

Are the same conditions valid for changing supplementary insurance?

Experience has shown that different periods and rules apply to a change or cancellation of supplementary insurance than to basic insurance. With these policies, policyholders usually have to give three months' notice. 

Some insurance providers even stipulate a period of up to six months. As with basic insurance, policyholders should submit the change request in writing by registered mail. 

But be careful: In contrast to basic insurance, supplementary insurance is entitled to reject applicants. However, for whatever reason, you may not be denied this change. 

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