Termination of pregnancy

What is a termination of pregnancy?

A termination of pregnancy, commonly called an abortion, is the medical ending of a pregnancy. In Switzerland, it is not punishable under certain conditions. These conditions are laid down in the Swiss Criminal Code (SCC). Health insurance builds on them: if the termination is not punishable, basic health insurance covers the costs.

A termination is not punishable in two cases. First, within twelve weeks of the start of the last period, if the pregnant woman requests it in writing and states that she is in a situation of distress. It is carried out by a licensed doctor. Second, also later, if in the opinion of a doctor it is necessary to avert serious physical harm or serious psychological distress. The further the pregnancy has progressed, the greater this risk must be.

The termination is part of basic health insurance, not supplementary insurance. So you do not need to take out any special insurance or answer health questions. All insurers pay the same benefits. A termination must be distinguished from maternity benefits, which apply when a pregnancy is carried to term and which are exempt from co-payment.

How it works

The process up to the payment of costs looks like this:

1. Consultation and counselling. The doctor personally holds a thorough consultation, informs you about the health risks and gives you a guide against your signature. It lists free counselling services, organisations offering moral and material support and information on adoption.
2. Written request. In the first twelve weeks, your written request is required. If you are under 16, the doctor makes sure that you have contacted a specialised counselling service for young people. If a woman lacks capacity of judgement, the consent of her legal representative is required.
3. Procedure. The termination is carried out with medication or surgically in a practice or hospital designated for this purpose by the canton.
4. Billing. The practice or hospital bills basic health insurance, often directly with the insurer. You receive a copy of the invoice and later a statement of benefits showing your share.

The termination is reported to the health authority for statistical purposes, without your name. The Federal Statistical Office (FSO) publishes the figures every year.

Legal basis

Art. 30 of the Federal Health Insurance Act (KVG) provides: if a pregnancy is terminated without being punishable under Art. 119 SCC, compulsory health insurance covers the costs of the same benefits as for an illness. The conditions under which it is not punishable are set out in Art. 119 paras. 1 and 2 SCC. Art. 119 para. 4 SCC obliges the cantons to designate the practices and hospitals that can carry out terminations properly and provide thorough counselling. Art. 120 SCC lists the doctor’s duties before the procedure, including the written request, the counselling, the guide and the counselling service for women under 16.

The normal co-payment under Art. 64 para. 2 KVG applies to the costs: the deductible and a 10% retention fee, up to CHF 700 a year for adults and CHF 350 for children (Art. 103 para. 2 of the Health Insurance Ordinance, KVV). The exemption under Art. 64 para. 7 KVG concerns the special maternity benefits and benefits from the 13th week of pregnancy. After a medically indicated termination from the 13th up to the end of the 23rd week, a midwife can make up to 10 home visits paid for by basic health insurance (Art. 16 para. 1 let. abis of the Health Care Benefits Ordinance, KLV). On data protection: under Art. 42 para. 5 KVG, the service provider must, at your request, disclose medical information only to the insurer’s medical adviser.

Example: co-payment with two different deductibles

Lea is 27 years old and has had no healthcare costs so far this year. Her termination of pregnancy in the eighth week costs CHF 800. The amount is chosen for illustration, because costs vary depending on the method and the tariff; the deductible and the retention fee follow the law.

What this means for you

You do not need any special insurance. These points matter:

1. Plan for your deductible. If you have a high deductible, you will often pay for the termination entirely yourself. If that is financially difficult, ask the counselling service about support or your insurer about paying in instalments.
2. Submit your invoices. Even if you stay below your deductible, send the invoice to your insurer. It counts towards your deductible.
3. Pay attention to data protection. You can ask for diagnoses to be sent only to the medical adviser. Ask your insurer who it sends statements to, especially if you are insured through your family.
4. Think about your deductible for next year. You can choose a lower deductible until 30 November; you will find all dates under deadlines.

Basic health insurance is the same at all insurers. If you want to compare premiums, use the premium calculator with the official FOPH data. You can find key figures on the service and finances of the insurers under health insurers.

Common mistakes

• Thinking you need supplementary insurance. A termination that is not punishable is a compulsory benefit of basic health insurance, at every insurer.
• Expecting an exemption from co-payment as for maternity. For a termination in the first twelve weeks, the deductible and retention fee apply as for an illness.
• Not submitting the invoice. Amounts below the deductible only count towards the deductible if your insurer receives them.
• Overlooking counselling services. The doctor’s guide lists free counselling services that can also help with financial questions.

We explain how we build our examples under how we calculate.