Deductibles for Health Insurance Policies Combined or Separate?

Good day,

SWICA and PROVITA seem to be the only health insurance companies which account for out-of-pocket costs already paid towards expenses covered by your mandatory health insurance policy when you claim on your additional health insurance policies. Compared to other health insurance cmpanies, the total out-of-pocket costs for supplemental health insurance can work out lower, depending on the madatory insurance deductible.

Are there other large health insurance companies which apply the deductible and coinsurance which you have already paid towards your mandatory insurance to claims for supplemental insurance?

Are there insurance companies which charge just one deductible for more than one person in the same household (for supplemental health insurance, at least)?

I would be grateful for a basic overview of deductible combinations.

Kind regards

Hi there,

According to SWICA (and its subsidiary Provita), it is the only Swiss health insurance provider which accounts for coinsurance payments paid towards compulsory health insurance when calculating out of pocket costs for supplementary health insurance (including outpatient and hospital insurance). Based on the information we have at this point, no other Swiss health insurance provider uses this model.

It is important to consider that most Swiss insurance providers do not require out of pocket payments for outpatient insurance. Certain benefits provided by SWICA outpatient insurance (such as alternative medicine and travel health insurance) have a 600-franc deductible.

That means the SWICA model is primarily beneficial for SWICA hospital insurance (general, semi-private or private ward) policyholders who also have compulsory health insurance from SWICA.

In Switzerland, hospital insurance normally comes with a broad choice of deductibles. SWICA offers hospital insurance policies with deductibles of 0, 1000, 2000 and 5000 Swiss francs. The higher the deductible, the lower the premiums (but the more costs you carry yourself). In the case of SWICA policies, the out of pocket costs of your compulsory health insurance policy are combined with those of your hospital insurance policy.

By using the combined-out-of-pocket-costs model, SWICA aims to motivate consumers to take out all of their health insurance policies from SWICA. Other health insurance providers accomplish this by offering multiple-policy discounts on premiums when you take out both their compulsory and supplementary health insurance policies.

Taking the time to compare both compulsory and supplementary health insurance policies based on your specific situation and needs is important, as many factors influence premiums.

Regarding household-based coinsurance models, some insurance providers do limit coinsurance payments for mutliple insured individuals in the same household.

For example, the Concordia Libero hospital insurance policy requires 20% (maximum 2000 francs per calendar year) coinsurance for semi-private ward insurance and 35% (maximum 4000 francs per calendar year) coinsurance for private ward insurance. The maximum coinsurance charged to all insured individuals in the same household per year is CHF 4000 – the same maximum coinsurance which applies to private ward coverage for an individual.

The flex hospital insurance from Krankenkasse und Unfallkasse Einsiedeln has a coinsurance requirement of 25% (maximum 4500 francs per year) for private-ward insurance, and 15% (maximum 1500 francs per year) for semi-private ward insurance. The maximum coinsurance required per year for all insured individuals in the same household combined is 4500 francs.

Best regards from Moneyguru

Unbiased health insurance comparisons:
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