This insurance is a comprehensive medical and accident insurance that complies with article 2 paragraph 4 of the Swiss Health Insurance Ordinance KVV / OAMal, which regulates the insurance obligations of foreign students, interns, and au pairs.
You have all benefits of the Swiss national health insurance scheme KVG-LAMal without having to submit any medical history or medical questionnaire.
What is an exemption and why do I need one?
The SWISSCARE Student Switzerland insurance plan covers all benefits of the mandatory Swiss national health insurance scheme KVG-LaMal. The exemption is a “waiver” from the obligation to have Swiss national health insurance and is only possible for a very limited group of individuals (e.g. foreign students, interns, trainees, au-pairs) who are in Switzerland temporarily. After completing your insurance application, you will receive an exemption form. Fill out this form and send it, along with all requested documents as PDF files of good quality, to SWISSCARE. Our team will then stamp, sign, and send these documents directly to the responsible cantonal authorities, except in the case of cantons that request online submissions only. For those cantons, Swisscare will provide you with instructions on how to proceed, as the process may vary for each canton. Upon reception of the documents, the cantonal authority will verify whether you are eligible for exemption according to article 2 paragraph 4 of the Swiss Ordinance on Health Insurance (KVV, OaMal). Depending on the authority concerned, the verification process can take a few weeks or even several months. Once the concerned authorities have rendered a decision, it will be sent directly to the insured. Unfortunately, Swisscare is not informed and can not obtain any information concerning this process.
Does this mean that I can be exempted from paying for my health insurance?
Answer: No.
The premiums are due and the exemption procedure has no impact on the obligation to pay for the insurance premiums.
According to Swiss law, it is mandatory for every resident in Switzerland to obtain health insurance coverage in accordance with the regulations set in the Swiss Health Insurance Act. However, for certain individuals such as foreign students, or interns, there is an option to waive this obligation and to obtain private health insurance coverage, as long as the benefits are equivalent to those required by the Swiss Health Insurance Act. During the exemption procedure, this is what the authorities verify.
Do I need to pay for my health insurance during the exemption procedure?
Answer: Yes
The reason the premiums are still owed during the time the exemption request is being processed is that should a client not pay and thus lose coverage, Swisscare is obligated to notify the authorities and the exemption process is then automatically stopped and the individual can be assigned to a Swiss national health insurance scheme by the authorities. Additionally, Swiss law requires compliant insurance coverage from the day of arrival on. For this reason, it is very important to respect the payment delays. In the case of non-payment, coverage can be suspended and a notification to the authorities may become necessary.
Is it possible that the exemption application is refused by the competent authorities?
The cantonal authorities can refuse an application for exemption based on a lack of eligibility - meaning that the individual does not fulfill the conditions set out in the applicable laws. The refusal decision always states the reasons for refusal, as well as a deadline for an appeal. Should the application be denied, a national Swiss health insurance provider must be found for the concerned individual and Swisscare should be contacted and the termination process initiated.
What is an exemption confirmation?
This is the document you will receive from the competent authorities (cantonal or communal), usually by post, which confirms that they have accepted that you are exempt from the State Health Insurance Scheme because you have equivalent coverage with the Swisscare Studentpass Switzerland insurance product.
Please take good care when you receive this document, because you must submit a scan or copy when you file a claim for reimbursement.
You can change your address by logging into your customer account or using the MySwisscare app on iOS or Android.
If you are in need of medical treatment, it is important the treatment is undertaken by a doctor whose certification is officially recognized in the country you receive your treatment. Depending on the insurance coverage you have chosen, certain exclusions may be applicable. We recommend that the General Insurance Conditions are consulted and if it is not clear, to ask questions concerning reimbursement and claims directly to the concerned claim service. Outpatient treatments (meaning you don’t have an overnight stay in a medical facility) generally have to be paid in advance, then you can proceed to submit your claim to the claim service via email, or via your customer account or the iOS / Android app.
In the case of hospital admission for inpatient treatment (meaning an overnight stay), you can present your digital insurance card saved on your MySwisscare account or on the iOS or Android app. If the inpatient facility requires further information, you can simply click or tap share - and then enter the email address given by the hospital. They will then receive the complete insurance policy with all the details. Most of the time, inpatient treatments will be billed directly to the concerned insurer, however, they may request a security deposit.
Dentists are usually not covered unless there is an accident. Should a plan provide coverage for dental treatments this will be stated in the General Insurance Conditions (GIC’s and the benefits list).
Important
Please note that coverage is only provided for the benefits stated in the General Insurance Conditions. At times exclusions are also applicable and they vary depending on the insurance product. It is recommendable to verify the coverage of the chosen product in advance.
In the case of outpatient treatment (no overnight stay at a medical facility), the insured always has to pay for the medical treatments (doctor’s, pharmacy, specialists, hospital outpatient treatments) in advance.
To ensure you are refunded quickly, it is recommendable to follow the claim procedure via your customer account or by using the MySwissare iOS or Android App.
Log into your MySwisscare Account
Select the concerned insurance policy and complete the online fields
Take a picture and/or upload the pdf or jpg file of your detailed invoice
Take a picture and/or upload the proof of payment (bank receipt or cash payment receipt from the pharmacy, doctor, specialist, hospital...)
Short statement concerning the medical issue and the administered treatment
Send / Submit
How long does it take for a refund to be made?
Once the concerned claim service has received all required documentation the insurer will initiate the refund procedure. In most instances, a refund is effected within 30 days of submission of the complete documentation. During peak seasons (for example December) it is possible that a refund will take longer. If within 45 days you have not been refunded by the insurer, we recommend that you contact them directly via email or our contact form.
Instantly if you pay by credit card
If you pay your insurance by credit card, you can download your insurance policy immediately.
Payment by bank transfer: it may take up to two weeks
Payments coming from the EU/EEA or Switzerland usually only take around 2-3 bank office days until we receive them, and then shortly after it is credited to our account the payment will be visible in your personal MySwisscare Account. You will receive an email confirming reception.
Payments made from outside of the EU/EEA or Switzerland can take up to two weeks until they are credited to our account. As soon as we have received them, you will receive an email confirming reception.
You can pay by credit card at any time to receive your insurance policy instantly.
Just log into your MySwisscare account and under the tab "finance" you can choose to pay your insurance premium by credit card. After a few seconds, you will be able to download your insurance policy.
Leaving Switzerland
If you are leaving Switzerland permanently, meaning that you will be returning your residence permit or it is no longer valid, you can cancel your insurance on the day following your departure (if you leave on the 25th, then that is the last day of validity and the cancelation takes effect on the 26th). To do so please email us a scanned copy of your official attestation of departure from the city hall. Premiums for the time after departure according to the policy you present will be refunded.
Please send us along with your attestation of departure your bank account coordinates for a refund. We require the following information: bank name, bank address, IBAN, SWIFT/BIC, account holder name and address. Once we have all the required information, the refund will be made.
You are no longer a student, intern, au pair and are remaining in Switzerland
By law and our General Insurance Conditions (GIC’s), once your status changes and you are no longer eligible for the Student health insurance plan, the plan must be canceled. As we are not necessarily informed of such changes, you are required to contact us to initiate the cancelation procedure and the switch to a Swiss national health insurance scheme KVG-LAMal. We are happy to support you with the switch.
You marry a Swiss national
Once you marry a Swiss national, your residence status changes and the main reason for your stay in Switzerland is no longer of a temporary nature - which means you are no longer eligible for an exemption to have student health insurance. You must inform Swisscare of these changes as well as the concerned authorities and you will have to switch to a Swiss national health insurance scheme KVG-LAMal. We are happy to guide you during this transition.
Change to a different insurer
If you wish to change to another insurer and none of the reasons above are applicable, then you can cancel at the end of the calendar year (December 31st) and must hand in the notice until September 30th of the current year.
To validate your cancellation, we need a confirmation from your new insurance that coverage will begin on January 1st of the following year. Please note, that an offer is insufficient to validate a cancelation, it must be an insurance policy.
Attention! A cancellation is only possible if your insurance policy was active for at least 12 months.
The costs of the treatments and the vaccination are covered.
You can find more information through the following link Federal Office of Public Health FOPH.
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Billing/invoices - important!
The pharmacies and health centers must always bill the related tests directly to the responsible authority Gemeinsame Einrichtung (EAN: 7601003005530).
The insurer does not cover or reimburse the vaccinations and tests invoices.
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CORONA-TEST:
From 01 January 2023
The Swiss Parliament has resolved that from 1 January 2023 onwards, the costs of COVID-19 tests will no longer be met by the Swiss Confederation and must therefore be paid by the individuals undergoing them.
COVID-19 tests ordered by a medical practitioner will have their costs met by the compulsory health insurance of the individual concerned, provided the test is required to determine any further medical action. Such costs will also, however, be subject to the insurance’s deductible and copayment provisions. The corresponding information on the website will be updated accordingly, with effect from 1 January 2023.
Please note: Implementation of testing is the responsibility of the cantons so that they may vary.
From 22 December 2021
The Swiss federal government covers the costs of individual PCR tests in the following cases:
You are being tested because you have symptoms.
You have received a notification from the SwissCovid app.
You have been in contact with a confirmed case.
You have been instructed by a cantonal authority or a doctor to perform a test.
The federal government does not cover the costs of individual PCR tests required to obtain a COVID certificate or travel.
Rapid antigen tests
You can get tested at a testing center, at your medical practitioner, at a hospital, or in pharmacies. The Swiss federal government covers the costs of nasopharyngeal rapid antigen tests for everyone.
Antigen self-tests
The Swiss federal government no longer covers the costs of antigen self-tests.
From 01 October 2021
The federal government will only cover the costs of tests in the following cases:
From 24 June 2021
The antigen self-test kits from pharmacies are free of charge only if:
You have not been fully vaccinated;
You have not been infected with the coronavirus.
If you are not in any of the above categories, you can still buy the self-test kits in drugstores and/or retail outlets in Switzerland, but at your own expense.
From 7 April 2021
Self-tests are available in Switzerland’s pharmacies, and you are entitled to 5 tests every 30 days free of charge. The pharmacy will bill the tests you obtain directly to the Gemeinsame Einrichtung KVG.
From 15 March 2021
All the costs of rapid tests requested by individuals, regardless of whether you have symptoms, will be covered by the federal government.
To get a rapid-tests by the pharmacies or any other health centers, you may simply state at the registration counter that you have student insurance and show them your ID card (permit/passport).
The pharmacies and/or health centers will bill directly to the Gemeinsame Einrichtung KVG.
From 2 November 2020
Rapid-tests have been carried out and are covered by the Swiss authorities, without taking into account the deductible and co-participation, in the case of those with specific symptoms or as a result of close contact with a person who has tested positive.
Before 25 June 2020
Tests and treatments are covered by the health insurance for those with severe symptoms or possible risk of complication, but deductible and co-participation are applied.
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COVID VACCINATION ::
The costs of the COVID-19 vaccination will be covered by the Swiss federal government.
You may find more information from the Federal Office of Public Health FOPH.
Registration procedure:
For some of the Canton's online registration process, please note that there is a required 20-digits insurance card number which only applies to the Swiss statutory KVG/LAMal health insurance cards. This number is not available for all student/private insurances like Swisscare's Foreign Student Health Insurance Switzerland plan. With this insurance plan, you will fall into the category of Foreign Insurance "Ausland / Pays étrangers". As well, you may choose "Cross-border" in the case if the online form requesting for Relation to Switzerland.
Cantonal websites at foph-coronavirus.ch.
Copayment (excess) is an amount per calendar year at the expense of the insured for covered insurance benefits.
The Swiss health insurance act requires that there is a copayment as well as a franchise for medical costs at the expense of the insured.
The copayment is limited to 10% of the covered medical costs up to a maximum of CHF 700 per calendar year.
Out-of-pocket expenses under basic health insurance:
The annual (01 January - 31 December) maximum out-of-pocket participation consists of a fixed annual amount which is the so-called deductible (aka. franchise) and the coinsurance part (10%).
Up to the threshold of the selected deductible, the insured has to pay the cost of medical services out of pocket.
After that, they must pay 10% of the costs exceeding this deductible, the coinsurance up to a maximum of CHF 700 per calendar year.
Your insurance deductible is also stated on the insurance policy.
Note: The deductible can only be changed with effect from 1 January and for at least one year.
Swisscare has in fact decided since 2019 that we are no longer distributing the physical insurance cards.
Simply download the MySwisscare app on iOS and Android and you will find your Digital Insurance Card in your policy account.
