Basic Insurance (KVG)
Basic Insurance According to KVG: Services and Models
Since 1996, mandatory basic insurance according to the Health Insurance Act (KVG) is required for all persons living in Switzerland to guarantee basic health services in case of illness, accident, and pregnancy. All insurers offer the same services, but premiums vary. Savings are possible by choosing alternative insurance models.
What Does Basic Insurance According to KVG Cover?
Basic insurance is mandatory for everyone living in Switzerland. Access to insurance is granted regardless of age or pre-existing conditions. The KVG defines the services of the basic insurance, which must be effective, appropriate, and economical when medically necessary.
The services of the compulsory basic insurance are defined in the Health Insurance Act (KVG) and specified in the Health Care Benefits Ordinance. Generally, the insurance covers necessary medical treatments and medications, provided they are effective, appropriate, and economical.
Additional services include:
- Emergency aid
- Transport and rescue operations
- Accommodation in hospitals and semi-inpatient facilities
- Rehabilitation and care
- Therapeutic measures such as occupational and physiotherapy, and chiropractic
- Certain alternative medical treatment methods
Every newborn must be registered in basic insurance immediately after birth. Newcomers to Switzerland have a period of three months to choose a suitable health insurance for the mandatory basic insurance.
Cost Participation in Basic Insurance
Costs for basic medical care include an annual franchise and a deductible. The normal annual franchise is CHF 300, after which insured persons pay 10% of further costs themselves, up to a maximum amount of CHF 700 for adults or CHF 350 for children. Higher franchises up to CHF 2,500 are available to lower premiums.
By opting for a higher annual franchise, you can reduce your monthly insurance contributions. For individuals over 26 years, it's possible to adjust the franchise to up to CHF 2,500 annually.
Same Service - Different Premiums
Although the basic insurance services are uniform, premiums vary depending on the insurance company and region. In urban areas, premiums are often higher than in rural areas. Premium savings are possible by choosing an alternative insurance model that restricts the choice of doctor.
The Alternative Insurance Models of Basic Insurance
By choosing an alternative insurance model, you can save on insurance premiums. While the standard model allows you the freedom to choose your doctor, the alternative models define your first point of medical contact more precisely.
- General practitioner model: In case of illness, you first turn to your general practitioner.
- HMO model: In case of illness, you first visit a group practice (HMO).
- Telmed model: Your first point of contact is the hotline of a telemedicine consulting center.
In these alternative models, your first point of contact, usually your general practitioner or a specialized professional, will refer you to a specialist or hospital if necessary.
Compare mandatory basic health insurers and find the right insurance model
Not all health insurers offer the same range of alternative models. Some providers expand the options, for example with models where you first contact a partner pharmacy in case of illness. Discover the Visana basic insurance model that fits your needs with our model comparison tool.