Cancelling and Switching Supplementary Insurance: The Safe Order

Anyone who wants to cancel their supplementary insurance needs to know the right order. Unlike basic insurance, there is no duty to accept: the company assesses your state of health and may impose reservations or reject your application. From that follows the most important rule, namely the written confirmation first and the cancellation afterwards.

The key points at a glance

• Basic insurance and supplementary insurance are legally separate: KVG versus VVG.
• In basic insurance every insurer has to accept you. With supplementary insurance they do not.
• The two may be held with different companies.
• Cancel existing supplementary cover only once the new cover is confirmed in writing and free of unwanted reservations.

The difference between basic and supplementary insurance

The difference is legal in nature and affects everything that follows. Basic insurance is a social health insurance under the Federal Health Insurance Act. Supplementary insurance is a private contract under the Insurance Contract Act.

The whole caution that is appropriate with supplementary insurance follows from this table. In basic insurance a switch has no consequences: you can go back at any time, because every insurer has to accept you. With supplementary insurance, a cancellation is a decision you may not be able to reverse.

Why you should not cancel your supplementary insurance first

The reason is that acceptance is not a formality. Anyone applying for supplementary insurance answers health questions. This pre-contractual duty of disclosure requires that all facts asked about and material to the risk assessment are stated truthfully and in full. The company decides on that basis.

The company can accept the application without restriction. It can accept it with a reservation for a particular condition. It can defer its decision, for instance until an ongoing investigation is complete. And it can reject it.

The reservation is often overlooked: it excludes only treatment of the condition concerned, and the remaining cover stays in place. So anyone who receives semi-private cover with a reservation because of a knee condition has the hospital comfort for everything else, but not for the knee. The cover exists, but precisely not for the thing they presumably wanted it for.

How the company will decide cannot be known in advance. What is decisive is what you state about your state of health. That is why the written confirmation is the only reliable signal, not an adviser's assessment and not an acquaintance's experience.

A common mistake happens here: the cancellation is sent because the deadline is pressing, and the application follows afterwards. In advisory practice that is the order that cannot be corrected after the event. Anyone who cancels first and applies afterwards can fall into a gap that can no longer be closed. A state of health that is unremarkable today can lead to a reservation in five years. So: obtain the new company's written confirmation first, check it for unwanted reservations, and only then cancel your existing cover.

What has applied in your favour since 2022

The Insurance Contract Act was revised with effect from 1 January 2022. Since then the company's right of cancellation in supplementary insurance has been restricted: it can no longer simply terminate a contract, for instance after a claim. Extraordinary rights are reserved, among others where the duty of disclosure has been breached.

For you that means: an existing, well-fitting supplementary insurance has become more stable. That is an additional argument for not giving it up lightly. The company can still adjust the premium. You then have a right of cancellation against that.

Do you even need supplementary hospital insurance?

This question comes up relatively often. Basic insurance covers a stay in the general ward, and you have a free choice among the listed hospitals. What supplementary hospital insurance adds is comfort and an extended or free choice of doctor and hospital.

Source: santésuisse/BSS Basel, «Bedeutung von Spitalzusatzversicherungen in der Schweiz» (2024).

The share of the population with supplementary hospital insurance rose from 13 percent in 2006 to 20 percent in 2022, with semi-private, private and the newer flex products taken together.

Behind that rise lies a shift that is lost in the overall figure. The growth is carried by the flex models. Demand for the classic semi-private and private cover has declined over some 25 years. So the market is moving away from a fixed room category and towards products where the decision is made case by case. For you that means a comparison of two offers quickly compares two different logics rather than two prices. Four out of five people, then, have none. Supplementary hospital insurance is therefore a decision about comfort and freedom of choice, not about medical necessity.

So check specifically what you expect: a twin room, free choice of doctor in hospital, treatment anywhere in Switzerland. And check equally what the cover will cost you over the years, because the premium rises with age.

This second figure is almost always underestimated, because the monthly premium looks small. So work it out once. Say your cover costs CHF 100 a month: that is CHF 1'200 a year and CHF 30'000 over 25 years, and that only if the premium stayed the same. Because it rises with age, that amount is merely the lower limit.

Semi-private or private: what the difference is

Semi-private usually means a twin room, private usually a single room. The bigger difference, however, lies with the doctor: private customarily includes free choice of doctor in hospital, semi-private only in part.

What is decisive here is the policy. The terms are not defined in law; each company fills them in itself. Two products labelled «semi-private» can differ considerably in choice of doctor, hospital list, cover abroad and limits. So compare the benefits and not the category.

Added to this are the newer flex products, where the decision is made case by case instead of buying a fixed category. They carry the growth of this market, while classic semi-private and private cover has declined over some 25 years.

What basic insurance already provides in hospital

It helps to be clear first about what basic insurance already provides in hospital. It covers a stay in the general ward, and you choose among the listed hospitals of your canton of residence or location. For elective treatment outside your canton, reimbursement follows the reference tariff of your canton of residence, and you bear any difference yourself. The medical treatment itself is therefore fully covered.

What supplementary insurance adds can be named narrowly: the room category, the extended choice of doctor and hospital, access to private clinics, and coverage of the out-of-canton tariff difference. Those are real advantages, but they are comfort advantages. Anyone who frames the question that way is deciding about something concrete rather than about a feeling of security.

One point belongs in the same calculation. Unlike in basic insurance, the premium for supplementary insurance is not independent of your state of health. It is calculated by the company and rises with age, while the benefit stays the same. Cover that looks cheap at 40 can be a different matter at 65.

What the 2022 revision changed in practice

The restriction of the right of cancellation has one concrete consequence: an existing supplementary insurance has become a more reliable asset. Previously the company could in some circumstances terminate the contract, for instance after a claim. Today that is restricted, and extraordinary rights are reserved, among others where the duty of disclosure has been breached.

For advisory practice that reverses the direction. The question used to be whether cover would hold. Today the question is whether it is worth giving up. Anyone who cancels well-fitting cover gives up not only the protection but also the stability they have acquired over the years.

One right remains yours in every case. If the company adjusts the premium, you have a right of cancellation. That is the moment for a review.

Switching supplementary insurance: when it is worth it

A switch is worth it if the cover no longer suits your situation or the premium is significantly above comparable offers. But it is not a foregone conclusion; it is a risk decision.

Check in this order: first, what your existing cover actually provides today. Second, what of it you use. Third, how high the premium is in relation to that. And only then whether another company will accept you without a reservation. Anyone who keeps to that order decides with their cards on the table. Anyone who reverses it decides under time pressure.

Before you give up existing cover, four things need clarifying. First, what it actually provides today. Second, what of it you have used in recent years. Third, how high the premium is in relation to that. Fourth, whether another company will accept you without a reservation. You can clarify the first three yourself; only a written confirmation clarifies the fourth.

A middle route is often overlooked: adjusting the existing cover instead of switching. Many companies offer tiers, and moving from private to semi-private within the same company is usually possible without a new health check.

There is a reason for this order. The first three questions cost nothing and can be asked at any time. The fourth requires an application, and an application leaves behind an assessment of your state of health.

If you would like to review basic and supplementary insurance together: smzh's comparison is free and non-binding.

Switching basic insurance, keeping supplementary insurance

This separation is expressly possible and often the most sensible solution. Basic and supplementary insurance may be held with different companies. So you can optimise your basic insurance annually and leave your supplementary cover unchanged.

Clarify two points in advance: whether your supplementary insurance is tied to the basic insurance of the same company, which is the case with some products, and whether discounts fall away if the two contracts are separated. Both are in the contractual terms and not in the sales brochure.

Cancelling supplementary insurance after a premium increase

If the company increases the premium, you have a right of cancellation on that basis. That is the second route out of a contract alongside ordinary cancellation, and it is tied to the increase, not to the calendar.

Not every higher invoice is a premium increase in that sense. If the company adjusts the premium, that triggers your right. If, on the other hand, the premium rises solely because you have moved into a new age band, that was built into the contract from the start and is as a rule not grounds for cancellation. What applies in your case is stated in the policy.

We deliberately give no deadlines here. They are set by contract and not by law, which is why any general figure would be wrong for some readers. Read the terms as soon as the letter with the new premium arrives, because that deadline runs from receipt.

And the same order applies as everywhere else. A right of cancellation is not a right to be accepted elsewhere. Check first whether, and on what terms, a new company will accept you, and cancel only afterwards. Anyone who takes the increase as a reason to cancel immediately is otherwise worse off than before.

Special cases with supplementary insurance

Four points decide whether supplementary cover will still be open to you later.

The reservation. The company can accept the application with a reservation for particular conditions. The cover then exists, but precisely not for the thing you wanted it for. So check the confirmation for reservations before you cancel existing cover.

The premium adjustment. If the company adjusts the premium, you have a right of cancellation.

The timing for a child. No duty to accept applies to supplementary insurance, and the state of health decides on acceptance. That is why taking it out should be considered early, for a child ideally before birth.

Changing the tier rather than the company. Many companies offer tiers. Moving from private to semi-private within the same company is usually possible without a new health check and is therefore the lowest-risk way to lower the premium.

What is confused about supplementary insurance

The duty to accept applies only to basic insurance. In basic insurance every insurer has to accept you, with no health check and no reservation. With supplementary insurance the company assesses the risk and can reject you.

Two laws, two logics. Basic insurance is a social health insurance under the KVG. Supplementary insurance is a private contract under the VVG. That difference is decisive from acceptance through the premium to cancellation.

Supplementary hospital cover is not better medicine. Basic insurance covers medically necessary treatment in the general ward. Supplementary insurance extends comfort and freedom of choice, not your entitlement to treatment.

Our assessment: with supplementary insurance the right question is rarely «where is it cheaper» but «what of it do I actually need». Anyone who has answered that question decides on an informed basis.

FAQ on supplementary insurance

Does a company have to accept me for supplementary insurance?

No. The duty to accept applies only to compulsory basic insurance. For supplementary insurance the company assesses the risk on the basis of what you state about your state of health and can accept the application with a reservation or reject it altogether. That is why existing supplementary cover is an asset you should give up only against a written confirmation. The legal basis is the Insurance Contract Act.

Can I hold basic and supplementary insurance with different insurers?

Yes, that is expressly permitted and common. You can optimise your basic insurance annually and leave your supplementary cover unchanged. Just check whether your product is tied to the basic insurance of the same company or whether combination discounts fall away. Both are in the contractual terms and decide whether the separation adds up for you.

What is a reservation?

An exclusion for particular, pre-existing conditions. The supplementary insurance then comes into effect but pays nothing for precisely those diagnoses. A reservation is the most important point to check in the written confirmation.

When do I have to cancel supplementary insurance?

The notice period for supplementary insurance follows your contract. The periods are often longer than the 30 days for basic insurance and in some cases end considerably earlier in the year. So look in your policy and start comparing correspondingly earlier.

Do I lose medical benefits without supplementary insurance?

No, no medically necessary ones. Basic insurance covers examination, treatment and care in the event of illness, as well as a stay in the general ward. Supplementary insurance extends comfort and freedom of choice, such as a twin room or free choice of doctor in hospital.

Is supplementary hospital insurance still worth it in old age?

Whether supplementary hospital insurance is still worth it in old age depends on how the premium develops and on your expectations. The premium rises with age while the benefit stays the same. In that situation, check first whether a lower tier within the same company is possible. That is usually available without a new health check.

Sources

Insurance Contract Act (VVG), SR 221.229.1, in particular Articles 4, 6 as well as 2a, 35a and 35c: fedlex.admin.ch

Federal Health Insurance Act (KVG), SR 832.10, Articles 4, 41 and 61: fedlex.admin.ch

santésuisse and BSS Basel, «Bedeutung von Spitalzusatzversicherungen in der Schweiz» (2024)

Federal Office of Public Health, information on health insurance: bag.admin.ch