Supplementary Hospital Insurance Guide

Swiss insurers offer hospital insurance as an optional rider with basic obligatory health insurance policies. In contrast to supplementary emergency coverage, hospital insurance policies provide primary coverage for charges related to hospital stays.

Although all insurers are required by law to offer equal benefits with their obligatory health insurance policies, supplementary coverage like hospital insurance can vary in a big way. Health insurance providers can raise or lower premiums based on your place of residence, services offered, the deductible you choose, your gender and your age.

Health insurers also have the right to express reservations, or turn down an applicant for supplementary insurance altogether, if they feel the person’s age, health or habits present a risk. In order to qualify for coverage, applicants have to present detailed information about their health and medical history.

You can choose between 5 supplementary hospital insurance coverage models: general ward, semi-private ward, private ward, flex and hospitality.

General ward insurance in all of Switzerland

The majority of Swiss health insurance policy holders take out this supplementary coverage for general hospital ward stays. It’s estimated that over 80 percent of insured persons have this affordable coverage.

The «general ward throughout Switzerland» rider covers the cost of hospital stays in the general wards of hospitals across the country. This extends the coverage for stays at hospitals in your canton of residence which you get with mandatory health insurance. You get the freedom to choose which Swiss hospital you would prefer to be treated in. Supplemental general ward hospital insurance also extends the coverage for medical emergencies in Switzerland outside of your canton of residence.

With the introduction of flat-rate compensation for medical services in 2012, coverage for public and private hospitals throughout Switzerland was incorporated into obligatory health insurance plans. Hospitals are compensated at a flat rate, regardless of the length of stays and which hospital delivers the services.

That means that you can now stay at any Swiss hospital even if you only have basic health insurance coverage.

However, there are limitations. For example, the hospital you choose must be on the hospital list issued by your canton of residence. If it isn’t, your mandatory health insurance provider only pays the flat rate compensation applicable to hospitals in your canton of residence, except in the case of medical emergencies.

Note: The government of your canton of residence covers a large portion of the cost of your stays in that canton, and the flat-rate benefit from your health insurance covers the remainder. When you get treatment at hospitals outside of your canton of residence (except when necessary facilities are not available in your canton), your cantonal government does not subsidize your treatment. But your mandatory health insurance still only pays the flat rate which applies if you were treated in your canton.

If the flat rate from your mandatory health insurance does not cover the full cost of getting treated at a hospital in another canton (which is generally the case), you will have to pay the difference out of your own pocket. This is why having supplemental general ward hospital insurance to cover this difference can be beneficial if you expect to use Swiss hospitals outside of your canton. 

You can find more information on supplemental general ward coverage here.

Semi-private ward hospital insurance: Free choice of doctor and two beds per room

Semi-private ward insurance covers hospital stays in Switzerland. It costs a lot more than supplementary general ward insurance. In addition to covering hospital stays in a ward with just two beds, it also gives you the freedom to choose which of a hospital’s doctors you would like to be treated by.

It’s worth noting though, that the general wards of many Swiss hospitals now only have two beds per room, so the upgrade is not as significant as it once was.

A more significant advantage of semi-private ward insurance is that it may cover stays in private clinics in addition to hospitals. Coverage for clinics varies between insurance providers. You can use the practical filters under "Selection of hospitals" in the supplemental hospital insurance comparison to find offers which cover the clinics of your choice.

In many cases, your treatment will be supervised by a head doctor. But depending on the semi-private insurance coverage you have, the free choice of doctors may be limited. Check into this ahead of time, and always get your insurance to cover the full cost of your treatment if possible.

You can get more information about semi-private ward coverage here.

Private ward hospital insurance: Free choice of doctor and private room

Private ward hospital insurance is the most expensive supplemental hospital insurance. It covers treatment in private wards (single-bed rooms) in Swiss hospitals. In many cases a head doctor will be responsible for your treatment.

Like semi-private ward hospital insurance, private ward insurance may cover treatment at private clinics in addition to hospitals. Here too, which clinics are covered varies between insurance offers. Just use the clinic filters in the hospital insurance comparison to find eligible offers.

As with other insurance models, a comparison of hospital insurance offers is a good first step when choosing the best policy. The price differences between insurance companies aren’t small. You can learn more about private ward hospital coverage here.

Flex coverage: You decide on a case-by-case basis

Flex hospital insurance gives you the freedom to choose between general ward, semi-private ward or private ward coverage for each individual hospital stay. For example, you could choose general wards for short stays and semi-private or private wards for longer hospital stays.

Generally, all costs are covered when you opt for treatment in a general ward. If you choose semi-private or private ward treatment, you have to cover part of the costs out of our own pocket (coinsurance). The coinsurance varies between policies. Like semi-private and private ward insurance, different offers have different coverage for clinics.

You can find out more about flex hospital coverage here.

Hospitality model: Hospital room insurance

Some Swiss health insurance providers offer a hospitality model. This covers stays in either semi-private or private wards, depending on the policy. But unlike semi-private and private ward insurance, it does not give you the option of choosing which doctor will oversee your treatment. If your main incentive for getting supplemental hospital insurance is to get a more comfortable or private room, then this more affordable model can be a good choice.

This model can be up to 80 percent cheaper than semi-private or private ward hospital insurance. As with semi-private and private ward insurance, coverage for clinics varies between offers.

More information:
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