The Federal Health Insurance Act (KVG/LAMal) regulates mandatory health insurance in Switzerland. It defines compulsory coverage, insured persons, covered benefits, premiums and cost sharing.

Outpatient care includes medical treatments without an overnight hospital stay, such as doctor visits, diagnostics or therapies.

International coverage defines whether and to what extent medical costs incurred abroad are covered by Swiss health insurance.

An exclusion refers to benefits or risks that are not covered by the insurance policy and are defined in the insurance terms.

The Federal Office of Public Health (FOPH) is the Swiss authority responsible for public health policy and supervision of mandatory health insurance benefits.

A check-up is a preventive medical examination for early disease detection and is partly covered by supplementary health insurance.

A coverage exclusion contractually defines which services are excluded from insurance coverage.

Supplementary benefits support individuals whose AHV or IV pensions are insufficient to cover basic living costs in Switzerland.

The Income Compensation Scheme (EO/APG) compensates for loss of income during military service, civil service, maternity or paternity leave.

FINMA supervises insurance companies and financial institutions in Switzerland and ensures market stability and consumer protection.

Generic drugs are equivalent alternatives to original medications with the same active ingredients, dosage and effectiveness.

Under the group practice model, insured persons must first consult a designated medical group practice before receiving further treatment.

The semi-private hospital ward is a coverage level within supplementary hospital insurance. It offers increased comfort, typically a two-bed room and free choice of doctor.

Mandatory health insurance covers recommended vaccinations in Switzerland, such as diphtheria, tetanus, polio or MMR. Travel vaccinations are not covered but may be partially reimbursed by supplementary insurance.

Capital insurance combines insurance protection with a savings component. It complements social insurance and pays out a predefined insured amount in the event of death or disability.

A collective contract is an agreement between an insurance company and an employer, association or organisation, allowing members or employees to take out insurance at reduced premiums without compulsory participation.

A health insurance provider is an insurance company with which residents of Switzerland are legally required to take out mandatory basic health insurance. Covered services are defined by law, with cost-sharing by the insured.

The health insurance obligation requires all persons residing in Switzerland to take out mandatory health insurance.

Supplementary health care insurance covers additional benefits beyond basic insurance, such as contributions to medication, visual aids, vaccinations or emergency treatment abroad.

Daily sickness allowance insurance protects income in the event of long-term illness by paying a daily benefit for a defined period.

The benefits catalogue defines all medical services covered by Swiss health insurance.

Mandatory health care insurance (OKP/LAMal) is the legally required basic insurance in Switzerland, ensuring access to medically necessary healthcare services.

Mandatory health insurance is compulsory for all residents of Switzerland and ensures basic medical care.

Mandatory accident insurance protects employees against the financial consequences of occupational and non-occupational accidents and occupational diseases.

Switzerland is divided into different premium regions. Health insurance premiums vary depending on place of residence due to regional cost differences.

Premium reduction is a government subsidy for individuals with low or middle incomes to reduce health insurance premiums.

The premium payer is the person or entity responsible for paying insurance premiums, regardless of who receives the benefits.

The private hospital ward is the highest coverage level within supplementary hospital insurance, offering maximum comfort, single rooms, superior catering and free choice of doctor.

Risk assessment evaluates an applicant’s health status before taking out supplementary insurance and determines premiums or exclusions.

Medical repatriation refers to the medically supervised transport of an injured or ill person back to Switzerland from abroad if local treatment is not reasonable.

A discount (Skonto) is a small premium reduction often granted for semi-annual or annual advance premium payments.

The general hospital ward provides legally defined basic inpatient care, usually in multi-bed rooms.

Hospital insurance is a supplementary insurance that provides enhanced benefits and comfort during inpatient hospital stays, covering general, semi-private or private wards depending on the policy.

Inpatient treatments require a hospital stay with at least one overnight stay.

A breastfeeding allowance is a voluntary benefit offered by some supplementary health insurance plans to financially support breastfeeding mothers after childbirth.

The Telmed model is an alternative basic insurance model where medical advice by phone is required before visiting a doctor. It usually offers a premium discount of around 10–20%.

Accident coverage covers costs resulting from accidents if no separate accident insurance exists.

Accident coverage suspension excludes accident coverage from basic health insurance if an employee works at least 8 hours per week, as accident insurance is then provided by the employer.

The Accident Insurance Act regulates mandatory accident insurance for employees, covering occupational and non-occupational accidents and occupational diseases.

The Insurance Contract Act governs private insurance contracts such as supplementary insurance and defines rights and obligations of insurers and policyholders.