Health Insurance Act (KVG)

What is the KVG?

The KVG is the Federal Health Insurance Act (Bundesgesetz über die Krankenversicherung), also known in French as LAMal. Parliament passed it on 18 March 1994, and it has been in force since 1 January 1996. In the Classified Compilation of Federal Legislation it has the number SR 832.10. Its constitutional basis today is Art. 117 of the Federal Constitution, which gives the Confederation responsibility for health and accident insurance.

The KVG governs social health insurance. Under Art. 1a KVG it consists of two parts: compulsory health insurance (OKP), known in everyday life as basic health insurance, and voluntary daily allowance insurance. It pays in case of illness, maternity and accident, as long as no accident insurance covers the costs.

Before 1996, the Health and Accident Insurance Act of 1911 applied. At that time there was no requirement for the whole population to take out insurance, and insurers were allowed to add reservations and charge different premiums depending on the age at which you joined. The KVG introduced three things that still shape the system today: compulsory insurance, a catalogue of benefits that is the same for all insurers, and a single premium per insurer, region and age group, regardless of health, gender and income.

How it differs from the VVG

Anything that goes beyond basic health insurance is not covered by the KVG. Supplementary insurance for the semi-private ward, dental treatment or complementary medicine is governed by the Insurance Contract Act (ICA, VVG in German). This is laid down in Art. 2 para. 2 of the Health Insurance Supervision Act (KVAG): health insurers may offer supplementary insurance alongside basic health insurance, but it is subject to the VVG. The difference matters to you. Under the KVG, insurers must accept you, the benefits are the same and the premiums are approved by the state. Under the VVG, freedom of contract applies: the insurer may ask health questions, add reservations or turn down an application.

How it works

The KVG divides responsibilities among several parties. Insured persons must take out insurance and pay premiums and co-payments. Health insurers run the insurance; they do not pursue profit with social health insurance (Art. 2 para. 1 KVAG). Doctors, hospitals, pharmacies and other service providers bill according to tariffs. The Confederation, represented by the Federal Office of Public Health (FOPH, BAG in German), supervises the insurers and approves the premiums every year. The cantons finance part of hospital costs and the premium subsidies.

Requirement to take out insurance and free choice of insurer

Everyone resident in Switzerland must take out insurance within three months of arriving or of birth (Art. 3 KVG). If you register on time, you are insured retroactively from birth or arrival. If you are late, you are only insured from the date you join and, if the delay is inexcusable, you pay a premium surcharge (Art. 5 KVG). More on this under requirement to take out insurance.

You are free to choose among the approved insurers (Art. 4 KVG). The insurer must accept you within its area of operation, without health questions, without reservations and without a waiting period. The overview of health insurers shows which insurers exist and how they differ in key figures.

The same catalogue of benefits

Basic health insurance pays for services used to diagnose or treat an illness (Art. 25 KVG), plus nursing care, maternity, certain preventive services and other areas under Art. 25–31 KVG. Every service must be effective, appropriate and cost-effective (Art. 32 KVG). Exactly which services are covered is set out in ordinances and lists: the Health Insurance Ordinance (KVV), the Health Care Benefits Ordinance (KLV), the List of Pharmaceutical Specialties (SL) for medicines and the List of Analyses. Because all insurers have the same catalogue, you receive the same benefits from the cheapest insurer as from the most expensive one.

Premiums, co-payment and premium subsidies

The insurer sets its own premiums, graded by canton, premium region and three age groups: children, young adults aged 19 to 25 (Art. 61 para. 3 KVG, Art. 16a KVG) and adults (Art. 61 KVG). The year of birth determines the age group (Art. 91 para. 3 KVV). The FOPH must approve the premiums before they can be published (Art. 16 KVAG). On top of that comes the co-payment, made up of the deductible and the retention fee (Art. 64 KVG). Insured persons of modest means receive a premium subsidy from their canton (Art. 65 KVG).

Switching insurer

After the new premium has been announced, you can switch with one month’s notice to the end of the year (Art. 7 para. 2 KVG). The insurer must inform you of the new premium at least two months in advance, i.e. by 31 October. Your notice must reach the insurer by 30 November. With the standard model and a CHF 300 deductible, you can also switch at the end of June, with three months’ notice (Art. 7 para. 1 KVG). The switching centre guides you through the steps.

Legal basis

The KVG is divided into titles on the requirement to take out insurance, benefits, service providers and tariffs, financing and daily allowance insurance. For insured persons, these articles matter most:

The details are set out in ordinances of the Federal Council and the Federal Department of Home Affairs: the Health Insurance Ordinance (KVV), the Health Care Benefits Ordinance (KLV) and the ordinance on premium regions. Since 2016, a separate act, the KVAG, has governed the supervision of insurers, the approval of premiums and reserves. For procedures and for terms such as illness and accident, the Federal Act on the General Part of Social Insurance Law (ATSG) also applies, unless the KVG provides otherwise (Art. 1 KVG).

Example: same catalogue of benefits, different premiums

Marco is 41, lives in the city of Bern and is insured in the standard model with free choice of doctor and a CHF 300 deductible. In 2026, 26 insurers offer this standard model in Bern. The cheapest premium is CHF 631.00 a month, the most expensive CHF 758.90 (premiums 2026, municipality of Bern, region 1, adults, with accident cover; source FOPH).

If Marco also opts for a GP, HMO or Telmed model, the premium falls further because he restricts his choice of doctor under Art. 41 para. 4 KVG. The benefits still remain the same; the only change is where he must go first. The premium calculator shows how large the differences are in your municipality, using the official FOPH premiums.

What this means for you

The KVG gives you some rights you should know about:

1. Acceptance without health questions. Every insurer must accept you for basic health insurance, however old or ill you are. Switching has no disadvantages for your benefits.
2. The same benefits everywhere. The price depends on the insurer, where you live, your age, deductible and model. So compare premiums every year when the new figures are published at the end of September.
3. Clear deadlines. Your notice cancelling basic health insurance must reach your insurer by 30 November. You will find all dates under deadlines and a ready-made template in the cancellation letter generator.
4. Your supplementary insurance stays. If you switch your basic health insurance, your current insurer may neither force you to cancel your supplementary insurance nor cancel it itself for that reason (Art. 7 paras. 7 and 8 KVG).
5. Help if your income is low. If the premium puts a heavy strain on your budget, check your canton’s premium subsidy.

If you need services that the KVG does not cover, such as a single room in hospital or dental treatment, that is a matter for voluntary supplementary insurance under the VVG.

Common mistakes

• Confusing the KVG with the VVG. The obligation to accept you and the uniform benefits apply only to basic health insurance. In supplementary insurance, an insurer can turn you down.
• Believing that an expensive insurer pays more. Basic health insurance pays the same with every insurer. A higher premium does not mean more benefits.
• Missing the registration deadline. If you wait more than three months after moving here or after a birth, you are only insured from the date you join and risk a premium surcharge.
• Thinking the postmark counts. For your notice, what counts is when it reaches the insurer, not when you sent it.
• Trying to switch with unpaid bills. If you have not paid premiums or co-payments for which you received a reminder, you cannot switch insurer until the arrears are settled (Art. 64a para. 6 KVG).