The Basic Healthcare Package
Healthcare in Switzerland is privately run although the government decrees that by law all citizens must be covered by a basic package of healthcare services. This basic package includes treatment for illness or accident and pregnancy. Each person must cover part of their treatment themselves by paying an annual excess known as the franchise on their insurance policy. All insurance companies must offer the basic healthcare package. Contribution rates vary between companies, but they are not allowed to turn people down or increase premiums based on risk. Citizens are free to use any insurance company for the basic package, providing it is registered with the caisse-maladie or Krankenkasse and is approved by the Federal Act, which governs healthcare. Premiums are paid directly to the insurance company on a monthly basis.
Free treatment even in emergency situations is non existent in Switzerland and medical fees are extremely high. Fees must be paid directly by the patient or by their insurance company. All citizens must pay an excess which ranges from 184 EUR to 1,350 EUR this excess can be designated by the individual and insurance premiums are calculated accordingly. Citizens also have to pay 10 percent of the costs of all of their treatment in addition to this excess. Pregnant women are exempt from this charge.
Swiss doctors and hospitals send a bill for their treatment, which must be paid within 30 days. You must submit the bill to your insurance company for reimbursement. Non residents without sufficient insurance cover will have to pay a deposit once admitted to hospital. The fee is in the region of 1,225 EUR to 6,123 EUR.
Prescription medicine, which is on the government’s official list is reimbursable through the basic insurance package, but you will have to pay for 10 percent of the overall cost yourself. All other medicine will have to be paid for in full, unless you have additional insurance, which supplements all medicine. Some insurance companies give their members an insurance card, which you show at the pharmacy. This allows the pharmacy to charge the insurance company rather than the individual. The insurance company then bills the individual for the 10 percent contribution to the cost of the prescription.
The nature of the Swiss healthcare system has meant that there is a well established private sector. Many people insure themselves over and above the mandatory basic package, to cover themselves for the costs of treatment not reimbursed with basic cover.
Doctors and Health Centres
Doctors are known as Arzt or médicin and citizens can register with the doctor of their choice. Private doctors take care of most outpatient treatment. Out of normal surgery hours there will be a duty doctor on call for emergencies. You can obtain details by calling your regular surgery, whose answer phone will provide details of who to call. Waiting times to see doctors are very short; people generally make an advance appointment.
GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education.
Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a consultant if he or she believes that a patient may need specialist help and diagnosis. Citizens have unlimited direct access to consultants in Switzerland and do not require a referral from a doctor. There are numerous specialist fields of medicine in Switzerland like gynaecology, oncology, paediatrics and dermatology. There is often a waiting list to see consultant doctors. Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a consultant if he or she believes that a patient may need specialist help and diagnosis. Citizens have unlimited direct access to consultants in Switzerland and do not require a referral from a doctor. There are numerous specialist fields of medicine in Switzerland like gynaecology, oncology, paediatrics and dermatology. There is often a waiting list to see consultant doctors.
Hospitals known as Krankenhaus, Spital or hôpital exist in all major towns and cities in the country; they are recognisable by a sign with a blue background with a white ‘H’. Patients are admitted to a hospital in the canton where they live, either through the emergency department or through a referral by their doctor.
The quality of hospital rooms is excellent and waiting lists are very short. Privacy is governed by the quality of a person’s health insurance scheme. Privately insured patients will get a single room. State insured patients with standard cover may have to share with two or three other people and those with half-private cover will share with one other person. Those with standard cover will not be able to choose the doctor who treats them in hospital.
The prohibitive cost of hospital stays has strengthened the home medical care sector known as Spitex. The basic insurance package covers this service, which is provided by the communes. Often the treatment itself is provided by private doctors and nurses.
Emergency care is not available free and once your condition is stabilised you will have to provide proof of your insurance status. Emergency treatment is provided at the emergency room of all hospitals and is known as the Notfalldienst or urgences. Emergency departments are open non stop all year. You may use their services if you need immediate attention, or if your GP refers you to them. There are also special emergency clinics for minor casualties, which are known as Pikett-Dienst or permanence.
Information on local medical emergency services is available at the local police stations as well as in the yellow pages and in the local press. If you need an ambulance you should dial 144.
Dental care in Switzerland is of a high standard, but extremely costly. Dentists operate predominantly private practices, but there are some public dental clinics. Dental care is excluded from the state’s basic health insurance scheme.
Pharmacies are known as Apotheke or pharmacie and should not be confused with drug stores (known as Drogerie) where you can purchase cough mixture and other non prescription drugs. Pharmacies can be recognised by the sign of a green cross on a white background. In case of emergencies, one pharmacy remains open in every area day and night. Most medicine is only available through a prescription from a doctor known as a Rezept or prescription. Swiss chemists stock many herbal remedies and will recommend these products for the treatment of common ailments.