Health insurance for children in Switzerland
While you are still flying high thanks to the hormones produced by your body in connection with the wonder of the birth of your child, much less exciting things are already creeping towards your home: the whole administration that comes with a baby as natural as pampers.
Actually, some things are worth considering even before childbirth, and health insurance is one of them. What may be striking for foreigners in this context is that for all persons domiciled in Switzerland (regardless of age) it is compulsory to take out health insurance. In fact, you will get a letter from the authorities asking you to provide the name of the health insurer of your child, and if you do not choose one, they will allocate one to your child.
The compulsory health insurance provides access to adequate health care in the event of sickness (and accident, if there is no cover by accident insurance). A few things are good to know in order not to get lost in insurance terms and conditions. First, there are currently around 90 insurers (in German: “Krankenkassen”) operating the compulsory health insurance. By law all these insurers must accept any person irrespective of age and state of health and they must apply the legal provisions in an identical manner and provide the same benefits (if you wonder whether this makes sense you are sure not alone, many Swiss also question this system). Thus in the area of compulsory health insurance the different insurers distinguish each other mainly by the premiums they charge (and in terms of customer service). Second, the possibility to give notice and to change to another insurer is restricted, depending on the applicable conditions that you have chosen (see third) and whether the insurer intends to raise the premiums for the next year. Third, premiums depend in particular on the standard deductible (so-called “Franchise”) chosen, which is the proportion of treatment costs that has to be paid by the policy-holder. Fourth, insurers may offer complementary insurance schemes providing additional benefits and in this area they may offer the benefits and services they choose to. Compulsory health insurance and complementary insurance have to be kept strictly apart since the legal framework under which the insurers operate – and the insurance products they offer – are very different.
While it thus may not matter so much which insurer you choose for your child’s compulsory health insurance (the insurer for the child does not have to be the same as for the parents, i.e. the child may have its own insurance), it will matter if you take out complementary insurance (not least from a financial point of view). Of course you only want the best for your child, and no parent would want to seem stingy when it comes to covering the child’s health risks. Unfortunately, while you want the best for your child, somebody else (i.e. the insurer) wants to make money. And the insurer knows very well that “the best for your child” is always a strong sales argument. But while you may tell that the expensive carbon pram is not really necessary for safety’s sake as suggested and give it a miss, the insurance question tends to be a bit more complex and less obvious. In fact, a little (certainly not representative) survey among my friends showed that most had taken out complementary insurance for their children, but when asked why exactly only extremely vague answers were produced (even by lawyers…).
If this short article wants to achieve just one thing, then it is this: make sure you exactly know why you take out complementary insurance and what is covered by it. In this context you may depart from the assumption that the compulsory health insurance is good and sufficient. At any rate, ignore anyone recommending a complementary insurance supposedly providing a single or double room (private or semi-private ward) in case of hospitalisation (these insurances are known as “private” or “semi-private” insurances, and the most common reason for adults to take out complementary insurance). There are only general children’s wards in Swiss hospitals (and no private or semi-private wards). In these general children’s wards your child will not get a single or double room based on its insurance, but only if necessary for medical reasons - and in this case the costs will be covered by the compulsory health insurance. However, for people living in a Canton without a specialised children hospital it may be advisable to opt for that sort of complementary insurance that allows for a free choice of hospitals all over Switzerland thus providing the possibility to have the child admitted to a specialised children hospital. Further, if you are interested e.g. in natural medicine or osteopathy you may also consider complementary insurance as the compulsory health insurance does not cover non-conventional medical treatment. Should you wish to take out complementary insurance for one reason or the other, it may be wise to do so even before the child is born, since some insurers will accept your child after birth only in their complementary insurance scheme if he or she first undergoes a health check (and, of course, if particular risks are revealed, the insurer will refuse to conclude the envisaged insurance contract).
If there is one type of complementary insurance that generally is recommended, then it is a dental insurance, because the costs of normal fillings for caries or corrective treatment (i.e. braces for children) are not covered by the compulsory health insurance (and in particular braces for children can be very costly). However, you don’t need to take out this insurance as of childbirth. It will be sufficient to do so before your child has an appointment at the dentist for the first time (however, check the applicable insurance terms as to until what age a child is accepted without a previous dental check).
On a separate note, it does not make sense to insure the death of a child: while a horrifying experience, there is no financial loss as such accompanied therewith that should be insured. Of course this issue is totally unrelated to the health insurance questions discussed above, but is mentioned here because of a general tendency of young parents to insure in excess.
Please note that this short article is by no means meant to be legal advice. If you are in doubt about what may be appropriate for you and your child, then seek professional advice. Another good resource is the homepage of the Federal Office of Public Health which provides helpful information, most of which is available in English (see http://www.bag.admin.ch/themen/krankenversicherung/index.html?lang=en).
From mamizeit.com - the web magazine for international women in Switzerland
Guide section: Health care
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