When you buy health insurance as an international student in Switzerland, you will often see the phrase KVG-equivalent (or LAMal-equivalent). This means the plan meets the same minimum coverage standards as Switzerland's compulsory public health insurance, but is offered at lower premiums specifically for students.
But what does that actually mean in practice? What does your insurance cover, and when do you have to pay out of pocket? This guide explains it clearly.
What Is Covered: The Core Benefits
General Practitioner (GP) Visits
All consultations with a licensed general practitioner in Switzerland are covered. If you feel unwell, visit a pharmacy first for minor issues, or book an appointment with a GP for anything more persistent. The GP will refer you to a specialist if needed.
Specialist Consultations
Visits to specialists (cardiologists, dermatologists, orthopaedists, and others) are covered when referred by your GP. Some plans allow direct specialist access without a referral; check your specific plan conditions.
Hospital Treatment
Both inpatient (overnight) and outpatient (same-day) hospital treatment is covered. This includes surgery, intensive care, and any medically necessary procedures. Standard coverage is for general ward treatment in the canton where you are insured.
Emergency Care
Emergency treatment is fully covered, wherever it occurs in Switzerland. Call 144 for an ambulance in life-threatening situations, or go to the nearest hospital emergency department. Emergency treatment abroad may also be partially covered depending on your plan.
Prescription Medications
Medications prescribed by a licensed physician and included on the Swiss list of approved pharmaceutical specialties are covered. Over-the-counter medications purchased without a prescription are generally not covered.
Maternity Care
Prenatal check-ups, childbirth, and postnatal care are covered for students who are pregnant during their time in Switzerland. This is a standard benefit of all KVG-equivalent plans.
Laboratory Tests and Imaging
Blood tests, X-rays, MRI scans, and other diagnostic procedures ordered by a physician are covered as part of diagnosis and treatment.
What Is Not Covered by Standard Plans
Dental Care
Routine dental treatment (fillings, cleaning, extractions) is not included in standard KVG-equivalent coverage. Dental care in Switzerland is expensive, so if you anticipate needing treatment, consider supplementary dental insurance.
Exception: dental treatment required as a direct result of an accident is typically covered by your main insurance.
Optical
Prescription glasses and contact lenses are not covered. Eye examinations may be covered if prescribed for a medical condition, but routine optician visits are not.
Alternative Medicine
Osteopathy, homeopathy, acupuncture, and similar treatments are generally not covered under basic KVG-equivalent plans unless specifically included as an add-on.
Cosmetic Procedures
Any treatment carried out for aesthetic rather than medical reasons is not covered.
Coverage While Travelling Outside Switzerland
Evasan Swiss Studies provides emergency coverage worldwide. If you are injured or fall seriously ill while travelling during semester breaks, emergency treatment costs are covered up to the equivalent of what the same treatment would cost in Switzerland.
This is not comprehensive travel insurance. For planned treatment abroad, you should ensure you have appropriate coverage. But for genuine emergencies while travelling, you are protected.
How Claims Work with Evasan
For most outpatient visits, you pay the bill directly to the healthcare provider and submit the bill to Evasan for reimbursement. Reimbursement is processed promptly once your claim documentation is received.
For hospital treatment, Evasan works with direct billing arrangements where possible, meaning the hospital invoices Evasan directly and you do not need to manage large upfront payments.
In any medical emergency, contact the Evasan Alarm Center at +41 22 929 52 52. This line is available 24 hours a day, 7 days a week