Flexible hospital insurance: choose your ward only when you go into hospital

What flexible hospital insurance does differently

A classic supplementary hospital insurance fixes the ward when you take out the policy: you pay every month for the semi-private or private ward, even in years without a hospital stay. Flexible hospital insurance turns this around. You only decide before admission where you want to stay, and you pay an agreed co-payment for the higher ward. If you choose the general ward, you pay nothing extra from the supplementary insurance.

Basic health insurance remains unchanged. It covers the hospital stay at the standard of the general ward (Art. 25 para. 2 let. e of the Federal Health Insurance Act, KVG) in a listed hospital in your canton of residence or in the canton where the hospital is located, at most at the tariff of your canton of residence (Art. 41 para. 1bis KVG). Anything beyond that, such as a two-bed or single room, the choice of hospital doctor and often hospitals throughout Switzerland, is only covered by supplementary insurance under the Insurance Contract Act (Art. 2 para. 2 KVAG).

“Flex” is not a legal term but a product type. Two examples with publicly available conditions are CSS myFlex and Visana Spital Flex. Other insurers offer similar products under their own names; what counts is always the general terms and conditions and the information from the insurer.

Two products in detail: CSS myFlex and Visana Spital Flex

CSS myFlex

According to CSS’s supplementary conditions for myFlex (edition 01.2009, retrieved on 25.09.2026), you choose one of three levels when you take out the policy: “Economy”, “Balance” or “Premium”. Before each inpatient treatment you decide on the general, semi-private or private ward and pay the annual co-payment stated on the policy (sections 2.2 and 5.2).

Ward	Economy	Balance	Premium
general	none	none	none
semi-private	40 %, at most CHF 8,000	20 %, at most CHF 2,000	none
private	70 %, at most CHF 14,000	35 %, at most CHF 4,000	35 %, at most CHF 2,000

There is also a variant 2 with lower co-payments, for example “Economy” semi-private 20 % up to CHF 4,000. The levels also differ in other benefits: “Economy” and “Balance” cover elective treatment in Switzerland and emergencies worldwide, “Premium” also covers elective treatment abroad up to CHF 500,000 per calendar year (section 2.1). Inpatient rehabilitation is limited to 60 days per calendar year in “Economy” and to 90 days in “Balance” (section 2.5).

Visana Spital Flex

On its product page (retrieved on 25.09.2026), Visana describes an annual co-payment in francs instead of a percentage. In the 2/4 variant you pay CHF 2,000 for semi-private and CHF 4,000 for private, in the 4/8 variant CHF 4,000 for semi-private and CHF 8,000 for private; the general ward costs nothing extra. With the Spital Flex Plus model, you pay a percentage of the costs up to a cap.

The difference between a percentage and a fixed amount matters: with a percentage, you pay little for a short stay and only reach the cap with expensive stays. With a fixed amount, the full sum is due from the first day on the higher ward, provided the general terms and conditions say so.

Step by step: using flex cover when you need it

1. Decide on the ward before admission. With myFlex you choose “before starting inpatient treatment” (section 2.2). Think in advance about how much co-payment you are willing to pay for a two-bed or single room.
2. Obtain a cost approval. For planned procedures, CSS’s cost approval for the hospital and the ward must be available at the latest on admission; otherwise no costs are reimbursed (section 2.3). In an emergency you request it immediately afterwards. Other insurers have similar rules; read your general terms and conditions.
3. Check the hospital. In “Economy” and “Balance”, myFlex only pays in hospitals that CSS recognises for the chosen ward (sections 2.3 and 6.3). Ask your insurer whether the hospital you want is on the list.
4. Tell the hospital your choice. The hospital bills the ward you actually stay on. If CSS cannot determine from the documents which ward you stayed on, it bills as for the private ward with the corresponding co-payment (section 2.1).
5. Check the statements. You receive two statements: one from basic health insurance with the deductible, retention fee and hospital contribution, and one from supplementary insurance with your flex co-payment.

Sample calculation: semi-private surgery at three levels

Example with fictitious people. Marco is 52, insured in basic health insurance with a CHF 2,500 deductible and has CSS myFlex, variant 1. For a planned hip operation he chooses the semi-private ward and stays in hospital for 5 days. The extra costs of the semi-private ward compared with the general ward are assumed, because they depend on the hospital and the procedure and are not published.

Level	Rule according to the supplementary conditions	Marco’s share	myFlex pays
Economy	40 %, at most CHF 8,000	CHF 4,800	CHF 7,200
Balance	20 %, at most CHF 2,000	CHF 2,000	CHF 10,000
Premium	no co-payment	CHF 0	CHF 12,000

Had Marco chosen the general ward, nothing would have been due from myFlex. Basic health insurance would have covered the stay, with the same CHF 3,275 from the deductible, retention fee and hospital contribution.

Flex or fixed cover: how to calculate

Whether flex cover is cheaper than fixed semi-private cover depends on two figures that only your quotes can provide: the premium difference and your maximum co-payment. No authority publishes the premiums of supplementary insurance; unlike basic health insurance, there is no official comparison.

The calculation only shows where the break-even point lies; nobody knows in advance how often you will need to go into hospital. For basic health insurance, which you can take out with any insurer regardless of your supplementary hospital cover, you compare the 2026 premiums in the premium calculator. The supplementary insurance comparison sets the benefits of supplementary insurance side by side.

Special cases and small print

Switching to a variant with a lower co-payment

With myFlex you can apply at any time to switch to a lower co-payment, but only with a health declaration. If CSS accepts it without reservation, the switch applies from the following month. Otherwise it is only possible for the calendar year after next in “Balance” and “Premium”, and not at all in “Economy” (section 5.3). If you choose the cheapest level today and want more cover later, you should therefore expect a new health assessment.

Upgrade option without a new health assessment

For an additional premium, myFlex lets you secure the one-off right to move up one level later without a health declaration, from “Economy” to “Balance” or from “Balance” to “Premium” (sections 8.1 and 8.2). You can apply for the option until your 68th birthday; the declaration must reach CSS by the last working day in November and takes effect on 1 January (sections 8.3 and 8.5).

Newborns

In myFlex, newborns are only insured without reservation from birth at the “Economy” level if the signed application reaches CSS no later than 30 days after the birth (section 1.3). How children are generally accepted is explained in the article Supplementary insurance for your child.

GP or HMO model in basic health insurance

If you have a model with a restricted choice of service provider in basic health insurance, according to the myFlex conditions you also lose free choice in the hospital insurance; if you do not comply, the supplementary insurance does not cover any costs (section 6.2). So check for every flex product how it interacts with your insurance model.

Emergency abroad

“Economy” and “Balance” cover emergencies worldwide, limited to the acute phase, if a return to Switzerland cannot reasonably be expected (section 2.1). For treatment abroad, you must contact CSS’s emergency call centre immediately (section 4.5). What basic and supplementary insurance pay abroad is shown in the article Ill abroad.

Health questions when you apply

Flex products are supplementary insurance: the insurer may ask health questions and may refuse you. If you answer a question incorrectly, it may terminate the contract (Art. 6 ICA). In supplementary health insurance, only the insured person may give ordinary notice, at the earliest at the end of the third year (Art. 35a para. 1 and 4 ICA). How to fill in the application correctly is explained in the article Health questions in the application.

Common mistakes

• Forgetting the cost approval. With myFlex, planned procedures without an approval on admission are not reimbursed, not even for the general ward from the supplementary insurance.
• Confusing the percentage and the cap. 20 % up to CHF 2,000 means: with extra costs of CHF 5,000 you pay CHF 1,000, with CHF 30,000 you pay CHF 2,000.
• Confusing per year and per stay. myFlex calculates the co-payment per calendar year. With other products it may apply per stay.
• Cancelling existing fixed cover before flex cover is confirmed. You only get supplementary insurance back after a health assessment. First get the new insurer’s written acceptance, then cancel.
• Signing under pressure. You can withdraw an application within 14 days (Art. 2a ICA); how this works is explained in the article Unwanted supplementary insurance.

Whether you need semi-private or private cover and which supplementary insurance suits you at all is covered in the articles Semi-private or private and Which supplementary insurance. You will find all topics in the Supplementary insurance section. The providers in the examples are described in the profiles of CSS and Visana; how to switch basic health insurance is explained under Switching health insurer.