Subside Assurance Maladie Valais : The complete guide
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As a Swiss canton, Valais offers its citizens the opportunity to benefit from an insurance subsidy. The subsidy is designed to help people pay their compulsory health insurance premiums. However, it's not always easy to know how to benefit from the insurance subsidy in Valais and how these subsidies work.
In this guide, find out everything you need to know about the insurance subsidy in Valais: what it consists of, how it works, how much it is, how to apply for the subsidy in Valais, what the conditions are for obtaining it, etc.
What is a health insurance subsidy?
In Switzerland, the LAMal (Law on Health Insurance) makes basic health insurance compulsory. Coverage includes, among other things, outpatient care, doctor-prescribed medication, cures and certain alternative medicines. However, some people are not in a position to pay health insurance premiums. To alleviate this problem, the cantons have introduced a financial support measure: subsidies.
A health insurance subsidy is a grant offered to certain individuals and families in financial difficulty. These subsidies are intended to cover a portion of medical expenses. They can include reimbursements for medication, doctor's visits, medical tests and procedures, and other healthcare services. Most cantons offer subsidies. Also, the amount of assistance and its terms vary from canton to canton.
The amount of the health insurance subsidy also varies according to income and family situation: for a family with several children, it is possible to obtain these subsidies even with a fairly high income.
Do insurance subsidies work for complementary health insurance?
Health insurance subsidies only work with basic insurance, i.e. compulsory LAMal coverage. Whether in Valais or any other Swiss canton, it is therefore impossible to obtain a subsidy for complementary health insurance.
Health supplements are optional insurances that cover additional benefits, such as optical or dental care. As they are not compulsory, they must be paid for through monthly premiums.
To take out complementary health insurance at the best price, you can use our online service. Comparea is an insurance comparator that allows you to find the contract that best suits your needs and budget.
What does the Valais health insurance subsidy consist of?
The health insurance subsidy in Valais is a subsidy program aimed at households in the canton with modest incomes. It enables them to benefit from discounts on medical expenses, i.e. on the payment of their compulsory insurance premiums (LAMal).
Present in Valais but also in other Swiss cantons, this scheme enables people on low incomes to obtain partial or total coverage of their healthcare bill. Subsidies are paid by the Office cantonal des assurances sociales du Valais (OCAS).
Insurance subsidies in the Valais concern around 70,000 people, or 20% of the canton's residents. They are therefore very common subsidies, and intended for a broad cross-section of the population. The beneficiaries of subsidies in Valais are diverse: they may be workers on modest incomes, people going through a difficult period, the elderly, disabled people, students or even people in precarious situations.
How does the health insurance subsidy work in Valais?
Health insurance subsidies in Valais are calculated and allocated according to your tax assessment. This calculation and allocation is done automatically. Each year, the administration notifies eligible persons of the amount of subsidy to which they are entitled. Beneficiaries then receive a certificate of entitlement.
This certificate specifies the beneficiary's income, family situation and the rate of subsidy he or she will receive. The subsidies are then paid directly to the health insurance company, which deducts them from the insurance premiums you have to pay.
Any change in situation (family or health insurance) must however be reported to the canton of Valais so that it can adjust the amount of subsidies if necessary.
How to choose the right basic health insurance?
In Switzerland, all citizens must be covered by basic health insurance: only supplementary health insurance is optional.
When referring to basic health insurance in Switzerland, we often speak of the LAMal. The LAMal is a law governing the public health insurance system. It guarantees the rights and obligations of insured persons and health insurers alike, and determines the benefits covered by health insurance.
In particular, this legislation stipulates which cover must be included in the basic insurance contract. However, each insurance company can offer additional services and benefits. As a result, prices vary from one organization to another.
To help you make your choice, Comparea has studied the offers of over 40 insurance companies in Switzerland. Our free, independent service will help you find the KVG insurance contract that meets all your needs.
What are the conditions for the health insurance subsidy in Valais?
To obtain the health insurance subsidy in Valais, 3 conditions must be met:
- Be insured for basic health insurance with an insurer recognized by LAMal
- Reside in the canton of Valais
- Not exceed the income ceilings set annually by the canton.
As an example, in 2021, the maximum income to receive the subsidy (at 10%) was CHF 31,600, compared with CHF 31,900 in 2022. For a couple with 3 children, the maximum was CHF 88,300 in 2021, compared with CHF 88,825 in 2022.
How are incomes calculated for a subsidy application in Valais?
To determine whether you are eligible for a subsidy in Valais, the canton's compensation fund takes into account your tax assessment. Thus, the administration takes into account all your income, namely:
- Your salaries, pensions and/or life annuities
- Your remuneration as a company director
- Your industrial, commercial, non-commercial or agricultural profits
- Your property income (rent received from which your property charges are deducted)
- Your capital gains on real estate, movable or immovable property.
Personal deductions are then made from your overall income:
- 5% of net revalued assets
- Negative income from real estate assets
- Business losses from a self-employed activity (when not absorbed)
- Contributions to recognized provident contracts
How to calculate the health insurance subsidy in Valais?
The amount of the subsidy depends on your income and family situation. Depending on your income, the canton of Valais will determine the percentage of subsidy to which you are entitled: 10%, 20%, 30%, 40%, etc.
There is currently no online calculator to find out how much subsidy you are entitled to. It should also be noted that income scales change every year and that allocation rules are subject to change.
To find out more about the rules for awarding subsidies, the best thing to do is go directly to the website of the compensation fund for the canton of Valais.
How to get the subsidy in Valais when you haven't received the notification?
Usually, health insurance subsidies in Valais are allocated automatically when you are eligible. However, sometimes you may not have received notification of entitlement to subsidies even though you meet the income requirements. This happens in particular to people taxed at source or whose residence permit has recently been changed.
In such cases, a special subsidy application is required. To make this application for a subsidy in Valais, only two conditions need to be met:
- Be at least 18 years old (18 years and one day)
- Have health insurance in Switzerland.
When to apply for a subsidy in Valais?
As we've seen: in the canton of Valais, health insurance subsidies are usually awarded automatically. However, if you have not received notification of entitlement and you think you meet the income criteria, you can apply for a subsidy in Valais.
The special subsidy application can be made at any time of the year. For example, to obtain the Valais health insurance subsidy in 2022, the form must be submitted by December 31, 2022.
How to apply for a subsidy in Valais
To apply for a subsidy in Valais, you can go to the regional agency responsible for health insurance in the canton of Valais. You can also download the online form from the Valais Health Service website ("special subsidy request [current year]"). This must then be forwarded to the Caisse de compensation du Valais.
Please note that your application must be accompanied by a copy of your work certificate and your latest tax return in order to be considered. Once your application has been submitted, you will receive a confirmation letter from the FOPH containing information on the amount and duration of the subsidy.
How can I find out about my subsidy entitlement in Valais?
To find out your entitlement to a health insurance subsidy in Valais, you can use the income scale made available by the canton. As we mentioned, this scale changes every year. It can be consulted directly at the Valais compensation fund office, or on its official website.
Depending on your annual income and family situation, you can also find out what percentage of the subsidy you are entitled to, between 10% and 67%.
How to obtain a subsidy renewal in Valais?
The annual renewal of the subsidy in Valais is done automatically for residents: the canton simply studies your taxation from the previous year. So there's no need to take any special steps to renew your health insurance subsidy. Similarly, you don't need to reapply for a subsidy in Valais every year.
However, in the event of a family or health insurance change, you must notify the canton and provide supporting documents.
How to contact the service linked to the Valais subsidy?
If you would like information about the health insurance subsidy in Valais, you can contact the service in charge of subsidies in 3 ways:
- Via the contact form on the Caisse de Compensation du Valais website
- By telephone on 027 324 91 15
- By post to Caisse de Compensation du Valais - Avenue Pratifori 22, 1950 Sion.
It is also possible to obtain general information or make a specific request via the e-mail address subventions@vs.ch.
Updated on: 01.02.2024Written by Alexis MilonHead of health insurance department at Comparea.To learn more about our team click here.