Supplementary hospital insurance

What is supplementary hospital insurance?

Supplementary hospital insurance is voluntary health insurance for cases where you need inpatient hospital treatment, meaning you stay at least one night. It picks up where basic health insurance stops. Legally, it is a private contract under the Insurance Contract Act (ICA; German: VVG). It is offered by health insurers and by private insurance companies, usually with a policy separate from basic health insurance.

To understand what supplementary hospital insurance adds, you need to know what basic health insurance pays for inpatient treatment:

• Treatment in the general ward, usually in a multi-bed room, by the hospital’s doctors on duty.
• Free choice among listed hospitals in your canton of residence and in the canton where the hospital is located. If you choose a hospital in another canton without a medical reason, your health insurer and your canton of residence pay at most the tariff applicable in your canton of residence. You or your supplementary insurance pay the difference.
• Full cover for medical reasons: in an emergency, or if the treatment is not offered in your canton of residence, the insurer and the canton also pay in full outside your canton.

Supplementary hospital insurance extends this at different levels, which are similar across providers but differ in the details:

The details, such as whether hospitals not on the hospital list are also covered, how high the co-payment is in flex variants or which benefits apply abroad, are found only in the general terms and conditions (AVB). No law defines the benefits.

How it works

Taking out cover. You submit an application and answer the health questions. Unlike in basic health insurance, the insurer may reject you here, add reservations for existing conditions or charge a higher premium. Some insurers have a maximum age for joining. The premium often depends on your age at entry, your age and the region. You can revoke the application within 14 days.

Duty of disclosure. You must answer all health questions truthfully and completely, as far as you know the facts or should know them. If you conceal something, the insurer may cancel the contract as soon as it finds out, within four weeks. For claims that have already occurred and are connected with the concealed point, the obligation to pay benefits then lapses.

Admission to hospital. Before a planned operation, the hospital usually asks the supplementary insurance for cost approval for the chosen ward. The insurer checks whether that level is insured and whether reservations apply. In an emergency, this happens afterwards.

Billing. Basic health insurance and your canton of residence first pay their share of the flat rate per case for the general ward; the canton pays at least 55%. Supplementary hospital insurance pays the additional costs of the chosen ward, the doctors’ fees for the supplementary level and any tariff differences. The deductible, retention fee and hospital contribution of basic health insurance remain your responsibility, because by law co-payments may not be insured.

Cancellation. You can cancel the contract under the terms of the policy, at the latest at the end of the third contract year with three months’ notice. The health insurer may not cancel supplementary hospital insurance with ordinary notice. It may not use a change of basic health insurer as a reason to cancel the supplementary insurance.

Legal basis

For supplementary hospital insurance, there are no benefits laid down by law. Under Art. 2 para. 2 of the Health Insurance Supervision Act (KVAG), health insurers may offer supplementary insurance alongside basic health insurance; it is subject to the ICA. The supplementary insurance business is supervised by the Swiss Financial Market Supervisory Authority (FINMA).

The most important provisions of the ICA are:

• Art. 4 ICA: duty of disclosure. You must disclose the facts material to the risk that are asked about in the questionnaire, as far as you know them or should know them.
• Art. 6 ICA: if the duty of disclosure is breached, the insurer may cancel; the right lapses four weeks after it finds out. The obligation to pay benefits for claims that have already occurred lapses insofar as they were influenced by the concealed fact.
• Art. 2a ICA: right of revocation of 14 days after the application or acceptance.
• Art. 35a ICA: ordinary cancellation at the end of the third or any subsequent year with three months’ notice (para. 1). In supplementary insurance to social health insurance, this right and the right to cancel after a claim belong only to the policyholder (para. 4).

The Federal Health Insurance Act (KVG) sets out what basic health insurance already covers for inpatient treatment: a hospital stay at the standard of the general ward (Art. 25 para. 2 let. e KVG), free choice among the listed hospitals of the canton of residence and of the canton where the hospital is located, at most at the tariff of the canton of residence (Art. 41 para. 1bis KVG), and full cover for medical reasons (Art. 41 paras. 3 and 3bis KVG). The canton pays at least 55% of the inpatient remuneration (Art. 49a para. 2ter KVG). Under Art. 7 paras. 7 and 8 KVG, the insurer may not force you to cancel the supplementary insurance when you change basic health insurer, and it may not cancel it solely because of the change. Under Art. 64 para. 8 KVG, co-payments in basic health insurance may not be insured; under Art. 104 of the Health Insurance Ordinance (KVV), the hospital contribution is CHF 15 per day, excluding the day of discharge.

Example: five days in hospital

Martin, 52, lives in the canton of Bern and has a CHF 2,500 deductible. For a planned operation, he is an inpatient for five days, admitted on Monday and discharged on Friday. We assume a flat rate per case of CHF 12,000 (assumed amount). The amounts for the deductible, retention fee, hospital contribution and cantonal share come from Art. 64 KVG, Art. 103 and 104 KVV and Art. 49a KVG. Martin has had no other costs so far in 2026.

What this means for you

Supplementary hospital insurance buys comfort and freedom of choice; it does not close a gap in medical care. These questions help:

1. How important is the choice of doctor and room to you? If it matters little to you, basic health insurance fully covers the medically necessary treatment.
2. Do you want to go to a hospital outside your canton without paying extra? Then the level “general ward throughout Switzerland” is often enough.
3. How old are you and how healthy? With every year and every diagnosis, taking out cover becomes harder. If you want this insurance, it is better to take it out earlier.
4. How will the premium develop as you get older? For many tariffs, the premium rises with age. Ask about the premium in 10 and 20 years and about the age bands.
5. Does a flex variant make sense? It lowers the premium if you are prepared to pay part of the additional costs yourself if you go into hospital.

In the supplementary insurance comparison we set the hospital tariffs and their benefits side by side. Which health insurers offer which levels is shown in the health insurer profiles. You can switch your basic health insurance independently of this; you compare the premiums in the premium calculator. For the individual levels, see entries such as privately insured and flex hospital insurance.

Common mistakes

• Cancelling the old insurance first. Without written confirmation from the new insurer, you risk ending up with no supplementary hospital cover at all.
• Answering health questions inaccurately. A breach of the duty of disclosure can lead to cancellation and the loss of benefits for related cases.
• Trying to save on the deductible and retention fee with supplementary insurance. Co-payments in basic health insurance may not be insured.
• Underestimating basic health insurance. Any medically necessary inpatient treatment is covered in the general ward of a listed hospital, including expensive operations.
• Looking only at today’s premium. Supplementary hospital insurance premiums rise with age. Ask about the age bands before you sign.

We explain how we compare benefits and check sources under How we calculate.