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Hospital insurance guide

Hospital insurance: general ward, semi-private, private or flex?

Basic insurance covers a hospital stay in the general ward. If you want to choose your hospital freely anywhere in Switzerland, stay in a two-bed room or choose your own doctor, you need supplementary hospital insurance. Here you can see the differences.

1. What does basic insurance pay in hospital?

Compulsory basic insurance (KVG) covers treatment in the general ward of a hospital that is on a canton's hospital list. The costs are shared between the health insurer and the canton of residence. You pay the deductible and retention plus a contribution of CHF 15 per day in hospital (exempt are, among others, children, young adults in education and maternity).

The gap in the choice of hospital

If you go to a hospital outside your canton of residence without a medical reason, the insurer and the canton only pay the rate that applies in your canton of residence. If the chosen hospital is more expensive, you bear the difference. Emergencies and treatments that are not available in your canton of residence are exempt. The inexpensive option “General ward anywhere in Switzerland” already closes this gap.

2. The wards compared

WardChoice of hospitalRoomChoice of doctorFor whom?
General ward (basic insurance)KVG, compulsoryListed hospitals; outside your canton at most at the rate of your canton of residenceMulti-bed roomDoctor on dutyEveryone. Medically equally good treatment
General ward anywhere in SwitzerlandSupplementary, cheapest optionListed hospitals throughout Switzerland with no rate differenceMulti-bed roomDoctor on dutyAnyone who wants to choose a specific hospital outside their canton of residence, e.g. a children's hospital or a specialist clinic
Semi-privateSupplementaryFree choice of hospital, including many private hospitals (according to the insurer's hospital list)Two-bed roomFree choice of doctorAnyone who wants more peace and quiet and treatment by a specific specialist
PrivateSupplementary, highest comfortFree choice of hospital, including private clinics (according to the insurer's hospital list)Single roomFree choice, often the senior consultantAnyone who wants maximum privacy
Flex modelsSupplementary, choice on admissionDepending on the ward chosenMulti-bed, two-bed or single roomDepending on the ward chosenAnyone who wants to stay flexible and save on premiums; a retention applies for semi-private/private

What all supplementary hospital insurance policies have in common: they only pay if the stay is medically necessary, and benefits usually only apply in hospitals on the respective insurer's hospital list. Semi-private and private often also cover benefits such as rooming-in for parents, home help after a hospital stay or emergencies abroad. These benefits vary greatly between insurers.

Which ward suits your budget? We compare the insurers' hospital insurance for you.
Hospital insurance quote043 200 02 92

3. Flex models: choose your ward only in hospital

Many insurers offer flexible hospital insurance. You only decide when you are admitted to hospital whether you want to stay in the general, semi-private or private ward. In the general ward, you pay nothing extra. If you choose a higher ward, you contribute to the additional costs with a retention.

Advantage

A significantly lower premium than with fixed semi-private or private cover. You only pay more if you actually use the extra comfort.

Disadvantage

If you stay in a higher ward, the retention applies. Depending on the product, it is a fixed amount per stay or a percentage up to a maximum amount.

For whom?

For anyone who wants to keep the choice open but rarely goes to hospital, and for younger policyholders who want an inexpensive start.

4. What to look out for when taking out a policy

  • Health checkSupplementary hospital insurance is governed by the VVG. The insurer may ask health questions and add exclusions (reservations). Answer the questions in full, otherwise the insurer may later refuse benefits.
  • Take it out earlyThe younger and healthier you are, the easier it is to be accepted. Many insurers no longer accept new customers into semi-private or private above a certain age. For children, it can be taken out before birth without a health check: prenatal insurance.
  • Premiums by ageHospital insurance premiums usually rise with age. Ask how the premium will develop in your age group.
  • The insurer's hospital listCheck whether your preferred hospital is on the list. Not every insurer has a contract with every private clinic.
  • Do not cancel too hastilyOnly cancel existing hospital insurance once the new one has been confirmed in writing. You can switch basic insurance separately at any time; your supplementary insurance is not affected.
  • Downgrade instead of cancellingIf the premium becomes too high, switching from private to semi-private or to a flex model is often better than cancelling. Switching back up later requires another health check.

5. Frequently asked questions about hospital insurance

What does basic insurance pay in hospital?

Treatment in the general ward of a listed hospital, i.e. a hospital on a canton's hospital list. If you choose a hospital outside your canton of residence without a medical reason, basic insurance and the canton pay at most the rate that applies in your canton of residence. You bear the difference yourself if you have no supplementary insurance. This restriction does not apply in emergencies.

Do I need supplementary hospital insurance?

No, it is voluntary. Medically, you receive equally good treatment in the general ward. Supplementary insurance gives you freedom of choice: free choice of hospital anywhere in Switzerland, and with semi-private and private also a two-bed or single room and free choice of doctor.

What is flex hospital insurance?

With flex models, you only decide which ward you want to stay in when you are admitted to hospital. If you choose the general ward, you pay nothing extra. For semi-private or private, you pay a retention, which is a fixed amount or a percentage depending on the product. In return, the premium is lower than for fixed semi-private or private insurance.

Will my health be checked?

Yes. Supplementary hospital insurance is governed by the Insurance Contracts Act (VVG). The insurer may ask health questions, add exclusions (reservations) or reject the application. So the rule is: only cancel existing hospital insurance once the new one has been confirmed in writing.

Is there an age limit?

Many insurers no longer accept new customers into semi-private or private insurance above a certain age. The limit varies from insurer to insurer. If you want hospital insurance, it is therefore best to take it out early, while you are healthy.

Does supplementary hospital insurance cover giving birth?

Many supplementary hospital insurance policies have a waiting period for maternity benefits. If you are planning a family, you should therefore take out the insurance early. The details are in the insurer's terms and conditions; we will be happy to check them for you.

How can I cancel my hospital insurance?

Supplementary insurance is subject to the notice periods in the contract, often three months to the end of the year, and for multi-year contracts only to the end of the term. If the premium increases, you usually have an extraordinary right of cancellation. You can switch basic insurance and keep your hospital insurance with your current insurer.

Compare hospital insurance: We obtain quotes from the insurers and review them with you, free of charge and without obligation. Would you rather ask a question? Go to the contact form

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