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HEALTH INSURANCE

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

If you pay for supplementary health insurance in Switzerland you can benefit from access to complementary therapies. We look at what's available and how the system works.

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)
What complementary therapies are available in Switzerland? Photo by Katherine Hanlon on Unsplash

Like numerous countries in Europe, health insurance in Switzerland is a compulsory coverage that all people must have.

Most Swiss insurance providers offer several options for their customers, which are separated into two categories: basic and supplementary.

Basic health insurance (KVG / LaMal) must be purchased, because it is compulsory. Supplementary insurance comes with extra benefits for healthcare but also of course an extra fee.

The franchise (or deductible) will need to be met, but thereafter, even basic insurance has you covered. It pays for medical care, prescriptions, and specialist care like eye doctors, sometimes even without  referrals from your primary care physician. Supplementary health coverage, however, gives you access to complementary therapies that can differ substantially from what basic coverage allows. 

CLICK HERE for more on health insurance in Switzerland

You have to fill out a form the insurance carrier provides and sometimes might have to undergo a health check and discuss preexisting conditions in order to see how much insurance coverage can be offered — if any at all. 

Unlike the KVG / LaMal, which must be provided to all residents regardless of their health status, insurers can deny supplementary coverage if they deem you too much of a risk.

This can happen if you have chronic illnesses or pre-existing health problems, in which case you could be either turned down or offered a policy with wavers for your specific conditions.

Each insurance company decides what coverage they will offer and what percentage they pay, depending on both your overall health at the time of enrolment, and which plan you choose. You’ll be able to read what’s included in your plan in the paperwork you receive from your health insurance and, as always, the fine print is important to read. 

People who only have basic KVG / LaMal insurance still have thorough coverage for many things, from standard doctor visits to in-patient care and hospital stays.

READ ALSO: What is not covered by compulsory basic health insurance in Switzerland?

What complementary treatments are available?

In Switzerland, homeopathy is included in all health insurance plans, as healthcare isn’t merely approached with classical treatments; instead, a holistic approach is applied to healthcare throughout the country. The complementary therapies available through the supplementary insurance give individuals the opportunity to play an important part in their own wellness. 

Having a supplementary insurance not only increases the financial coverage you’ll have for some of your standard medical needs, but it also brings expanded access to numerous forms of wellness therapies. The Swiss are very focused on health and wellness and it is clear through the various types of insurance available, that a primary focus is getting the population healthy and keeping it that way. This additional insurance creates a way for people to access treatments and care for their well-being which, in turn, creates a healthier population. 

Complementary therapies can include various styles of massage including, classic, manual lymph drainage, therapeutic, connective tissue, acupressure, and medical massage, among others.

There are additional treatments and therapies such as foot reflexology, osteopathy, and Rolfing (massage/treatment of connective tissues) that are included in the coverage, plus there is also access to traditional Chinese medicine including cupping (suction cups applied to your body), acupuncture, and herbal medicine. Some practitioners also offer consultations in naturopathic health, including detoxification (guided cleansing of your digestion and body), nutrition, and hydrotherapy (using the element of water as therapy).

READ ALSO: How people in Switzerland can save money on healthcare

Your insurance provider will be able to better detail what is covered for you.

Another thing to take into consideration is that some insurance plans will even reimburse a portion of the costs of other health-related things, such as a part of the annual cost of a gym membership. Some plans will refund about 800 Francs per year for a gym membership that costs about 1,400 Francs. Granted, you will pay more each month for some of these extra options, but having access to them– and utilising them– can make the pricier monthly cost worth it. 

How do you go about getting complementary therapy?

Once you’ve signed up for supplementary insurance, you’re able to view a list of complementary therapies on the website of your insurance provider. Getting connected with a masseuse, osteopath, or other care provider is as simple as calling them up and scheduling an appointment. Once you have the supplementary insurance, there is no need to go to your primary physician and get a referral. 

In Switzerland, the reimbursement process for these therapies is also a little different. While some practitioners will still have you pay direct and out of pocket for the treatment (with a reimbursement coming later, after you’ve submitted the receipt to your insurance company), others will send you a bill in the mail. This creates a unique way that you can receive the receipt from the treatment, file it with the insurance, and often times have the reimbursement from the insurance deposited directly into your bank account before you even pay for the initial treatment. This makes it so that people who also don’t have a lot of access to cash can still receive quality care.

READ ALSO: Which Swiss cantons see the biggest hikes in health insurance premiums?

Be aware though you can’t just go for as much cupping, acupuncture or “rolfing” as you’d like because most insurers will put a limit on how much treatment you can get in a certain period. Some insurers might not cover the full cost meaning the patient might have to pay 10 to 20 percent of the fee.

This focus on providing access to things that augment an individual’s overall wellness makes Swiss healthcare among some of the best in the world. If you can see beyond the price tag (and let’s admit, it is expensive: sometimes 400-500 Francs or more each month), there are myriad ways to source treatments and therapies that will benefit your overall health and well-being, making for a healthier and ultimately happier person. 

When you first move to Switzerland, you can either select an insurance on your own, or sit down with an insurance consultant who will not only go over what each insurance offers, but can help you find the best coverage for you, your family, and your situation. When you need to make a change with your health insurance, you can get in touch with the consultant and they will procure the papers needed to make the changes. Although there is a cost associated with this sort of service, it can make selecting and signing up for health insurance in Switzerland an easy and smooth process. 

To find out more and compare rates for health insurance in Switzerland, information can be found here: https://en.comparis.ch/krankenkassen/default

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HEALTH

Ambulance, ER or doctor? What are Switzerland’s guidelines for health emergencies?

How unwell do you need to be to visit to a hospital emergency room in Switzerland, or what about calling an ambulance?

Ambulance, ER or doctor? What are Switzerland's guidelines for health emergencies?

In some countries it is common for people who don’t have their own doctors to go to an emergency room (ER) with all kinds of health complaints.

In some cases, they even routinely call an ambulance to take them there.

But in Switzerland the rules are different.

This is all the more relevant now, when emergency departments in a number of Swiss hospitals are understaffed and therefore already stretched to the limit. 

“We didn’t think that Switzerland would be affected [by scarcity of health workers] so badly,” said Vincent Ribordy, co-president of the Swiss Society for Emergency Medicine. “We thought that the capacity of the system would be limitless, but this is not the case.”

Given this growing lack of capacity to handle patients, “people need to understand that they don’t have to come to us for every little thing, but that in many cases pharmacies, family doctors, and duty practices can help them,” he added

So how can you know whether your symptoms are serious enough to warrant a visit to the ER?

Emergency rooms are for just that: true medical emergencies, which, if not treated quickly and immediately, can be life-threatening.

This includes (but is not limited to) heart attacks and strokes, head trauma, severe respiratory distress, heavy bleeding, serious injuries, and other conditions where any delay in treatment can put your life or health at risk.

In June 2021 the Swiss government introduced a charge of 50 francs for those people who visit the emergency room for non-urgent treatment.

It was introduced as a co-pay, meaning that the patients would have to pay out of their own pockets (i.e. it will not be covered by insurance).

However at the time no concrete indications were given as to what amounts to ’non-urgent’ treatment in the eyes of the law.

If you don’t feel well (even in the absence of the above-mentioned symptoms), you may overestimate your ailment and think it requires an urgent visit to the ER.  

But before you go there, get your condition evaluated by other medical professionals. Your first point of contact should be your primary physician (GP), who can decide whether you need to go to the hospital or can be treated another way.

In the event you don’t have a GP (or are a tourist), there are other options available in Switzerland, such as medical centres and walk-in clinics in virtually all cities.

If you are not sure how serious your condition is, you can call a “duty doctor” service (Notarzt in German, médecin de garde in French). Their numbers vary by cantons; it is 0800 33 66 55 in Zurich, 022 748 49 50in Geneva, 061 261 15 15 in Basel, and 0848 133 133 in Vaud.
 
People who answer the phone will ask questions about your symptoms and can decide whether you need to go to the ER, require a visit from the duty doctor, or can just wait and see how your condition evolves.
 
A duty doctor is also an alternative to the emergency room if you start feeling ill at night, as this service responds 24/7.
 
Can you be turned away from the ER if your symptoms are not serious enough?
 
If emergency services are overcrowded, then yes, you can be turned away.
 
On average, ERs refuse the admission to the 30-40 percent of patients deemed non-urgent, according to Swiss Medical Review.

READ MORE: Reader question: Can my Swiss health insurance refuse to pay my medical bills?

What about calling an ambulance?
 
Before you dial 144 — the national number for urgent medical help — know that conditions are even stricter for ambulances than for ER visits.

A dispatcher will ask you what the nature of your emergency is, as well as other follow-up questions to determine if you need an ambulance in the first place.
 
Even if you are going to the ER, an ambulance will only be dispatched if you have serious, life-threatening symptoms listed above.
 
Otherwise, you are expected to get to the hospital by other means.
 
Keep in mind that the ambulance ride is not exactly cheap, ranging — depending on where you live — from about 900 to 2,100 francs.
 
The compulsory health insurance (KVG / LaMal) covers half of this amount, but only up to 500 francs a year if the ambulance is called when there is no immediate danger to life.

However, if ambulance is required for life-threatening conditions, KVG / LaMal will cover up to 5,000 francs of the cost of emergency transportation.

Some supplemental insurance policies guarantee a higher, or even unlimited, cover of all transportation and rescue costs.

READ MORE: Am I liable for ambulance costs in Switzerland?
 

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