What is Swiss health insurance?
Since 1996, all persons staying in Switzerland for more than three months must have health insurance. This health insurance must cover certain benefits, all of which are insured by Swiss health insurance companies under what is known as basic insurance. These include examinations, treatments and medication costs in the event of illness, accident, childbirth and abortions. Dental treatments are only covered in exceptional cases.
In general, insured persons must first pay for the benefits claimed themselves and then apply for a refund from the insurance company. Hospitals can arrange direct settlement with the insurance company. For all basic insurance policies, the insured persons must contribute to the costs incurred. This contribution includes excesses and a deductible.
• The excess is a sum of money that you can usually choose yourself. All health costs incurred during the course of a year are borne by the insured person until this amount is reached. Once the amount is reached, any additional invoice amounts are covered by the health insurance.
• If the excess has been exhausted and new invoices are added, 90% of these will be covered by the insurance policy. The remaining 10% must be paid by the insured person. Here, too, there is an annual upper limit (CHF 700). Once this cap is reached, the invoices will be covered in full by the insurance.
This is regulated by the Health Insurance Act (HIA). Certain persons such as
foreign students, interns or trainees, can apply to be exempted from statutory health insurance. If an exemption is granted by the local authorities, you can opt for private insurance as long as you meet the requirements of the HIA. Private insurance may be less costly. coverio offers the necessary benefits in accordance with the HIA.
What is an exemption from compulsory health insurance?
According to the Swiss Health Insurance Act (HIA), all residents of Switzerland are obliged to take out basic insurance. However, certain groups of people (including students, interns) may apply for an exemption from compulsory Swiss health insurance. This exemption must be approved by the cantonal authorities. This exemption means that these groups of people can instead take out private insurance as long as it meets the requirements of the HIA. coverio offers the necessary benefits in accordance with the HIA.
Can the exemption application be refused?
Yes, if the local authorities determine that you are not eligible, they may refuse your exemption request. Reasons for the refusal and a deadline for contesting the decision would be communicated in this case. In the event of a refusal, you must take out insurance with a Swiss health insurance company and contact coverio to initiate the premium refund process.
What is an exemption confirmation?
An exemption certificate is a document that is usually issued by the local authorities of your canton of residence and confirms your exemption from statutory health insurance based on your cover through coverio. Upon receipt of this document, send a copy to coverio, quoting the policy number.
Keep the document in a safe place, as you will need a copy or scan of the document if you submit a refund request.
Does an exemption mean that I don't have to pay contributions for health insurance?
No, regardless of the exemption outcome, you will still have to pay contributions. The exemption does not release you from the obligations of the Swiss Health Insurance Act (HIA), which stipulates that every resident of Switzerland must have health insurance. The exemption means that, subject to official approval, you are permitted to choose a private health insurance such as coverio.
HOW DO I APPLY FOR AN EXEMPTION FROM COMPULSORY HEALTH INSURANCE?
After you become a coverio customer, you will receive detailed instructions by e-mail, as the procedures may vary depending on the local authorities in your canton of residence. As a rule, you must fill out an exemption form and submit the completed form, together with the required documents, to the competent cantonal authority. If this authority requires further confirmation from coverio, you can request this from coverio. If possible, the documents should be submitted by e-mail and in PDF format. The coverio team will confirm the insurance cover and return the documents to you. You can then submit these to the competent authorities. This review process may take a few weeks to several months.
Please note that coverio will not be able to provide you with updates on the status of the procedure in the meantime. Your insurance cover is valid during the exemption process if the authorities give you a positive decision. As soon as you receive the notification from the local authorities, you are obliged to submit the exemption confirmation to coverio without being asked.
How long is the exemption valid?
If you have received written confirmation of exemption from compulsory health insurance in Switzerland, it is usually valid for 3 years. Thereafter, it may be extended for up to three more years by a written request. The insurance term with coverio with a valid exemption is therefore a maximum of 6 years.
Do I have to pay contributions for my health insurance during the exemption process?
Yes, cover is mandatory while your exemption request is being processed. Non-payment will lead to the cover being suspended. coverio is then obliged to inform the authorities. This suspension interrupts the exemption process and you may be registered with a Swiss health insurance company by the authorities. The Swiss Health Insurance Act (HIA) requires you to have insurance cover from the day you arrive in the country. The payment deadline must be adhered to in order to prevent cover being suspended and the authorities being notified as a result. The law specifies that the exemption confirmation must be obtained and submitted to the insurance company within three months.
Which cantonal office do I need to contact in order to be exempted?
If you have received written confirmation of exemption from compulsory health insurance in Switzerland, it is usually valid for 3 years. Thereafter, it may be extended for up to three more years by a written request . The relevant forms and the addresses to which they must be submitted can be found on this page under "Useful Information".