Requirement to take out health insurance

What is the requirement to take out insurance?

The requirement to take out insurance is the legal obligation to take out compulsory health insurance. It is also referred to as compulsory insurance. It applies to everyone resident in Switzerland, regardless of age, nationality, income or health. The requirement concerns only basic health insurance under the Health Insurance Act (KVG). Supplementary insurance under the Insurance Contract Act (ICA, VVG in German) is voluntary.

The requirement has a flip side that matters to you as an insured person: every health insurer must accept you within its area of operation. It may not turn you down because of your age or an illness, and it does not ask you any health questions for basic health insurance. You are free to choose among all insurers approved to offer social health insurance.

What counts is your place of residence (Wohnsitz) as defined in the Civil Code, i.e. the place where you live with the intention of staying permanently. In addition, there are groups without residence that the Federal Council has expressly made subject to the requirement, for example people with a residence permit or short-term residence permit valid for at least 3 months, asylum seekers and certain cross-border commuters.

How it works

After moving to Switzerland or after the birth of a child, you have 3 months to register with a health insurer of your choice. This period is called the three-month deadline to take out insurance. If you register within these 3 months, your insurance starts retroactively on the day of birth or of taking up residence. You then also pay premiums from that day, but you are covered without a gap.

If you register later, cover only starts on the day you join. No insurer pays for treatment in between. If the delay is inexcusable, a premium surcharge for late enrolment is added. It amounts to 30 to 50% of the premium and is charged for twice the length of the delay, for a maximum of 5 years. The insurer sets the rate according to your financial situation. If the surcharge would put you in financial hardship, it must reduce it to below 30%. If social assistance pays your premiums, there is no surcharge.

The cantons make sure that everyone is insured. In practice, the residents’ registration office (Einwohnerkontrolle) asks for proof of insurance after you register. Anyone who does not provide it is assigned to an insurer by the responsible cantonal authority. The requirement to take out insurance ends when you leave Switzerland or are no longer subject to it for another reason.

Despite the requirement, you may switch at any time within the legal deadlines, as long as you have no payment arrears. The only important thing is that cover continues without interruption: your old insurance only ends once the new insurer has confirmed to the old one that you are insured with it. You will find the dates under deadlines and the procedure under switching health insurer.

Legal basis

Art. 3 para. 1 KVG requires everyone resident in Switzerland to take out health insurance for themselves, or have it taken out for them, within 3 months of taking up residence or of birth. Under Art. 3 paras. 2 and 3 KVG, the Federal Council can provide for exceptions and extend the requirement to people who are not resident in Switzerland. Art. 4 KVG guarantees free choice among the approved insurers.

Art. 5 KVG governs the start and end of cover: if you join on time, insurance starts at birth or on taking up residence (para. 1); if you join late, it starts when you join, and if the delay is inexcusable, you owe a premium surcharge (para. 2). Art. 6 KVG gives the cantons responsibility for checking and allows them to assign people to an insurer.

The details are set out in the Health Insurance Ordinance (KVV): Art. 1 KVV lists the additional groups required to take out insurance, Art. 2 KVV the exceptions, Art. 7 KVV special cases such as people with a residence permit or cross-border commuters, and Art. 8 KVV the amount and duration of the premium surcharge. The insurers’ obligation to accept applicants is laid down in Art. 5 let. i of the Health Insurance Supervision Act (KVAG).

Example: moving to Zurich

Lena is 34, moves from Germany to Zurich and registers with the municipality on 1 March 2026. She compares offers and takes out basic health insurance on 20 May 2026, i.e. within 3 months.

The premiums apply to 2026, municipality of Zurich (region 1), adults born in 1992, with accident cover; source FOPH. The range shows how much the choice of insurer matters for the same cover: with a CHF 300 deductible, there is a difference of CHF 206.30 a month between the lowest and the highest offer.

What this means for you

If you move to Switzerland or have a child, put the 3-month deadline in your calendar straight away. Use this time to compare premiums in the premium calculator and sign up before the deadline expires. Cover then applies retroactively and you do not lose a single day.

Basic health insurance offers the same statutory benefits with every insurer. The differences lie in the premium, the insurance model and the service. The health insurer profiles show key figures from the FOPH’s supervisory data.

If you are moving from abroad, check whether an exception applies to you, for example because you continue to work in an EU state and are insured there. In many cases an exemption is only granted on application to the canton; until the decision, you should not be left without cover.

The same deadline applies to newborns from the date of birth. Many parents register their child before the birth; this is not necessary for basic health insurance but can make sense for supplementary insurance.

Common mistakes

• Counting the deadline from entry instead of from registration. For people with a residence permit, the deadline runs from registration with the residents’ registration office. If you mix this up, you risk a gap.
• Thinking foreign travel insurance is enough. It does not replace basic health insurance. Only an exemption granted by the canton releases you from the requirement.
• Believing an insurer may turn you down. In basic health insurance, insurers must accept you. Health questions exist only in supplementary insurance.
• Underestimating the surcharge. With a delay of one year, the surcharge can amount to up to half the premium for 2 years.
• Confusing the requirement with supplementary insurance. Only basic health insurance is compulsory; supplementary insurance is voluntary.

We explain how we present premiums under How we calculate.