Reality Check: KVG vs. Real Life
The Concept: Basic Insurance (KVG) is a socialist construct designed to prevent you from dying. It focuses strictly on medical treatment within cantonal borders. It ignores logistics, comfort, and international mobility.
The Risk: A helicopter rescue or a medical flight home from Spain can cost CHF 20,000+. Basic insurance pays CHF 0 for this.
Most expats assume "Universal Healthcare" means "Everything is covered." In Switzerland, this assumption is the leading cause of unexpected medical debt.
Category 1: The "High Risk" Gaps
These are not about comfort. These are about preventing financial ruin. For the international expat, these are non-negotiable.
1. Ambulance & Rescue
The Gap: Basic insurance only covers 50% of transport costs, capped at CHF 500 per year (CHF 5,000 for rescue/helicopter).
The Cost: A single ambulance ride in Zurich costs CHF 900. A helicopter rescue costs CHF 3,500+. KVG protection runs out almost immediately.
2. Medical Repatriation
If you break your leg skiing in Austria or get sick visiting family in the USA, Basic insurance will treat you locally (emergency only). It will never pay for a medical flight back to Switzerland.
Insight: A REGA patronage is good, but it is not a legal insurance right. Supplementary insurance guarantees your flight home.
3. World Coverage
Basic insurance covers emergency treatment abroad at max 2x the Swiss canton rate. In expensive countries like the USA, Japan, or Canada, this is often insufficient to cover the hospital bill.
Read more about the strict legal difference between KVG (Basic) and VVG (Supplementary) at our partner Insurance-Guide.ch.
Category 2: The "Lifestyle" Gaps
These affect your daily comfort and dignity.
- 4. Dentistry: 0% coverage. Unless you have a severe jaw disease, you pay 100% out of pocket.
- 5. Glasses / Lenses: CHF 180/year for children. For adults? Almost nothing.
- 6. Privacy (Hospital): Basic insurance means a multi-bed room (up to 4-6 people) in your canton of residence. No privacy, no choice of specialist.
- 7. Choice of Doctor: Most cheap basic models (Telmed/GP) restrict direct access to specialists.
Category 3: The "Hidden" Gaps
Things you expect to be free, but aren't.
8. Alternative Medicine
Osteopathy, Acupuncture, and Massage are only covered under KVG if performed by a medical doctor with specific additional training. Most naturopaths are excluded.
9. Gym Memberships
Basic insurance pays CHF 0 towards prevention. Supplementary packages (VVG) often contribute CHF 200 - 800 per year towards gym or sports club memberships.
10. Prenatal Upgrades
Basic covers the birth perfectly well medically. But it does not cover the "Family Room" (upgrade to private) or elective C-section comfort measures. These "hotel costs" can run CHF 2,000+ per night without insurance.
The Solution Strategy: The "Bundle"
You do not need "Platinum" coverage for everything. The smart strategy is to bundle:
- Outpatient Package: Covers Ambulance, Gym, Glasses, and Travel. Usually very cheap (~CHF 15-25/month).
- Hospital Flex: The middle ground. Gives you access to Private/Semi-Private rooms without the full cost of a Private layout. You pay a deductible only when you use the room.
Frequently Asked Questions
Does Rega replace insurance?
No. Rega is a system of patronage, not an insurance contract. They can waive rescue costs for patrons, but they are not legally obligated to do so. Rega also does not cover ambulance rides on the ground.
Can I add supplementary insurance later?
Only if you are healthy. Unlike Basic insurance, insurers can reject you for Supplementary coverage based on medical history. The golden rule: Sign up while you are healthy.