Supplementary insurance

What is supplementary insurance?

Supplementary insurance complements compulsory basic health insurance. It pays for benefits that the Health Insurance Act (KVG/LAMal) does not cover or covers only in part, or it gives you more freedom of choice, for example of the hospital ward or of the doctor treating you in hospital. It is voluntary: nobody is required to have supplementary insurance.

Legally it is a private contract under the Insurance Contract Act (ICA, in German VVG). The Health Insurance Supervision Act (KVAG) allows health insurance funds to offer supplementary insurance alongside basic health insurance, but expressly makes it subject to the ICA (Art. 2 para. 2 KVAG). Besides health insurance funds, private insurance companies also offer supplementary health insurance. According to the insurance market report of the Swiss Financial Market Supervisory Authority (FINMA), in 2024 these were 16 insurance companies domiciled in Switzerland, 2 branches of foreign insurers and 9 health insurance funds. The five largest providers together held 75% of the market.

The main types

• Supplementary hospital insurance: a stay in the semi-private (two-bed room) or private ward (single room), free choice of doctor in hospital, often free choice of hospital throughout Switzerland. Variants where you choose the ward on admission and pay a retention fee are often called flex insurance.
• Supplementary outpatient insurance: contributions towards glasses and contact lenses, medicines not covered by basic insurance, complementary medicine from recognised therapists, transport and rescue costs, prevention or fitness, and treatment abroad.
• Dental insurance: contributions towards check-ups, dental hygiene, treatment and, for children, often orthodontics.
• Others: travel and cover abroad, nursing and household help, a lump sum in the event of disability or death, and a daily allowance during a hospital stay.

How it works

You take out supplementary insurance by submitting an application. In it you answer a health questionnaire, sometimes in more detail or with a medical report for higher benefits. The insurer examines the application and decides: it accepts you, accepts you with a reservation that excludes certain existing conditions, or rejects you. There is no obligation to accept you.

The benefits are not set out in the law but in the product’s general and supplementary terms and conditions (in German AVB and ZVB). There you will find annual limits, percentages, retention fees, waiting periods (for example for maternity), age limits for joining and the rules on cancellation. Two products with similar names can provide very different benefits.

The premium depends on the product and may vary by age on joining or age bands, sex, region and the retention fee chosen. Tariffs and terms and conditions of supplementary health insurance require FINMA approval; FINMA checks whether they safeguard the insurer’s solvency and protect insured persons from abuse. There is no public premium data as there is for basic health insurance.

How it interacts with basic health insurance

Basic health insurance pays first. Supplementary insurance covers what goes beyond that, according to its terms and conditions. In hospital, for example, the canton and basic health insurance pay for a stay in the general ward of a listed hospital; the canton covers at least 55% of the remuneration (Art. 49a KVG). The extra costs for the semi-private or private ward and for free choice of doctor are borne by supplementary hospital insurance. No insurance may cover the deductible and retention fee of basic health insurance; Art. 64 para. 8 KVG prohibits this.

Basic and supplementary insurance are separate contracts. You can take them out with different providers. If you switch basic health insurance, your current insurer may not force you to cancel your supplementary insurance as well, and it may not cancel your supplementary insurance solely because you switched (Art. 7 paras. 7 and 8 KVG).

Legal basis

There is no statutory list of supplementary benefits. The basis is the Insurance Contract Act (ICA) together with the product’s terms and conditions. Art. 2 para. 2 KVAG provides that the supplementary insurance offered by health insurance funds falls under the ICA.

The ICA provisions that apply include: the 14-day right of withdrawal (Art. 2a ICA), the insurer’s duty to provide information before the contract is concluded (Art. 3 ICA), the duty of disclosure when answering health questions and the insurer’s right to terminate the contract if this duty is breached (Art. 4 and 6 ICA), and ordinary cancellation at the end of the third or any subsequent year with three months’ notice (Art. 35a para. 1 ICA). Art. 35a para. 4 ICA states that in supplementary insurance to social health insurance, the ordinary right of cancellation and the right of cancellation after a claim belong only to the policyholder.

In the KVG, Art. 7 paras. 7 and 8 KVG are important (no forced cancellation of supplementary insurance when you switch basic health insurance), as is Art. 64 para. 8 KVG (the co-payment in basic health insurance may not be insured). Supervision of tariffs and terms and conditions lies with FINMA under the Insurance Supervision Act (ISA).

Example: hospital stay with and without supplementary hospital cover

Thomas is 45 and has basic health insurance with a CHF 1,500 deductible. Up to June 2026 he had costs of CHF 200. He then spends five days in a listed hospital in his canton of residence for a planned operation. The amounts on the hospital bill are fictitious; the rules are statutory.

Item	Amount	Who pays
Canton’s share, at least 55%	CHF 6,600	Canton of residence
Basic health insurance share, at most 45%	CHF 5,400	Health insurer, after deducting the co-payment
Remaining deductible	CHF 1,300	Thomas
Retention fee 10% of CHF 4,100	CHF 410	Thomas
Hospital contribution CHF 15 × 4 days (excluding day of discharge)	CHF 60	Thomas
Extra costs for semi-private ward and choice of doctor	according to hospital tariff	Supplementary hospital insurance under its terms, otherwise Thomas

Whether supplementary hospital insurance is worth it therefore does not depend on the treatment costs, but on how much you value comfort and freedom of choice. The comparison of supplementary insurance benefits shows which products offer which benefits.

What this means for you

Before you take out or switch supplementary insurance, answer these questions:

1. Which gap do you want to close? Write down which benefits you have paid for yourself in recent years: glasses, dental hygiene, complementary medicine, physiotherapy outside basic health insurance. Compare this with the annual premium.
2. Are you healthy enough to switch? With every new diagnosis, the risk of a reservation or a rejection increases. If you have good supplementary insurance and health problems, do not cancel it lightly.
3. How does the premium develop with age? Products with age bands become more expensive over the years. The terms and conditions show whether the premium is based on your age on joining or your current age.
4. Which deadlines apply? Notice periods and cancellation rights in the event of premium increases are set out in the terms and conditions and often differ from those of basic health insurance.

You can switch basic health insurance every year regardless. You can compare premiums in the premium calculator, and key figures on providers are under health insurers. For a personal assessment of supplementary insurance, you can request advice.

Common mistakes

• Cancelling first, applying later. Only cancel an existing supplementary insurance policy once the new insurer has accepted your application in writing and without an unwanted reservation.
• Answering health questions inaccurately. A treatment you did not disclose allows the insurer to terminate the contract and can cost you benefits.
• Insuring twice. If you already have cover abroad through your employer or a travel insurance policy, a second policy often means paying for the same benefit twice.
• Comparing only product names. “Semi-private” or “complementary” means something different at every provider. What matters are the limits, percentages and retention fees in the terms and conditions.
• Tying basic and supplementary insurance together. Switching basic health insurance does not put your supplementary insurance at risk. You do not have to stay with an expensive basic health insurance policy just because your supplementary insurance is with the same insurer.