How do you choose an insurer in Switzerland from a Hungarian perspective?

What is the basic structure of Swiss health insurance, and why is it mandatory?

The Swiss health insurance system is based on the Federal Act on Health Insurance (Krankenversicherungsgesetz / KVG, French: LAMal), which has been in force since 1996. Under the law, every resident registered in Switzerland is required to take out basic health insurance, regardless of citizenship, employment status, or income.

The system is built on three pillars:

1. Basic insurance (Grundversicherung / assurance de base): It provides the statutory minimum — medical care, hospital treatment, medicines, maternity care. The scope of coverage is the same with every insurer and is defined by the Federal Department of Home Affairs (Bundesamt für Gesundheit / BAG) .

2. Supplementary insurance (Zusatzversicherung / assurance complémentaire): A voluntary add-on under private law — for example, a single-room hospital stay, treatment abroad, dental care, alternative medicine. The content and premium vary by insurer.

3. Accident insurance (Unfallversicherung / assurance-accidents): For employees, the employer is obliged to provide coverage for occupational accidents and work-related illnesses through the SUVA (Schweizerische Unfallversicherungsanstalt) or another authorized insurer. If someone works more than 8 hours a week for one employer, the employer’s coverage also extends to leisure-time accidents — in that case, accident coverage can be excluded from basic insurance, which results in a small premium reduction.

Important from a Hungarian perspective: There is no reciprocal healthcare agreement between Hungary and Switzerland that would automatically cover a stay in Switzerland. The EU EHIC card is not valid in Switzerland beyond basic emergency care, and it is irrelevant from the Swiss system’s point of view. At the same time as registering, you must terminate or suspend your Hungarian health insurance status with OEP (today NEAK — the National Health Insurance Fund Manager), otherwise parallel contribution obligations may arise.

Basic insurance (Grundversicherung) vs. supplementary insurance: what is the difference?

Basic insurance: what the law guarantees

Basic insurance covers primary medical care, hospital treatment (general ward, cantonal hospital), laboratory tests, prescription medicines, maternity care, and certain preventive screenings (e.g. mammography, colorectal cancer screening at specified ages).

What basic insurance does not cover:

• Dental care (except damage caused by an accident or a serious illness)

• Glasses and contact lenses (for adults)

• Private hospital room

• Treatment abroad beyond emergencies

• Alternative medicine (partially covered, depending on the model)

• Cosmetic procedures

Supplementary insurance: where the real differences are

Supplementary insurance (Zusatzversicherung) is a private-law contract governed not by KVG but by the Insurance Contract Act (Versicherungsvertragsgesetz / VVG). This means the insurer is entitled to refuse a client based on health risk, and premiums and terms can be set freely by each insurer.

Typical supplementary insurance packages:

• Spital halbprivat / privat: semi-private or private hospital room, choice of senior consultant

• Dental / Zahnversicherung: dental coverage (usually 75–80% reimbursement per year, with an annual cap)

• Ausland / Worldwide Coverage: treatment abroad, including care received in Hungary

• Alternative medicine: homeopathy, acupuncture, naturopathy

From a Hungarian perspective: If you regularly go home for treatment, it is worth looking into foreign supplementary coverage — but read the terms carefully, because many insurers reimburse only emergency care abroad, not planned treatment.

Comparing insurers: which criteria matter most?

In Switzerland in 2025, there are around 50–60 licensed health insurers (Krankenkasse), but only about 10–15 of them offer nationwide coverage. The best known are: CSS, Helsana, Swica, Concordia, Sanitas, KPT, Assura, Visana, Groupe Mutuel.

1. Monthly premium (Prämie)

The premium for basic insurance varies by canton and region — the BAG sets three premium regions even within a canton (for example, premiums are higher in the city of Zürich than in the rural parts of the canton). For the same coverage, the difference between the cheapest and most expensive insurer can be as much as 30–40%.

For comparison, the only official and reliable tool is the federal comparison portal: priminfo.ch (run by the BAG). There you can enter your canton, age, and desired deductible, and the system lists all licensed insurers by premium.

2. Deductible (Franchise)

The Franchise is the amount you pay each year out of pocket for healthcare costs before insurance starts to pay. The legally defined bands (based on data valid in 2025):

Above the Franchise, insurance starts to pay, but there is still an annual co-payment (Selbstbehalt): 10% of annual costs, up to a maximum of 700 CHF for adults (in 2025). So the maximum annual out-of-pocket cost can be 2500 + 700 = 3200 CHF.

Calculation logic: If you are rarely ill and do not expect a major procedure, a high Franchise means a lower monthly premium — and if you stay healthy, you make a net saving. If you have a chronic condition or take medication regularly, a low Franchise protects you from high annual costs.

3. Insurance model (Versicherungsmodell)

Basic insurance can be taken out under different models, which differ in how freely you can choose your GP and access specialists:

• Standard model: You can freely choose any doctor or specialist. The most expensive.

• Hausarzt model (HMO / Telmed): You must first contact the designated GP or a telephone triage center. It can be 10–25% cheaper.

• HMO model: You are tied to a healthcare group and can only receive treatment within it (except in emergencies). Typically the cheapest.

From a Hungarian perspective: If you are not fluent in German / French / Italian, the Hausarzt model carries risks — with telephone triage (Telmed), the first contact takes place in a foreign language. At first, it may be worth choosing the more expensive but more flexible standard model until you settle in.

Deductible (Franchise) and premium: how should you calculate it?

The essence of the decision: how much financial risk are you willing to take on voluntarily in exchange for a lower monthly premium?

Example calculation (approximate, with 2025 premium levels, in Zürich canton, for a 35-year-old adult):

Between the two extremes, the annual difference is surprisingly small — if you get through the year without illness, the high Franchise wins; if you need significant treatment, the difference reverses. In the case of a chronic illness, the low Franchise is almost always the better choice.

⚠️ The figures above are illustrative. Check the actual premiums on the priminfo.ch portal based on your canton, region, and age.

Changing insurer and your rights: what options do you have?

When and how can you switch?

The basic insurer once a year can be switched. The notice period is usually November 30., and the switch takes effect on January 1. In some cases — if the insurer raises premiums — the notice period is shorter, and the insurer is obliged to notify you of this in writing.

The cancellation must be sent by registered mail, and the old insurer must issue proof that coverage has ended. This proof must be shown to the new insurer.

Rights you should know

• The insurer may not reject the application for basic insurance on the basis of health status — under KVG, it has a mandatory duty to contract.

• The premium may not increase because of a deterioration in health under basic insurance.

• Premium reduction (Prämienverbilligung / réduction de primes): Households with low income are eligible for cantonal support. This is not automatic — you must apply to the cantonal authority. As a Hungarian, you can also apply if you meet the income requirements.

Public employees and self-employed people: different rules?

Employees

The employer does not pay for basic insurance — in Switzerland, this is entirely the individual's responsibility, unlike in the Hungarian system. The employer is only required to pay for occupational accident insurance (SUVA).

Some employers — especially larger companies and public institutions — offer discounted group supplementary insurance, but this is not mandatory and does not replace basic insurance.

Self-employed people (Selbstständigerwerbende)

Self-employed people are required to take out basic insurance under the same conditions as employees. The difference lies in AHV/AVS (old-age and survivors' insurance) contribution payments — but this does not directly affect health insurance.

Important: If you also have a business in Hungary and pay contributions in both countries, the double taxation agreement and social security coordination rules (EU/EFTA framework) determine which country's legislation applies. This is a complex situation that is worth discussing with an expert.

Practical steps: registration, notification, documentation

1. Register at the municipal office in your place of residence (Einwohnerkontrolle / contrôle des habitants): This is the first step — the insurer will need proof of registration.

2. Choose an insurer on the priminfo.ch portal: Enter your canton, region, age, and desired deductible level.

3. Request a quote and conclude the contract: Directly with the insurer, online or in person. Required documents: passport or ID card, proof of registration (Anmeldebestätigung).

4. Insurance is retroactively valid: If you take out insurance within 90 days of registering, coverage is valid from the date of registration. If you are late, the canton will assign an insurer, and the premium must be paid retroactively.

5. Notify NEAK in Hungary: Inform NEAK (formerly OEP) that you live in Switzerland and are insured there — this helps you avoid duplicate obligations.

6. Keep your insurance card (Versicherungsausweis): You will always need it for medical visits.

Common mistakes and tips for Hungarians moving to Switzerland

1. Missing the 90-day deadline If you do not take out insurance in time, the canton will assign an insurer for you — usually not the cheapest one. You will also have to pay premiums retroactively.

2. Relying on the EHIC card The European Health Insurance Card is not valid in Switzerland for the Swiss system. In an emergency it may provide limited assistance, but it does not replace basic KVG insurance.

3. Not aligning the Franchise with your actual health status Many people automatically choose the cheapest monthly premium (high Franchise), then face CHF 3200 in annual out-of-pocket costs if they suddenly fall ill.

4. Confusing supplementary insurance with basic insurance Supplementary insurance can be rejected on health grounds — if you first take out basic insurance and then want supplementary cover as well, the insurer may have you fill out a questionnaire. Existing conditions must not be concealed.

5. Not applying for the premium reduction Especially in the first year, when Swiss income may still be lower, it is worth asking the cantonal authority whether you are eligible for Prämienverbilligung.

6. Ignoring the choice of model The Hausarztmodell is cheaper, but if you are not familiar with the local medical system and do not speak the local language fluently, the flexibility of the standard model may be worth the extra cost.

Sources

• Federal Department of Home Affairs – Federal Office of Public Health (BAG): https://www.bag.admin.ch/

• Swiss federal information portal (ch.ch): https://www.ch.ch/en/

• Health information (ch.ch/health): https://www.ch.ch/en/health/

• Official premium comparison portal (BAG): priminfo.ch

• Krankenversicherungsgesetz (KVG / SR 832.10): in the Federal Chancellery legal database (fedlex.admin.ch)

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