Basic health insurance

What is basic health insurance?

Basic health insurance is the health insurance that is compulsory for everyone in Switzerland. In law it is called “compulsory health insurance” (obligatorische Krankenpflegeversicherung), or OKP for short. It is governed by the Federal Health Insurance Act, the KVG (LAMal in French). In everyday speech people also say basic insurance or simply “the health insurance” (die Krankenkasse).

Basic health insurance pays for treatment in case of illness, maternity and accident, as long as no accident insurance covers the costs. It is a social insurance: health insurers may use its funds only for social health insurance, must treat all insured persons equally and must accept everyone who applies. There are no health questions and no reservations. An 80-year-old with several illnesses pays the same premium with the same insurer, in the same model and in the same premium region as a healthy person in the same age group.

It must be distinguished from supplementary insurance. Supplementary insurance is governed by the Insurance Contract Act (ICA, VVG in German), is voluntary and covers benefits that basic health insurance does not pay for, such as the semi-private hospital ward, dental treatment or complementary medicine not provided by doctors. For supplementary insurance, the insurer may ask health questions and turn you down. You do not need to have basic and supplementary insurance with the same insurer.

Who does basic health insurance apply to? To everyone resident in Switzerland, including children, pensioners and foreign nationals with a residence permit. The Federal Council can extend the requirement to certain people who are not resident in Switzerland, for example cross-border commuters working here. There are exceptions, for instance for diplomats.

How it works

Registration and start of cover

You have three months to take out insurance after birth or after moving to Switzerland. If you register on time, the cover applies retroactively from the date of birth or arrival. If you are late, cover only starts when you join, and if the delay is inexcusable the insurer charges a premium surcharge. Anyone who does not take out insurance at all is assigned to an insurer by the canton. The statutory requirement to take out insurance has very few exceptions.

The same benefits with every insurer

What basic health insurance pays for is set by law and ordinances: medical treatment as an outpatient and in hospital, medicines on the List of Pharmaceutical Specialties (SL), laboratory tests, physiotherapy prescribed by a doctor, a stay in the general ward of a listed hospital, maternity benefits, certain preventive check-ups and contributions towards transport. The catalogue of benefits describes the exact scope. The insurer may not cover any other costs, not even as a goodwill gesture. That is why the most expensive insurer does not give you any more medical cover than the cheapest one.

The precondition is that a service is effective, appropriate and cost-effective and is provided by an approved service provider. For outpatient care you can choose your doctor freely, and in the standard model you can also go straight to a specialist. For hospital care you choose among the hospitals on the Hospital List of your canton of residence or of the canton where the hospital is located.

Premium and co-payment

You pay a premium every month. The insurer sets it per canton and premium region, and the Federal Office of Public Health (FOPH, BAG in German) approves it every year. Children up to 18 pay less than young adults, and young adults aged 19 to 25 pay less than other adults. Within these age groups, the premium does not depend on age or gender.

When you use benefits, the co-payment comes on top: first the deductible (Franchise) of CHF 300 to CHF 2,500 per calendar year, then the retention fee (Selbstbehalt) of 10%, up to a maximum of CHF 700. For a hospital stay, many adults also pay a contribution of CHF 15 per day. From the 13th week of pregnancy until eight weeks after the birth, the insurer does not charge any co-payment.

Models

Alongside the standard model with free choice of doctor, insurers offer cheaper models: the GP model, HMO, Telmed or the pharmacy model. In these models you commit to contacting a specific first point of contact before anything else. The benefits stay the same; only access is restricted. The insurance models page gives an overview.

Legal basis

Basic health insurance is based on Art. 117 of the Federal Constitution and governed by the KVG. Art. 1a KVG states that social health insurance provides benefits in case of illness, accident (where no accident insurance pays) and maternity. Art. 3 para. 1 KVG requires everyone resident in Switzerland to take out insurance within three months of taking up residence or of birth. Art. 5 KVG governs the start and end of cover and the premium surcharge for late enrolment, and Art. 6 KVG the assignment to an insurer by the canton.

The free choice of insurer is set out in Art. 4 KVG, and the obligation to accept applicants in Art. 5 let. i of the Health Insurance Supervision Act (KVAG). Art. 5 let. f KVAG requires mutuality and equal treatment of insured persons. Switching is governed by Art. 7 KVG: para. 2 allows you to cancel with one month’s notice to the end of the year when the new premium is announced, which must happen at least two months in advance.

The benefits are listed in Art. 25–31 KVG, and the conditions of effectiveness, appropriateness and cost-effectiveness in Art. 32 KVG. Art. 34 para. 1 KVG prohibits insurers from covering other costs. The principles for premiums are set out in Art. 61 KVG, the co-payment in Art. 64 KVG, with the amounts in Art. 103 and Art. 104 of the Health Insurance Ordinance (KVV). The premium reduction when accident cover is provided under the UVG is set out in Art. 91a KVV.

Example: what basic health insurance costs in Zurich in 2026

Lara is 36, lives in the city of Zurich (premium region 1) and has no accident cover through an employer. The table shows the monthly premiums for 2026 for adults with accident cover from the official FOPH data: the cheapest, the median and the most expensive of 128 offers.

Deductible	cheapest	median	most expensive
CHF 300	CHF 517.70	CHF 580.00	CHF 724.00
CHF 2,500	CHF 389.40	CHF 453.90	CHF 595.70

For comparison: in the city of Bern (region 1), premiums in 2026 for the same person with a CHF 300 deductible range from CHF 545.90 to CHF 758.90 a month. Where you live therefore has a big influence on the premium, while the benefits stay the same. You can find your own figures in the premium calculator and the insurer profiles under health insurers.

What this means for you

Because the benefits are the same everywhere, comparing almost always pays off. Go through these steps in this order:

1. Set your deductible. Estimate your healthcare costs over the past few years. If you rarely see a doctor, a high deductible often works out better; if you need regular treatment, CHF 300 usually does. The deductible calculator works through both cases.
2. Choose a model. If you are prepared to contact a GP practice, an HMO or a telephone advice line first, you save on the premium. If you do not follow the rules of the model, the insurer can refuse to pay.
3. Check your accident cover. If you are employed and work at least 8 hours a week for the same employer, you are insured against accidents under the UVG. You can then have the accident cover excluded from your health insurance.
4. Compare insurers and switch. The new premiums are published every autumn. Your notice must reach your insurer by 30 November; the switch then takes effect on 1 January. You will find instructions and a template under switching insurer and all dates under deadlines.
5. Check for a premium subsidy. If your income is low, your canton pays part of the premium. The rules differ widely from canton to canton, see premium subsidies.

If you have supplementary insurance, you can still switch your basic health insurance. The supplementary insurance stays with your current insurer until you cancel it separately.

Common mistakes

• Believing that a more expensive insurer pays more. The benefits of basic health insurance are laid down by law. A higher premium does not mean more benefits.
• Cancelling the supplementary insurance as well. If you switch with pre-existing conditions, you often lose your supplementary insurance for good, because the new insurer is allowed to turn you down. Cancel only the basic health insurance if you want to keep your supplementary cover.
• Paying for accident cover twice. Employees covered under the UVG often pay the accident share unnecessarily. Conversely, you must reinstate accident cover if you leave your job or drop below 8 hours a week.
• Missing the deadline. A notice that arrives on 1 December is too late. Send it by registered post (Einschreiben) and in good time.
• Putting off registration after moving here. If you have not registered after three months, you lose the retroactive cover and risk a premium surcharge.

We explain how we calculate premiums and examples under How we calculate.