Information Brochure Compulsory Health Insurance

Transcription

1 Information Brochure Compulsory Health Insurance Canton of Bern Department of Justice, Communal and Ecclesiastic Affairs Social Insurance Office

2 Thanks to compulsory health insurance in Switzerland (basic insurance), you have access to high quality, comprehensive healthcare 09/2013 2

3 Who requires basic insurance in Switzerland? People resident or staying in Switzerland People who are permanently resident in Switzerland. Every family member must be insured, both adults and children People with a short stay or residence permit for three months or longer People in gainful employment whose short stay permit is valid for less than three months and whose foreign insurance cover is not as comprehensive as compulsory basic insurance People with a short stay or residence permit under the Agreement on the free movement of persons or the EFTA Agreement that is valid for at least three months People who are gainfully employed in Switzerland for no more than three months and who do not require a residence permit under the Agreement on the free movement of persons or the EFTA Agreement, but who do not have insurance cover for medical treatment in Switzerland that is equivalent to basic Swiss cover People who have applied for asylum and people who have been granted temporary protection People resident or staying outside Switzerland People who live in an EU/EFTA state but whose income (from employment/pensions/unemployment benefits) comes from Switzerland Swiss employees who are posted abroad Family members not in gainful employment who are resident in an EU/EFTA state (see page 4) Are there exceptions to the obligation to be insured in Switzerland? Yes. The following people are not required to obtain insurance in Switzerland: People who are resident in Switzerland but who are covered by Swiss military insurance People who are staying in Switzerland exclusively in order to undergo medical treatment or a spa treatment Cross-border commuters: people resident in Switzerland but gainfully employed in an EU/EFTA state Retired people: people resident in Switzerland who receive a pension from an EU/EFTA state but not from Switzerland and who are not gainfully employed Unemployed people: people resident in Switzerland who receive unemployment benefit from an EU/EFTA state People resident in Switzerland who have preferential rights under international law (e.g. diplomatic staff) Employees posted to Switzerland from an EU/EFTA state. For the duration of their posting, all rights and obligations in their country of origin continue to apply 09/2013 3

4 Special conditions for people who live or work in an EU/EFTA state People resident in an EU/EFTA state who receive earnings / pensions / unemployment benefits in Switzerland are in principle required to obtain insurance in Switzerland Their family members who are not in gainful employment and resident in an EU/EFTA state must in principle be insured in the same country as the employed / retired / unemployed person People resident in Switzerland who receive earnings / pensions / unemployment benefits from an EU/EFTA member state must obtain insurance in the EU/EFTA state where they work, or draw the pension or unemployment Health Insurance Classification for people resident in an EU/EFTA state (not available in English) Factsheet: Information for family members not in gainful employment and resident in an EU/EFTA state (not available in English) Detailed information for retired people EU/EFTA premiums (not available in English) 09/2013 4

5 Are you already insured in your home country and would you like an exemption from the obligation to be insured in Switzerland? An exemption from the obligation to be insured in Switzerland is only possible for certain groups of people and must be applied for in writing. Our office must receive the application within three months of the date on which the obligation to be insured in Switzerland begins (which is normally on entry into Switzerland) Groups of people who can apply for an exemption include: People in basic or continuing education and training, posted staff, cross-border commuters, family members not in gainful employment who are resident in certain EU-/EFTA-states. The foreign health insurance company must prove that it offers insurance cover that is at least equivalent to the list of services provided under Swiss compulsory basic Factsheet Information on the exemption from the obligation to be insured in Switzerland What services do I get under the compulsory basic insurance? Newly arrived residents in Switzerland must obtain compulsory basic insurance from a Swiss health insurance company within three months. The compulsory basic insurance must be taken out with retrospective effect from the start of the obligation to be insured in Switzerland If you meet this requirement, the health insurance company will reimburse any costs of treatment you have incurred since the date on which you took up residence in Switzerland When does the insurance cover begin? If you obtain compulsory basic insurance in good time, i.e. within three months of the start of the obligation to be insured in Switzerland, your insurance cover applies from the start of the obligation to be insured If you are late in obtaining compulsory basic insurance, insurance cover begins at the time you sign the contract health care costs incurred beforehand will not be covered; in addition you may have to pay a surcharge on the premium You can obtain further information from the health insurance company The list of services is identical for all recognised health insurance companies. For further information on the extent of the insurance cover, you should contact your health insurance company or the Federal Office of Public Health How soon do I have to obtain compulsory basic insurance? 09/2013 5

6 Am I free to choose my health insurance company? Yes. You can choose any one of the health insurance companies recognised by the FOPH. It is worth getting quotes from various health insurance companies. These are nonbinding and free of charge Every health insurance company licensed by the FOPH must accept you for compulsory basic insurance cover, regardless of your age or state of health. All the health insurance companies provide identical insurance cover under compulsory basic insurance. However there are differences in the amount of the premium and the way in which services are provided by the companies (quality of advice, speed of reimbursement, contact and access to List of recognised health insurance companies I have obtained basic insurance. What do I do now? Please send us a copy of the insurance policy for your compulsory basic insurance We should receive a copy of the insurance policy within three months of the start of the obligation to be insured 09/2013 6

7 How can I reduce my insurance premiums? Choose a health insurance company offering lower premiums: compare offers from various companies. There will be differences in the quality of advice, on when and how they can be contacted and how quickly they will reimburse your medical bills. The list of services, however, is identical Choose a special form of insurance: limit your choice of doctor and hospitals (e.g. HMO insurance) Choose a higher deductible: the health insurance company will reduce your premiums if you agree to increase the deductible, i.e. the fixed annual amount that you pay towards your healthcare costs, to more than the minimum amount of 300 francs Am I eligible to pay reduced premiums? People on low incomes who are obliged to have health insurance and are insured with a Swiss health insurance company are entitled to financial assistance with their compulsory health insurance premiums The tax administration will automatically check your tax return to see if you are entitled to assistance with paying your premiums People holding residence permits B, G, L, N or F must make a written request to have their entitlement to reduced premiums checked What happens if I do not obtain basic insurance? The Social Insurance Office (SIO) is responsible for ensuring compliance with the obligation to obtain health insurance in the Canton of Bern If you are required to have insurance in Switzerland but have not obtained compulsory basic insurance, the SIO may assign you to a health insurance company You can find further information here Factsheet: Information on the exemption from the obligation to be insured in Switzerland, Table: Health Insurance Classification for people resident in an EU/EFTA state (not available in English) Factsheet: Information for family members not in gainful employment who are resident in an EU-/EFTA state (not available in English), Forms, information on reduced premiums and on how to make savings (not available in English) Comparison of premiums List of recognised health insurance companies (not available in English) Compulsory Health Insurance Your questions, our answers 09/2013 7

8 Do you have any further questions? We look forward to hearing from you! Give us a call +41 (0) Monday to Friday, :00 and 13:30 17:00 (Friday to 16:00) Pay us a visit Write to us Monday to Friday, :00 and 13:30 17:00 (Friday to 16:00) Amt für Sozialversicherungen Abteilung Prämienverbilligung und Obligatorium Forelstrasse Ostermundigen asv.pvo@jgk.be.ch The information in this factsheet provides a general summary which does not claim to be comprehensive. No legal rights may be derived from the content hereof. 09/2013 8