Supplementary insurance for your child: which is worth it?

What basic health insurance already pays for your child

Before you take out supplementary insurance for your child, it is worth looking at basic health insurance. It pays for all medically necessary treatment in the event of illness and, if included, accident: paediatrician, hospital in the general ward, medicines on the List of Pharmaceutical Specialties, therapies on prescription. Every insurer must accept your child, without health questions (Art. 5 let. i of the Health Insurance Supervision Act, KVAG).

For children, the co-payment is low:

• Deductible: no standard deductible; CHF 100 to CHF 600 can be chosen (Art. 64 para. 4 of the Federal Health Insurance Act, KVG, Art. 93 KVV).
• Retention fee: 10 %, at most CHF 350 a year (Art. 103 para. 2 KVV).
• Hospital contribution: none (Art. 104 para. 2 let. a KVV).
• Congenital disorders: For recognised congenital disorders, disability insurance pays for medical measures up to the age of 20 (Art. 13 IVG).

The gaps lie elsewhere: in benefits that basic health insurance does not pay for at all or only with a fixed contribution.

Exactly which benefits a product pays for is set out in its general terms and conditions (GTC). The table shows which topics such contracts cover, not what a specific insurer pays. What counts are the GTC and the information from the insurer.

Which supplementary insurance is worth it for your child? The modules

Supplementary insurance for a child usually consists of individual modules that you combine. The question is not whether they pay anything, but whether the expected benefits exceed the premium over the years and whether you could otherwise bear the costs yourself.

• Dental insurance. Basic health insurance only pays for dental corrections in exceptional cases. Dental insurance may provide for waiting periods and ask about the condition of the teeth. Details in the article Dental insurance for children.
• Supplementary outpatient insurance. It bundles contributions to glasses, complementary medicine, transport and prevention. Here, the premium is weighed against the benefit you expect (example below).
• Supplementary hospital insurance. Depending on the level, it pays for a two-bed or single room and free choice of doctor in hospital. Basic health insurance pays for medically necessary treatment anyway.
• Travel and foreign cover. Basic health insurance pays for emergencies abroad at most up to twice the Swiss tariff (Art. 36 para. 4 KVV). In countries with high hospital prices, a gap remains.

You will find an overview of all types of supplementary insurance under Supplementary insurance.

Step by step to supplementary insurance for your child

1. Identify the gaps. Which costs from the table above could you not bear yourself? You need a module for those, not necessarily for the rest.
2. Ask before the birth. Ask two or three insurers whether they accept children before birth without a health questionnaire, by when the application must arrive and which products this applies to. The keyword is registration before birth; there is no statutory rule on this.
3. Compare quotes with the same modules. Before the contract is concluded, the insurer must inform you about the insured risks, scope, premiums, term and termination (Art. 3 of the Insurance Contract Act, ICA). Compare benefit limits, retention fees and waiting periods.
4. Answer the health questions in full. You must state all material facts asked about that you know or ought to know (Art. 4 ICA). Ask for a copy of your answers.
5. Know the revocation period. You can revoke the application in writing within 14 days (Art. 2a ICA).
6. Choose basic health insurance separately. You compare basic health insurance for your child in the premium calculator; it does not have to be with the same insurer.

The legal rules of supplementary insurance

No obligation to accept. Supplementary insurance is governed by the Insurance Contract Act (ICA), not the KVG. The insurer may reject an application or accept it with a reservation that excludes certain illnesses from cover. A reservation can be limited in time or unlimited; this is set out in the contract.

Duty of disclosure. If you answer a material fact asked about incorrectly or conceal it, the insurer may cancel the contract within four weeks of becoming aware of it (Art. 6 ICA). The obligation to pay benefits then lapses for cases connected with the concealed fact.

Cancellation. In supplementary health insurance, only the policyholder may cancel with ordinary notice (Art. 35a para. 4 ICA); for a child, this is usually the parents. The law allows cancellation at the end of the third or any subsequent year with three months’ notice (Art. 35a para. 1 ICA); the contract may allow earlier cancellation (Art. 35a para. 2 ICA).

Separate from basic health insurance. If you change your child’s basic health insurance, the previous insurer may neither require you to cancel the supplementary insurance nor cancel it itself for that reason (Art. 7 para. 7 and 8 KVG).

No insurance of the co-payment. No supplementary insurance may cover the deductible and retention fee of basic health insurance (Art. 64 para. 8 KVG).

Example calculation: premium versus benefit

Example with fictitious people. Jonas is 9 years old and needs new glasses for CHF 400 (assumed). His parents are wondering whether supplementary outpatient insurance is worth it. The product is a sample contract: premium CHF 12 per month, contribution of 90 % to the cost of glasses above the basic health insurance contribution, at most CHF 150 per year. The basic health insurance values are the statutory ones; Jonas has a CHF 0 deductible.

You do the same calculation for each module: expected benefits per year against the premium per year. For dental corrections and hospital stays, the comparison helps less, because the costs are rare but high. There, the question is rather whether you could bear the amount yourself if it came to it.

For basic health insurance, the comparison is clearly measurable: child premiums 2026, municipality of Zurich (region 1), born in 2026, CHF 0 deductible, with accident cover: CHF 120.30 to CHF 185.70 per month for the same benefits (source: FOPH). What you save there can finance a supplementary module.

Special cases

Your child has already been born

After the birth, the insurer may ask health questions about the child. Depending on the answers, the insurer accepts the child without reservation, adds a reservation or rejects the application. Another insurer may decide differently. Basic health insurance is not affected: it must accept every child.

Congenital disorders

If a child is born with a recognised congenital disorder, disability insurance pays for medical measures up to the age of 20. For supplementary insurance, such a disorder is often a reason for a reservation. The article Congenital disorders and disability insurance explains how disability insurance and the health insurer share the costs.

Several children and family discounts

In basic health insurance, the law does not prescribe a family discount, but several children with the same insurer together pay at most the co-payment of one adult (Art. 64 para. 4 KVG). In supplementary insurance, some insurers grant family discounts; the amount and conditions are set out in the GTC. The article Lowering child premiums explains how to reduce your children’s premiums overall.

Your child becomes an adult

Children’s products may switch to an adult product from a certain age, with a different premium. From what age and on what terms is set out in the GTC. Ask about this when you take out the policy, because an existing contract can later continue without a new health assessment, while a new one cannot.

Common mistakes

• Only thinking about supplementary insurance after the birth. After that, the insurer may ask health questions and reject you.
• Insuring everything on offer. A module is only worth it if the expected benefits exceed the premium or you could not otherwise bear the costs.
• Comparing quotes with different modules. Only compare offers with the same scope, the same benefit limits and waiting periods.
• Answering health questions inaccurately. An incorrect answer can entitle the insurer to cancel the contract and refuse benefits.
• Insisting on bundling basic and supplementary insurance. The cheapest basic health insurance and the right supplementary insurance can be with different insurers.

You will find key figures and contact details for the insurers in the health insurer profiles. If you want to discuss quotes for supplementary insurance personally, you can submit an enquiry; you do not have to. The article Giving birth: costs and who pays explains what applies to hospital and the postnatal period, and all topics for parents are in the Family and children section.