KVV (Health Insurance Ordinance)

What is the KVV?

The KVV is the Health Insurance Ordinance (Verordnung über die Krankenversicherung, OAMal in French) of 27 June 1995, listed in the Classified Compilation of Federal Legislation under the number SR 832.102. It is the most important implementing ordinance for the Federal Health Insurance Act (KVG). The KVG lays down the principles; the KVV fills them in with amounts, deadlines and procedures.

Swiss health insurance law has three levels that you should keep apart:

The KVV matters to you whenever concrete figures and dates are involved. Almost every franc amount in basic health insurance, from the deductible (Franchise) to the hospital contribution, is set out in the KVV. Which treatments the insurer pays for exactly, on the other hand, is laid down in the Health Care Benefits Ordinance (KLV); the KVV instructs the FDHA to specify these benefits (Art. 33 KVV).

The KVV is amended regularly. The version on fedlex always shows a status date; on 25.09.2026 that was the version of 01.08.2026. What counts is always the version in force at the time of the treatment or event.

How it works

The KVV is divided into five parts: compulsory health insurance, voluntary daily allowance insurance, rules on coordination with other social insurance schemes, decisions and data, and final provisions. For insured persons, these areas are the most important:

Requirement to take out insurance

The KVV specifies who is required to take out insurance and who can be exempted (Art. 1 and 2 KVV). It regulates the premium surcharge for joining late: 30 to 50% of the premium, charged for twice the length of the delay, for a maximum of five years (Art. 8 KVV). It also covers the suspension of the requirement to take out insurance during military service of more than 60 days (Art. 10a KVV).

Premiums

Premiums are payable in advance and, as a rule, monthly (Art. 90 KVV). The insurer must show the share of the premium for accident cover separately and keep basic health insurance, daily allowance insurance and supplementary insurance clearly apart (Art. 89 KVV). Assignment to age groups is based on year of birth (Art. 91 para. 3 KVV). The premium for a special type of insurance or an optional deductible must be at least 50% of the premium for standard insurance with accident cover (Art. 90c KVV). How municipalities are assigned to premium regions is regulated in a separate FDHA ordinance; see premium region.

Deductibles and models

The KVV regulates the special types of insurance: optional deductibles (Art. 93–95 KVV), bonus insurance (Art. 96–98 KVV) and models with a restricted choice of service provider such as the GP, HMO or telemedicine model (Art. 99–101 KVV). You can only choose a higher deductible from the start of a calendar year (Art. 94 para. 1 KVV). You can switch into a model at any time, but you can leave a model or switch to another insurer only at the end of a calendar year (Art. 100 paras. 2 and 3 KVV).

Co-payment

The standard deductible is CHF 300 per calendar year, and the retention fee is capped at CHF 700 for adults and CHF 350 for children (Art. 103 paras. 1 and 2 KVV). What counts is the date of treatment (Art. 103 para. 3 KVV). If you switch insurer during the year, the new insurer credits the deductible and retention fee you have already paid (Art. 103 para. 4 KVV). For a hospital stay you also pay CHF 15 per day; the day of discharge, children, young adults in education and women receiving maternity benefits are exempt (Art. 104 KVV).

Unpaid premiums

If you do not pay premiums or co-payments, the insurer must send you the payment request no later than three months after the due date, separately from any other arrears (Art. 105b KVV). The further steps up to debt enforcement and notification of the canton are set out in Art. 105a–105m KVV.

Legal basis

The KVV is based on the KVG, which instructs the Federal Council in many articles to lay down details. Examples:

• Art. 64 para. 3 KVG: the Federal Council sets the deductible and the maximum retention fee. Implemented in Art. 103 KVV.
• Art. 64 para. 5 KVG: the Federal Council sets the contribution towards the costs of a hospital stay. Implemented in Art. 104 KVV.
• Art. 5 para. 2 KVG: the Federal Council sets the guideline rates for the premium surcharge for joining late. Implemented in Art. 8 KVV.
• Art. 62 KVG: special types of insurance such as optional deductibles, bonus insurance and restricted choice of service provider. Implemented in Art. 93–101 KVV.
• Art. 64a KVG: procedure for non-payment of premiums and co-payments. Implemented in Art. 105a–105m KVV.

An ordinance may not go beyond the act. If a provision of the KVV contradicts the KVG, the act takes precedence. You can find the current text with all amendments on fedlex.admin.ch; the Federal Office of Public Health (FOPH) supervises implementation.

Example: a year with a hospital stay

Noah is 38, has an optional deductible of CHF 1,500 and no other costs in 2026 apart from an operation. He is admitted to hospital on 09.06.2026 and discharged on 14.06.2026. The bill for basic health insurance comes to CHF 12,000 (sample figure). This is how the insurer calculates under the KVV:

The insurer charges the hospital contribution directly to Noah. The canton’s share of the hospital costs is not included in the table because it does not affect Noah.

What this means for you

1. Always check figures and their date. Amounts in the KVV can change. When you read information online, pay attention to the date and the source.
2. Know the deadlines in the KVV. A lower deductible and leaving a model are possible only at the end of the year; you choose a higher deductible with effect from 1 January. All dates are listed under deadlines.
3. Work out your maximum share of costs. Your deductible plus CHF 700 retention fee is the maximum per year, plus the hospital contribution if applicable. Budget for this amount if you choose a high deductible.
4. Compare premiums properly. Because the KVV sets minimum premiums for models and deductibles, the discounts are limited. The premium calculator compares all insurers, and the insurer profiles under health insurers show their key figures.
5. Cite the provision in a dispute. If you disagree with a bill, it helps to refer to the specific article, for example Art. 103 para. 4 KVV if you switched insurer during the year.

Common mistakes

• Treating the KVV and the KVG as the same. The KVG contains principles, the KVV the concrete amounts. If you are looking for a figure, you will usually find it in the KVV.
• Looking for benefits in the KVV. Whether a particular treatment is paid for is set out in the KLV and its annexes, not in the KVV.
• Taking the hospital contribution for a deductible. The CHF 15 per day is added to your co-payment and does not count towards the retention fee.
• Quoting outdated versions. Old amounts and articles circulate on websites. The version in force on fedlex is what counts.
• Forgetting the credit when switching insurer. If you switch insurer during the year, the new insurer must credit the deductible and retention fee you have already paid. Keep your statements.

How we apply legal provisions in our calculators is explained under how we calculate.