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Germany and Switzerland are so close together that there are many commuters between the two countries. Nevertheless, there are fundamental differences between the neighboring countries. This comparison is particularly interesting for the health system and health insurance companies.
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Many people live in Germany or Switzerland and work in the other country and are therefore not just commuters, but so-called Frontier workers. A cross-border commuter is a person who works in a different country than they live. This person returns to their own place of residence daily, but at least once a week. There is also an agreement between Germany and Switzerland that people are allowed to have 60 non-return days in a calendar year. Anyone who does not adhere to this so-called 60-day rule will be taxed in the country of employment. Moving to Switzerland shortens the daily commute, but should be considered carefully. Because in Switzerland a lot is different than in Germany. For example, there are crucial differences in health insurance.
Attention: The 60-day rule will be adjusted accordingly if you work part-time or if you start work in the current calendar year.
Compulsory health insurance: Basic medical care for everyone
Health and accident insurance has been mandatory for every citizen in Switzerland since 1996. Insurance companies offer so-called basic insurance for this. An insurance company must include every person in this. This compulsory health insurance (OKP) is intended to ensure basic medical care for all Swiss. The three terms health insurance, OKP or basic insurance are used synonymously in Switzerland. The OKP pays the costs for examinations, treatments and medication due to illness, accident, childbirth or abortion. Dental treatment is an exception. Possible costs can only be covered with additional insurance.
While most hospitals – hospitals – settle the costs directly with the health insurances, the insured pay other services first. As in Germany with private insurance, the various documents relating to the treatment are submitted to the health insurance company for reimbursement.
Info: In June 2019, the OKP was expanded to include asylum seekers and people who are required to leave Switzerland. Those who stay in the federal asylum centers in Switzerland are taken in by the CSS health insurance.
OKP costs
The health insurance companies freely determine the premium payable within the legal requirements. The Federal Office of Public Health sets a so-called standard premium depending on the region and age group. Switzerland is currently divided into 43 different premium regions. A distinction is made between the age groups:
- Children (0 to 18 years)
- Adults (19-25 years)
- Adults (from the age of 26)
The insured can reduce his contributions through various bonus models. Supplementary insurance – for example for dental care – is quite common in Switzerland. Since the offers of the different insurance companies differ widely, it is very important to make a comparison beforehand. Depending on the canton, personal life situation and personal requirements, the differences in the premiums can be very high.
Tip: the side Gidu.ch comparison gives a comprehensive overview of different insurance models including benefits and premiums in Switzerland.
What does OKP do?
The OKP is about basic medical care. What is called basic care is in the Federal Law on Health Insurance (short: KVG) precisely recorded. There is always a deductible for the insured. This is made up of a deductible and the deductible. With Franchise is an annual fixed amount that the insured determines. Below this amount, all costs are to be paid by the insured. The following applies: the higher the deductible, the lower the monthly insurance amount. As Deductible is the proportionate share in the costs incurred. This is usually 10 percent of the total invoice amount. However, the retention increases to 20 percent if original pharmaceutical preparations are used, although corresponding generics are available. However, the deductible is limited to the year. For an adult Swiss, it can amount to a maximum of 700 francs. For children and adolescents, a maximum of CHF 350 deductible may apply over the year.
Is there a family insurance?
In Germany, the family insurance model is relatively well known and popular. Children or non-working members of a family are insured for free through another family member. This can be a financial relief for the family for families with children, in the event of dropping out or during parental leave. However, there is no family insurance in Switzerland. Each person is individually insured there. Depending on age and life situation, the insurance companies offer different models for calculating premiums.
Termination? Only possible once a year
If you want to change your insurance in Switzerland, you can only change every year. In the event of such a change, termination is valid until November 30th. than timely. Only people with a decent franchise can also take advantage of the OKP on June 30th. switch. The notice period for voluntary supplementary insurance is contractually agreed. If you want to change, it is worth taking a look at the small print.
What is the employer’s share?
For employees, the rules in Switzerland regarding health insurance contributions are different. Unlike in Germany, the employer does not contribute anything to health insurance. For people with a low income there is a so-called Premium reductionwhich can be requested from the canton of residence. Who is entitled to a premium reduction varies from canton to canton.
What is Health Promotion Switzerland?
In Switzerland there is the Health Promotion Switzerland Foundation. Each OKP bonus includes a fee for this foundation. This fact has come under fire because a large part of the money goes to the administration of the foundation and not to the financed projects to improve the health system in Switzerland.
Informing and comparing beforehand pays off
As positive as compulsory health insurance may sound, the devil is in the details. Attractive bonus programs and various additional services make the offers of some health insurance companies in Switzerland more attractive. An individual comparison is useful, as the attractiveness of the offers is often very different for different life situations.
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