Insurance options and costs
The premiums you are obliged to pay for health insurance depend on the insurance benefits you require as well as your age, gender and the canton and region in which you live. This means that premium amounts can vary significantly.
Franchise and excess
In addition to paying a monthly premium, policyholders must bear part of their medical costs themselves. This contribution to costs is made up of two components, known as excess and franchise.
The franchise is a fixed annual amount of at least CHF 300.00 which you must pay yourself towards medical costs. Children up to the age of 18 are not obliged to pay a franchise.
You can determine the franchise amount yourself, choosing from the following options: CHF 300, CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 or CHF 2,500. A lower range from CHF 100 to CHF 600 applies to children.
Paying a higher franchise allows you to save on premiums, but it also means you bear a higher risk as you will be liable to cover medical costs up to the specified franchise amount in the event of illness.
Supplementary accident insurance
Supplementary accident insurance can be excluded from your health insurance policy if your employment contract stipulates a level of employment of at least 19.5% (eight hours per week). You would then be covered through ETH Zurich against the financial consequences of accidents at or outside work.
In such cases, the health insurance fund will require confirmation from ETH Zurich, as your employer, that you have accident insurance cover via ETH. You can obtain this confirmation from your personnel assistant or by sending an e-mail to the Welcome Center.
Compulsory basic insurance models
In terms of compulsory basic insurance, you can choose between the standard model and an alternative model. The standard model gives you the freedom to choose which medical practitioner to go to for treatment, but you will have to finance this by paying an appropriate premium amount.
With the alternative insurance models, you have no free choice of medical practitioners. The health insurance funds choose their own service providers (doctors), which allows them to reduce costs. As the policyholder, you will therefore benefit from lower premiums. Depending on the insurance fund and model as well as your age and place of residence, the three insurance models described below could enable you to save 5% to 25% on your premiums for basic insurance.
In the case of the HMO (Health Maintenance Organisation) model, the health insurance fund runs its own health centres staffed by its own HMO medical practitioners.
With this model, you do not have a free choice of medical practitioners. In the event of illness, you will always have to see your doctor at the HMO centre first who, depending on what is deemed necessary from a medical perspective, will refer you to a specialist or decide whether you need to be admitted to hospital. The exceptions to this rule are gynaecological screenings, eye examinations and paediatric services.
If you are unable to contact your HMO doctor in an emergency or if you are abroad or not at your place of residence or work, you must contact the nearest available emergency medical service. You will then be obliged to contact your HMO doctor as soon as possible.
In the case of the family doctor model, the health insurance fund forms a network of general practitioners (selected by the insurance fund itself) or an association of doctors in private practice with whom it has concluded an agreement.
With this model, you do not have a free choice of medical practitioners. In the event of illness, you will always have to see your GP first who, depending on what is deemed necessary from a medical perspective, will refer you to a specialist or decide whether you need to be admitted to hospital. The exceptions to this rule are gynaecological screenings, eye examinations and paediatric services.
If you are unable to contact your GP in an emergency or if you are abroad or not at your place of residence or work, you must contact the nearest available emergency medical service. You will then be obliged to contact your GP as soon as possible. Any follow-up treatment after a medical emergency will also have to be arranged via your GP.
In the case of the Telmed model, the health insurance fund runs its own telephone helpline, which is usually available round the clock. Through this helpline, medical specialists offer medical information, advice and recommendations. This may mean that you do not actually need to see a doctor, which can save you time and money, but it is no substitute for medical treatment.
With this model, you are obliged to contact the telephone helpline first before going to see a doctor, whatever health problem you may have. Depending on what is deemed necessary from a medical perspective, the medical specialist you speak to via the helpline will refer you to your GP or to a specialist. The exceptions to this rule are gynaecological screenings and eye examinations.
You are not obliged to contact the telephone helpline first in the event of an emergency.
Comparing premiums
The institutions external page comparis, external page priminfo and external page vzonline offer an overview of the health insurance options available, including a comparison of costs and benefits.
external page List of approved health insurers in Switzerland