Supplementary insurance guide
Hospital supplementary insurance: fixed and flexible models explained
Traditional hospital supplementary insurance sets the ward when the policy is taken out — flexible models shift the choice to hospital admission. How both principles work, structurally and without judgement.
Last updated on September 8, 2026 · Reviewed by our FINMA-licensed advisory team
In brief
Hospital supplementary insurance determines the ward in which a hospital stay is insured: general throughout Switzerland, semi-private (twin room) or private (single room, usually with a free choice of doctor). Under the traditional — fixed — model, this level is set when the policy is taken out and determines the ongoing premium.
Flexible models turn the principle around: what is insured is the right to choose the ward only on hospital admission — case by case, against an own contribution that depends on the level chosen. In return, the ongoing premium is calculated differently. Such models are product designs of individual insurers; design, levels and names differ by provider.
This page provides general information and does not replace personal advice. As of 2026, without guarantee. Flexible hospital models are product designs of individual insurers — names, levels and own contributions differ; the applicable contractual conditions (AVB) are decisive.
The basis: what basic insurance covers in hospital
Basic insurance covers a hospital stay in the general ward of a hospital that is on the hospital list of your canton of residence or of the canton where the hospital is located (KVG Art. 41). Anyone who goes to a listed hospital outside their canton without a medical reason is reimbursed at most at the tariff that would apply in their canton of residence — any difference is borne by the patient.
Everything beyond the general ward — a twin or single room, a wider choice of doctor, a free choice of hospital without a tariff difference — is the domain of hospital supplementary insurance under the VVG.
The fixed models: general, semi-private, private
Under the traditional model, the insured ward is set when the policy is taken out:
| Level | Typical scope |
|---|---|
| General, throughout Switzerland | General ward, but a free choice of hospital throughout Switzerland without a tariff difference to the canton of residence. |
| Semi-private | Twin room; depending on the product, a wider choice of doctor. |
| Private | Single room; usually a free choice of the treating doctor. |
The level is part of the contract and determines the ongoing premium. Moving to a higher level later usually counts as a new application — with a new health check.
The flexible models: choice on admission, own contribution per case
Flexible hospital models move the decision from the conclusion of the contract to hospital admission: the insured person chooses afresh for each stay whether to be accommodated in the general, semi-private or private ward. An own contribution per case is payable for the level chosen — the higher the ward, the higher the own contribution. In return, the ongoing premium is calculated differently than for a high level insured on a fixed basis.
Structurally, this is the same principle as the deductible in basic insurance: part of the risk stays with the insured person and is paid only when an event occurs, rather than on an ongoing basis through the premium. Whether, and at what amount, the «general» level also triggers an own contribution is governed by the respective product.
Flexible models are not a legal term but product designs of individual insurers — under various names and with differing levels, own contributions and caps. Exactly what applies is set out in the AVB of the respective product.
Admission: the same VVG mechanics as for any supplementary insurance
Fixed or flexible — hospital supplementary insurance consists of contracts under the VVG. The same admission mechanics apply as for any supplementary insurance: the insurer may ask health questions and may accept the application, attach a benefit reservation or a premium surcharge, or reject it. Age at entry may also influence the premium — risk-based premiums are permissible in supplementary insurance.
Once concluded, the statutory protection of existing policies applies: ordinarily, only the insured person may cancel the hospital supplementary insurance, not the insurer (VVG Art. 35a Abs. 4).
The four admission decisions are explained in detail in the overview guide →
What applies with a pre-existing condition is covered in depth in its own guide →
What the decision depends on
Whether a fixed or a flexible model fits a given situation depends on how three factors are weighted: the ongoing premium, the possible own contribution when an event occurs, and the value of predictability — that is, the certainty that the desired ward is secured without additional costs. Someone who rarely expects hospital stays will weight these differently from someone who wants the firm promise of a specific ward.
There is no universally valid answer — the trade-off is individual, and the specific figures (premiums, own contributions, caps) differ by product and age.
Frequently asked questions
What does hospital supplementary insurance cover that basic insurance does not?
Basic insurance pays for the general ward in a listed hospital; outside your canton without a medical reason, at most at the tariff of your canton of residence (KVG Art. 41). Hospital supplementary insurance additionally covers twin or single rooms, a wider choice of doctor and a free choice of hospital without a tariff difference (source: KVG, VVG).
What do semi-private and private mean?
Semi-private usually stands for a twin room, private for a single room with, as a rule, a free choice of the treating doctor. The exact scope differs by product and is set out in the AVB (source: product practice).
How does a flexible model work on hospital admission?
The ward is chosen not when the policy is taken out but afresh for each stay. A per-case own contribution is payable for the level chosen — the higher the ward, the higher the own contribution. Levels, amounts and caps are governed by the respective product (source: product practice).
Under a flexible model, do I pay anything if I choose the general ward?
That differs by product — with some, the «general» level carries no or only a small own contribution, with others it does not work that way. The AVB of the specific product are decisive (source: product practice).
Is there a health check with flexible models?
Admission follows the same VVG mechanics as for any supplementary insurance: health questions are permissible, as are a reservation, a premium surcharge or rejection — regardless of whether the model is fixed or flexible (source: VVG, BAG).
Can I switch later from the fixed to the flexible model?
A change of model usually counts as a new application — with a new health check. Therefore only give up your existing cover once the new cover has been confirmed in writing; until then, it enjoys the statutory protection of existing policies (VVG Art. 35a Abs. 4) (source: VVG, product practice).
Sources
- Fedlex — KVG Art. 41 (choice of service provider, hospital list, treatment outside the canton)
- Fedlex — VVG Art. 4 und 35a (duty of disclosure, protection of existing policies in supplementary health insurance)
- BAG — Supplementary insurance (health check, risk-based premiums)
Every deadline and figure on this page has been verified against the official sources linked above. As of the date shown at the top. This page does not replace individual advice.
Advice
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