Health insurance restriction: simply explained
Definition of restriction
A restriction means that the health insurer doesn’t cover certain costs or only covers part of the costs. This applies to treatments resulting from illnesses or consequences of accidents that already existed when the insurance policy started.
Why are health insurers allowed to apply restrictions?
Health insurers are required by law to check the risks of new contracts. This kind of risk assessment helps protect customers and the company in the long term. Restrictions help insurance companies reduce the risk of having to bear high costs at a later date that would burden the pool of policyholders.
Which restrictions can health insurers apply?
Health insurers decide themselves which restrictions they want to apply to supplementary insurance plans . They may also reject applications outright. They do so depending on the answers to the health questions. New customers have to answer questions on their state of health truthfully when they apply for insurance.
Do restrictions also apply to basic insurance?
No, the Swiss Health Insurance Act states that health insurance companies have to admit any person living in Switzerland into basic health insurance without any restrictions.