Swisscare

According to the Swiss Federal Law on Health Insurance (KVG/LAMal), each person residing in Switzerland must take out health insurance or get insured by their legal representative within three months after taking up residence or after the birth of a child in Switzerland. Since the Swiss insurance obligation begins from the very first day of either arrival or birth in Switzerland, the start date of the insurance contract must coincide with that date.

Every individual can choose freely between the health insurers (health insurance companies) recognized and authorized to operate by the Swiss Federal Office of Public Health (FOPH). To access the complete list, click here.

Through the websites Priminfo and Comparis.ch it is possible to compare the various offers available and choose the most suitable one.

The insured person bears part of the costs of health by paying:

• the premiums, which vary according to the age, canton of residence, insurer and insurance plan chosen by the insured (for example, for a 20-year-old between 200 CHF and 500 CHF per month);
• the deductible (aka. franchise), which for adults varies between a minimum of 300 CHF and a maximum of 2500 CHF per calendar year (the higher the annual deductible, the lower the monthly premium);
• the co-payment - once the annual deductible has been reached and exceeded, the additional 10% share must be paid on any subsequent expenses up to a maximum of 700 CHF per calendar year;
• contribution to the costs of a hospital stay - 15 CHF per each day spent in hospital (with no time limit).

The remaining costs are borne by the insurer, if covered by the chosen policy.

According to article 2 paragraph 4 of the Swiss Health Insurance Ordinance (KVV/OAMal), on request, foreign students and interns can apply for exemption from Swiss compulsory health insurance, provided that they have a policy offering equivalent coverage. The competent cantonal authority can exempt these people from the obligation to take out health insurance in Switzerland for a maximum of 6 years.

The request for non-subjection / exemption must be received by the competent cantonal authority - for the Canton of Ticino it is the Istituto delle assicurazioni sociali (IAS) in Bellinzona - within three months from the date of entry in Switzerland. Late requests cannot be accepted and, after the period of three months from the arrival has passed, they are required to take out Swiss compulsory health insurance (KVG/LAMal) for the entire duration of the stay.

Foreign insurances recognized as equivalent to that required by the Swiss Federal Law on Health Insurance (KVG/LAMal) are the following:

• the European Health Insurance Card (EHIC) - accepted only for students who are at the same time citizens and residents of an EU/EFTA state[1] (form TI 6.1);
• foreign private insurances that provide a coverage that is financially unlimited and equivalent to the one guaranteed by the Swiss Federal Law on Health Insurance (KVG/LAMal) - accepted both for students coming from EU/EFTA states (form TI 6.2) and for those who come from non-EU/EFTA states (form TI 6.3).

[1] ;The only exception relates to students with non-EU/EFTA citizenship who come from and are insured with the EHIC in Germany, which is the only state that still pays for the healthcare services obtained in Switzerland by Third-country nationals.

Foreign students who do not have any of the above-mentioned insurances are subject to compulsory health insurance in Switzerland. As an alternative to the Swiss state health insurance (KVG/LAMal), through USI they have the possibility to take out and apply for exemption with the Swiss private health insurance (VVG/LCA) “Swisscare”.

In order to offer its foreign students basic compulsory health insurance coverage in the event of illness, accident and maternity in accordance with the regulations set by the Swiss Federal Law on Health Insurance (KVG/LAMal), but at a much lower cost, Università della Svizzera italiana has signed a collective agreement with Europäische Reiseversicherung (insurer) and Swisscare Switzerland AG (broker) for the introduction of the policy named "Swisscare Foreign Student Health Insurance Switzerland", hereinafter referred to as "Swisscare".

The “Swisscare” General insurance conditions (GIC) and Table of benefits can be accessed by clicking here.

A summary of the main coverage and exclusions is available here.

Please note that the only “Swisscare” insurance plan available for USI students is Standard.

The costs of the Standard "Swisscare" insurance plan for USI students are the following:

• premium per insured: 99.00 CHF per month;
• discount of 10% for the group contract with USI: 9.90 CHF;
• final premium per insured: 89.10 CHF per month;
• deductible (franchise) per insured: 300.00 CHF per calendar year;
• co-payment of 10%: up to 700.00 CHF per calendar year.

The “Swisscare” insurance offer is valid for foreign students - primarily non-EU/EFTA citizens, who are enrolled in one of USI's Bachelor, Master or PhD programmes, who have not yet turned 45, who hold the residence permit for the Canton of Ticino for study purposes (i.e., the one with the notation “soggiorno per formazione”) - no other type of permit is accepted and who do not work in Switzerland.

Applications from EU/EFTA citizens and residents are accepted only if they do not have the right to obtain the European Health Insurance Card (EHIC). In this case, they are required to submit a certificate issued by the competent authority of their country of residence specifying the reason(s) for the denial of the EHIC translated by a sworn translator into one of the Swiss national languages.

It is possible to take out the “Swisscare” insurance and submit the related exemption request to the Istituto delle assicurazioni sociali (IAS) in Bellinzona within three months from the date of entry in Switzerland.

The registration has to be done online through the appropriate platform accessible by clicking on the following link.

Please note that, since the insurance obligation begins from the day of arrival in Switzerland, the start date of the "Swisscare" insurance contract must coincide with that date.

After completing the online application form, the student will receive from Swisscare Switzerland AG the e-mails containing:

• the link to activate his personal customer account and to download the MySwisscare App on his smartphone (through which is possible to change personal data, download the insurance policy, access the digital insurance card, pay premium bills, request reimbursement of medical expenses, search for doctors, etc.);
• the form for requesting exemption from the compulsory health insurance in Switzerland together with the list of documents to attach (USI enrollment certificate, front and back copy of the Swiss residence permit or another official document containing the date of entry in Ticino/Switzerland, copy of the "Swisscare" policy);
• the e-invoice for the payment of the first premiums by bank transfer (unless the insured chose to pay them by credit card already during the registration).

If you don’t find these e-mails in your Inbox, please check the messages in the Spam/Junk e-mail folder.

In order to have sufficient time to check and, if necessary, correct and collect the missing documents, as well as to send the exemption request to the IAS within the aforementioned deadline, we invite you to register online at the latest after (approximately) two and a half months from the date of your arrival in Switzerland.

Please be aware that late requests cannot be accepted and, after the period of three months from the arrival has passed, it becomes necessary to take out Swiss compulsory health insurance (KVG/LAMal) for the entire duration of the stay.

The insured has a free choice of doctors and hospitals among the service providers recognized under KVG/LAMal, who are licensed to provide the necessary care services in the event of illness, accident or maternity in Switzerland.

The official and comprehensive list of doctors in Switzerland is available on the web site www.doctorfmh.ch/en.

Moreover, in the MySwisscare mobile App there is a "Find a Doctor" tab where the insured can easily look for a nearby doctor.

Please note that the “Swisscare” insurance is valid in Switzerland. When the insured is outside of Switzerland temporarily, the insurance provides coverage only in cases of emergency (excluding USA, Canada and Japan) and for a maximum of double the cost of the same treatment in the canton of residence in Switzerland.

Premium billing is carried out by Swisscare Switzerland AG. As a rule, premiums are billed by semester – i.e. every 6 months, covering the period from January to June and from July to December. Payments by installments are not allowed. The payment deadline is 30 days from the date of the invoice issue.

Claims are managed by Europäische Reiseversicherungs (ERV).

The payment and the reimbursement of medical expenses are supposed to be made in the following way:

• inpatient treatments (hospital admission) - the insured person does not have to pay medical expenses in advance and the treating physician must submit the request for cost reimbursement to the insurer's claims office before the start of treatment;
• outpatient treatments (no hospital admission), i.e. hospital emergency outpatient treatments, general practitioners, specialists, pharmacies, etc. - the insured person will have to pay medical fees in advance and afterwards can submit the request for reimbursement.[2].
   

  [2] Pharmacies, medical studios, hospitals, laboratories and other test centers must always bill the COVID-19 tests directly to the Gemeinsame Einrichtung KVG.

The insured person can submit the claim for reimbursement of medical expenses through his online customer account, by using the MySwissare iOS or Android App or by sending via e-mail to [email protected] the following documents:

• claim form;
• copy of the “Swisscare” insurance policy;
• short statement concerning the medical issue and the administered treatment;
• medical invoices and proof of their payment;
• his own bank account details.

It is possible to submit the medical claims anytime within five years after the occurrence of the event on which the obligation to provide benefits is based.

Once the request has been received, ERV will determine whether the insured is entitled to the reimbursement of the medical expenses incurred - i.e., if the health services received are covered by his policy (see the GICs) and, if so, will proceed with the payment of the due amount to the insured (after deducing the annual deductible and the co-payment).

The reimbursement process normally takes between 3 and 5 weeks.

Please note that USI will not release neither the enrollment certificate nor the diploma at the end of the studies to students who haven't paid off all their debts.

It is possible to benefit from the “Swisscare” insurance coverage, at the earliest, from the day of the insured person’s entry in Switzerland and, at the latest, until:

• the day on which the insured has ended his studies (graduation, withdrawal, “ex-officio” de-registration or exclusion from the studies), or
• the day on which the insured has permanently left the Canton of Ticino (the departure must be notified to both the Residents' Registration Office of his municipality and to the Migration office in Bellinzona and the notifications of departure must be submitted to the persons in charge of the policy management), or
• the day preceding the day on which the insured has started a gainful employment (internship or work) which is not mandatory for the completion of the studies (in this case, it is necessary to submit a copy of the employment contract), or
• the day preceding the day on which the insured has started family reunification (e.g., marriage to a Swiss citizen or a foreign citizen residing in Switzerland) – in this case, it is necessary to submit a copy of the civil status record, or
• the end of the year (i.e. the 31st December) in which the insured turns 45, or
• the day on which the insured has reached 6 years of exemption, which is the maximum duration allowed (KVV/OAMal), or
• the day on which the insured no longer meets the criteria for exemption according to the Swiss Health Insurance Ordinance (KVV/OAMal) and becomes subject to compulsory health insurance in Switzerland in accordance with the Swiss Federal Law on Health Insurance (KVG/LAMal) for some other reason.

Please note that the event that determines the cancellation of this insurance policy is the one which occurs first.

Besides paying timely the "Swisscare" insurance premiums and the medical expenses, the insured student must inform both USI ([email protected]) and Swisscare Switzerland AG ([email protected]) of any relevant changes, such as:

• change of address;
• issue, renewal, modification or revocation of the residence permit;
• end of studies;
• definitive departure from the Canton of Ticino;
• start of a gainful employment;
• change of marital status;
• any other changes relevant to insurance coverage.

For further information about the health insurance system in Switzerland and for the latest COVID-19 updates, please consult the following pages:

• Swisscae FAQs
• Swiss Federal Law on Health Insurance (KVG/LAMal)
• Swiss Health Insurance Ordinance (KVV/OAMal)
• Swiss Federal Office of Public Health FOPH - Home page
• Swiss Federal Office of Public Health FOPH - The compulsory health insurance system guide
• Swiss Federal Office of Public Health FOPH - Coronavirus
• ch.ch Easy answers about life in Switzerland - Health
• World Health Organization (WHO)
• COVID-19 campus protection provisions and the organisation of the academic semester at USI

Policy Management

SWISSCARE Switzerland AG
Customer Care Unit
Morgenstrasse 129
3018 Bern

tel. +41 58 523 00 40
fax +41 58 523 00 41
[email protected]
www.swisscare.com

Claims Management

Europäische Reiseversicherung (ERV)
Zweigniederlassung der Helvetia Schweizerische Versicherungsgesellschaft AG
Swisscare Claims Management
St. Alban-Anlage 56
Postfach
4002 Basel

tel. +41 58 275 27 27
fax +41 58 275 27 30
[email protected]

Emergency Assistance 24/7

Out of office hours and only in cases of emergency, the Insured or his Representative can contact the following number:

tel. +41 44 655 12 59

USI

Vlasta Re
Elena Pedroni
Università della Svizzera italiana
Admissions and Diplomas Service
Main Building
Office 331
Via Giuseppe Buffi 13
6900 Lugano

tel. +41 58 666 45 10

      +41 58 666 49 90
[email protected]
www.desk.usi.ch/en/swisscare