Wer zahlt das Altersheim in der Schweiz?

The financing of a nursing home place in Switzerland is based on three pillars:

• Health insurance (care costs): The mandatory health insurance (OKP) covers a contribution towards care costs, graded according to the level of care. This contribution ranges from CHF 9 to CHF 108 per day depending on care needs. The patient contribution is limited to a maximum of CHF 23 per day.
• Residual financing by canton/municipality: The difference between the actual care costs and the contributions from health insurance and the resident is borne by the canton or municipality of residence. This so-called residual financing has been enshrined in law since 2011.
• Residents' own contribution: Hotel costs (accommodation, meals) and care charges must be paid by the residents themselves, from their AHV pension, occupational pension, savings, or supplementary benefits. These costs make up the largest share of the monthly bill.

One of the most common questions is: Do children have to pay for their parents in a nursing home? The answer in most cases is: No.

The Swiss Civil Code (ZGB) does provide for a maintenance obligation towards relatives in ascending and descending lines. According to Art. 328 and 329 ZGB, relatives are obliged to assist those in need, but only if they are in 'favourable circumstances'. This means:

• The maintenance obligation only applies when children are financially significantly above average.
• In practice, this family support obligation is extremely rarely enforced in Switzerland.
• Supplementary benefits (EL) and social assistance generally take priority over family support.
• The responsible authority only examines children's income and assets in exceptional cases.

Conclusion: In Switzerland, children practically never have to pay for their parents' nursing home costs. The social system with supplementary benefits and social assistance covers the vast majority of cases.

Supplementary benefits to AHV/IV are the most important source of financing when personal means are insufficient for the nursing home. They are not social assistance but a legally established entitlement.

Persons eligible for supplementary benefits are those who:

• Receive an AHV or IV pension (or are entitled to one)
• Are resident in Switzerland
• Whose recognised income does not cover recognised expenses
• Have net assets below the statutory limit (CHF 100,000 for single persons, CHF 200,000 for married couples; the owner-occupied property is not counted)

The application for EL is made at the cantonal compensation office or the municipality. In addition to annual EL, reimbursements for illness and disability costs can also be claimed, which are particularly relevant for nursing home residents.

If supplementary benefits are also insufficient to cover nursing home costs, social assistance serves as the last safety net. This particularly affects persons who are not entitled to EL or whose needs exceed EL benefits.

Social assistance is provided by the municipality of residence. Unlike supplementary benefits, social assistance payments can be reclaimed under certain circumstances, for example if the financial situation of the person concerned improves or from the estate.

In practice, however, most cantons and municipalities first rely on supplementary benefits before granting social assistance. The advisory service of your municipality or Pro Senectute can support you in clarifying your individual situation.