Every relocation entails risks and uncertainties for you and your family. But with professional assistance and planning, these issues can be reduced to a minimum. On the day of your relocation, either as an expat, a student or for a temporary or permanent change of residence, you should have peace of mind that all the necessary arrangements have been made for the next chapter in your life. The same holds true for health insurance – a small, but essential aspect of everyone’s life that is often forgotten by clients and advisors alike.
Relocation to Switzerland – what inbound expats need to consider
For individuals and families wishing to relocate, Switzerland is a highly popular destination. There is a wealth of reasons for the country’s popularity, including its political stability, strong economy and high-quality healthcare system, among many others.
The Swiss health insurance system
Once you have established your residence in Switzerland, you will be required to sign up for mandatory Swiss health insurance. The so-called KVG (or LAMAL in the French-speaking areas of Switzerland) is the mandatory basic health insurance provision that every resident in Switzerland must have. The deadline for acquiring the Swiss basic health insurance is three months after moving in at your new residence. The KVG is offered by more than 50 Swiss health insurance companies. Some of the best-known providers include CSS, Visana, Swica, Helsana and KPT. These Swiss health insurance companies are obliged to accept and insure you for basic insurance without a medical examination. There are a range of different insurance models that define both, how you can access healthcare when required, and the level of your monthly health insurance premium. For example, telemedicine models require you to first call a doctor of the health insurer, to whom you will need to describe your symptoms and state of health. After assessing your condition, if required, the doctor will send you to a specialist who will provide appropriate treatment. The HMO (health maintenance organization) and Hausarzt (general practitioner) models operate in a very similar way. Your first point of contact is always your family doctor, who is a GP. If he or she cannot treat your health condition, they will refer you to a specialist.
The basic KVG health insurance includes the essentials, but no more. Alternative medicine, single rooms at hospitals and clinics, eyecare cover, dental cover, access to private hospitals and other benefits are not included. You are also required to seek care in your canton of residence, and from doctors and medical institutions based in that canton. In short, the KVG covers only basic requirements and does not include free choice of doctors or hospitals.
There are various options to extend your health cover with supplementary insurance – called VVG (or LCA in the French-speaking areas of Switzerland). This offers modules to extend the insured benefits and to offer a free choice of hospitals and doctors in Switzerland. This supplementary insurance is always subject to a medical review that comes in the form of a questionnaire. Those with pre-existing conditions and health problems are often rejected and are not given access to supplementary health insurance.
When leaving Switzerland, you will be required by law to cancel your insurance and seek new health cover in your future country of residence. Exceptions may apply in specific cases, such as retired people who receive a pension from Switzerland.
Recommendation for international individuals and families – private insurance with an international insurer
Especially for inbound expats who travel from time to time or are not yet sure they wish to reside in Switzerland permanently and for the foreseeable future, it is advisable to choose private supplementary insurance with an international health insurance company. You will be covered worldwide (also when traveling or on holiday), and you will have a free choice of hospitals and doctors across the world, including private hospitals. The insured benefits are also much more attractive since alternative medicine, preventative medicine and medical evacuations are often standard. Because this is a supplementary insurance policy, a medical review is required before you can be accepted. However, in our experience international insurance companies sometimes have more room to accept individuals with preexisting conditions.
If you are unsure whether you will be staying in Switzerland permanently, it is a must to consider international health insurance providers. Once you are subscribed at an international health insurance provider, you can renew you policy for life, and you can seamlessly continue the insurance without medical examination if you leave Switzerland. This is a huge advantage that is often underestimated, but is crucial for all individuals approaching 40 and beyond.
Unfortunately, Swiss health insurance companies will not inform you about the options offered by an international provider. As profit-driven organisations, they naturally want to sell their own products.
The next paragraph provides further details on why international health insurance providers are better suited for those relocating out of Switzerland.
Relocation out of Switzerland – what outbound expats need to consider
If you decide to move out of Switzerland later in life, you will also be leaving one of the best healthcare systems in the world. But this will not necessarily mean that you cannot benefit from its excellent care anymore.
Upon leaving Switzerland, you will be considered an expatriate in insurance terms. This will allow you to access health insurance plans that are not available for “local nationals”. Local nationals are individuals whose citizenship is that of their country of residence. International health insurance with for example Bupa, Cigna, Swiss Global Insurance or Now Health will enable you to return to Switzerland for any treatment or surgery. A free choice of doctors and hospitals allows you to select your preferred medical institution and the most experienced doctor to advise and treat you. If a specific treatment or medication is not available in Switzerland, you may also go to the USA, or wherever available.
Most of times, business professionals who move away from Switzerland will subsequently relocate again. Businesspeople mostly relocate several times due to international assignments and may even move back to Switzerland at some point in time. Insurance products that are specifically designed for globally mobile people can be seamlessly continued with every relocation, with a minimum of administrative effort, and most importantly, without the need for a medical examination and the underlying risk of losing coverage due to health problems. Once having developed certain conditions, you may be stuck forever with the insurance policy that you hold at that time. This could even prevent you from relocating again at a later stage – unless you are willing to pay for any treatment costs relating to your health problems out of your own pocket.
International health insurance with Swiss insurance providers
Some Swiss health insurance companies also offer international cover for individuals moving abroad. In our experience this often leads to complications, and the service provided may prove to be unsatisfactory when it is urgently required.
You may be wondering why Swiss health insurance companies are not the right choice for those relocating out of Switzerland. There is a plain and simple answer to this – they are set up to work for Swiss residents seeking medical assistance in Switzerland, not outside of the country. An excellent international health insurance company has a worldwide medical network, with offices on every continent. The insurer therefore knows which hospitals have the required experience to manage a health problem. The provider understands the local healthcare system, speaks the language and has direct access to decision makers. Not having these capabilities often leads to a lack of service quality just when it is urgently required. There is no direct billing system in place to save you from having to pay for the treatment yourself and subsequently go through a time-consuming reimbursement process.
Furthermore, local Swiss insurance companies are not known outside of Switzerland. If a hospital is not certain it will be paid for the care it provides or has concerns about the workload involved in obtaining payment, patients may experience an extended wait before they can see a doctor. Providers such as Cigna or Bupa are well known around the world and their brand offers hospitals a guarantee that their costs will be covered. Naturally, people with insurance policies from providers like these are usually the first to get an appointment.
In summary, when relocating it is always essential to seek professional advice on how best to maintain health insurance cover. Numerous considerations need to be taken into account, and your satisfaction with a policy often comes down to the small written details of an insurance policy. International insurance policies promise excellent cover. However, the actual service really makes the difference when determining the value of a health insurance.