A distinction exists between basic health insurance, which is compulsory, and supplementary health insurance, which is not compulsory and covers other medical costs such as travel medical expenses, alternative medicine costs, private or semi-private hospitalisations, etc. There are several health insurers in the canton of Vaud, choose one freely. The latter has the obligation to accept you for compulsory health insurance, whatever your age and state of health.
As an insured person, you will pay a monthly insurance premium which does not depend on your income, but which varies according to the amount of your deductible. However, depending on your income and the size of your household, you may be eligible for a subsidy (see below). The deductible is part of your medical expenses that you will have to pay in addition to the premiums. Depending on the formula you have chosen, the deductible is an amount between CHF 300 and 2,500, which will have to be paid by you each year, as a contribution to the treatment costs. Once this amount is reached, your health insurance will cover 90% of the costs that exceed your annual deductible. The remaining 10% will be your responsibility up to an annual amount of CHF 700.
Regarding the deductible, you have the choice of paying CHF 2,500, CHF 2,000, CHF 1,500, CHF 1,000, CHF 500, or CHF 300 per year. However, it must be taken into account that the lower your annual contribution (deductible), the higher your monthly insurance contribution (premium). It is therefore necessary to ensure that the amount of the deductible chosen is adapted to your finances, but also to your state of health. If you have to undergo regular medical treatment which incurs significant costs each year, a small deductible may be more appropriate.
On the other hand, if you are in good health and rarely go to the doctor, a high deductible could be more interesting. In the latter case, however, it would be important to have sufficient financial reserves to meet unforeseen medical costs: suddenly having to pay CHF 2500 may constitute a risk of indebtedness.
Insurance companies operate according to two very distinct systems with regard to the payment of medical costs. The first system is the so-called “third-party guarantor”: the insured persons pay their bills themselves and are reimbursed by their fund, once the annual deductible has been reached. The second system is the so-called “third-party payment” system: the fund receives the invoice directly and pays certain invoices from healthcare providers. The insured persons only pay the deductible and their participation in the costs. It is important to take into account these two different systems of coverage of medical costs when choosing which insurance to contract, so that it is in accordance with your finances.
Premium calculator 2021
The premium conditions change every year and it is possible to change health insurance by sending a cancellation letter by registered mail before the end of November. It is essential to have paid to your current health insurer all the invoices due (premiums and participations) on 31 December in order to be able to change health insurer the following year.
Guidelines: premiums and change of health fund