What is the need for supplementary insurance
Why do we need additional insurances?!
“Thank you, I don’t need additional insurance”… we hear this phrase all the time. What is this statement based on? On the belief that basic insurance already covers all the necessary services one can use in everyday life… Basic insurance does cover a lot of medical services and serves to ensure affordable access to good medical care. In other words, it is intended to prevent people insured by basic insurance from getting into financial difficulties due to health care costs in the event of accident, illness or maternity. Unfortunately, however, not all areas are adequately insured. Some examples:
Emergencies abroad
Your basic health insurance will only reimburse you or pay for services abroad in an emergency and upon presentation of your European Health Insurance Card. The scope depends on the country you’re travelling in and their billing systems as well as the local deductible.
Outside Europe, there ist the following restriction: up to a maximum of twice the amount that would be covered by the health insurance for the same service in Switzerland, i.e. 200% of the tariff for outpatient treatment according to the Swiss Health Insurance Act. Swiss tariff and 90% for an inpatient hospital stay in relation to swiss tariffs.
This sounds like a lot, but health care costs in countries like the U.S., Canada, Japan, and Australia are proportionately much higher, and thus basic insurance coverage alone would be very low in such countries.
For this reason, we strongly recommend taking out additional insurance for coverage abroad, especially for travels outside Europe.
Transport costs
From the basic insurance you will receive for transport costs 50% to max. CHF 500. If you are transported by ambulance, this can cost thousands of francs, depending on the distance to the nearest hospital. Return transport to Switzerland is also not usually covered by basic insurance. Again, it pays to have additional coverage to cover this gap.
General hospital department
In Switzerland, basic coverage pays only the Tariff at the place of residence and work. If you would go to a more expensive hospital outside of these cantons, for example to see a specialist who does not work in your canton of residence or work, the difference in costs would not be covered by basic insurance – and the tariffs vary extremely from canton to canton.
Alternative Medicine
Since 2012, some services from complementary medicine have also been covered by basic insurance, but only if they are performed by physicians with certain additional training. Moreover, not all alternative therapies are recognized.
Glasses and contact lenses
For visual aids, children up to 18. receive a contribution per year. Young adults receive CHF 0 for this. Spectacle wearers know that an eye test is due almost every year and that vision can change very quickly, mostly in the younger years, possibly while still studying or through today’s so widespread use of digital means such as PCs, cell phones, tablets.
Very quickly, a new pair of glasses may be needed. For people wearing glasses or lenses, it is worthwhile to receive a little contribution for this from the health insurance.
…and watch out for deductibles!
…because in the basic insurance you always have to consider the deductible. This means that if a service would be paid from the basic insurance, you must first deduct your annual deductible. The lowest deductible for adults is CHF 300. Normally, you have the highest deductible so that you save on premiums. This means, however, that during the year all costs, even if recognized by the basic insurance (there are exceptions such as maternity and hospitalization, more here), up to CHF 2500 must first be paid by yourself. Only after this achievement will all other services recognized by the basic insurance be reimbursed during the year.
In addition, after reaching your annual deductible, there is still the 10% deductible. This means after you reach the deductible, the insurance company will pay for the service, but will recover 10% participation per bill from you. The maximum deductible is CHF 700 for adults.
We are then a total of CHF 3200 that you have to pay yourself, with a deductible of CHF 2500.
Supplementary insurance, on the other hand, is usually independent of the basic insurance and its deductible. This means: if a service is covered by a supplementary insurance, for example contributions to glasses and contact lenses, then you do not have to deduct a franchise or calculate the deductible first, but the supplementary insurance pays directly the service according to the policy (or conditions). If the policy says “Supplementary insurance xy for contributions to glasses and contact lenses : 90% up to 250.- CHF” then this means that you will get exactly 250.- CHF francs paid out on your glasses bill of, for example, 1’000 CHF. If the benefit is only included in the basic insurance
That’s why, in so many situations, it makes sense to cover the areas of benefits that are important to you through supplemental insurance.
Let us advise you so that together we can see what is important to you and where you might need additional insurance (and where not).
