Supplementary benefits

What are supplementary benefits?

Supplementary benefits (Ergänzungsleistungen, EL) help when your pension from the old-age and survivors’ insurance (AHV) or the invalidity insurance (IV) and your other income do not cover minimum living costs. They are a means-tested benefit, not welfare: if you meet the requirements, you have a legal entitlement. The Confederation and the cantons finance supplementary benefits jointly; the cantons administer them.

Supplementary benefits matter for health insurance for two reasons. First, the calculation includes an amount for the basic health insurance premium, which is paid directly to the health insurer. Second, the canton reimburses recipients for illness and disability costs that no insurance pays, such as the deductible and retention fee, dental bills, or help and nursing care at home.

For those entitled, supplementary benefits replace the ordinary premium subsidy. The lump sum usually covers the premium fully or largely. At a minimum, recipients get the amount the canton has set as the highest premium subsidy for people without supplementary benefits or social assistance, or 60% of the lump sum for basic health insurance, whichever is higher.

How they differ from social assistance and premium subsidies

Social assistance is the last safety net for anyone who cannot cover their living costs, and may have to be repaid if your situation improves. Supplementary benefits, by contrast, require a pension from the AHV or the invalidity insurance and are calculated under federal rules. The premium subsidy, in turn, only reduces the premium and is governed by cantonal law. If you receive supplementary benefits, you usually do not need to apply for a premium subsidy separately.

How it works

The annual supplementary benefit is the difference between recognised expenses and countable income. The responsible office sets the two sides against each other.

Recognised expenses for people living at home include:

• general living costs, in 2026 CHF 20,670 a year for single people and CHF 31,005 for married couples,
• rent including service charges up to a maximum that depends on the rent region and household size; for a single person living alone in region 1 it is CHF 18,900 a year,
• the lump sum for basic health insurance equal to the cantonal or regional average premium, at most the actual premium,
• social insurance contributions, maintenance payments and other items.

Countable income includes pensions from the AHV, IV and occupational pension fund, two thirds of earned income above an allowance, investment income and a share of assets. For old-age pensioners, one tenth of net assets above CHF 30,000 (married couples CHF 50,000) is counted as income.

If your net assets are CHF 100,000 or more (married couples CHF 200,000), you do not receive supplementary benefits. A property you live in yourself does not count towards this threshold. For people in a care home or hospital, other expense items apply, such as the care home fee instead of rent and living costs, plus an amount for personal expenses.

The amount for the health insurer

Each year, the Federal Department of Home Affairs (FDHA) sets the average premiums used to calculate supplementary benefits. Zurich, Bern, Lucerne, St. Gallen and Grisons have regional amounts; the other cantons have one amount per canton. For 2026, the average premium for adults in premium region 1 is CHF 7,680 a year in the canton of Zurich and CHF 8,004 in Bern. This amount is recognised as an expense, but at most the actual premium of your health insurer.

The responsible office pays the amount directly to the health insurer. If the whole annual supplementary benefit is smaller than this amount, the entire benefit goes to the insurer. Your premium bill falls accordingly.

Illness and disability costs

On top of the annual supplementary benefit, the canton reimburses documented costs, including dental treatment, help, nursing and companionship at home, spa treatment ordered by a doctor, special diets, transport to the nearest place of treatment, aids and appliances, and the co-payment for basic health insurance, i.e. the deductible and retention fee. Cantons may set maximum amounts, but for single people living at home not below CHF 25,000 a year. If you receive no annual supplementary benefit because your income exceeds your expenses, illness costs are reimbursed insofar as they exceed this surplus.

Legal basis

Supplementary benefits are governed by the Federal Act on Supplementary Benefits to Old-Age, Survivors’ and Invalidity Insurance (ELG), with details in the Ordinance on Supplementary Benefits (ELV). Art. 4 ELG sets out the conditions of entitlement: residence and habitual abode in Switzerland plus a pension from the AHV or IV, a helplessness allowance from the IV or an IV daily allowance for at least six months. Under Art. 5 ELG, foreign nationals are subject to a waiting period of ten years of uninterrupted residence, refugees and stateless persons five years.

Art. 9 ELG defines the calculation as the difference between recognised expenses and countable income; Art. 9a ELG sets the asset threshold of CHF 100,000 or CHF 200,000. Recognised expenses are listed in Art. 10 ELG; under Art. 10 para. 3 let. d ELG, they include the amount for compulsory health insurance as an annual lump sum equal to the cantonal or regional average premium including accident cover, at most the actual premium. Art. 21a ELG requires this amount to be paid directly to the health insurer.

Reimbursement of illness and disability costs is governed by Art. 14 ELG, including in para. 1 let. g the co-payment under Art. 64 of the Federal Health Insurance Act (KVG). Under Art. 12 ELG, entitlement starts at the beginning of the month in which the application was submitted; on entering a care home or hospital, a six-month deadline applies. Repayment from an estate above CHF 40,000 is set out in Art. 16a ELG. Under Art. 26 ELV, rent region 1 covers the five major centres of Bern, Zurich, Basel, Geneva and Lausanne.

Example: a pensioner in the city of Zurich

Ruth is 78, single and lives in a rented flat in the city of Zurich. She receives an AHV pension of CHF 2,000 and an occupational pension of CHF 500 a month. Her rent including service charges is CHF 1,400 a month, and her savings amount to CHF 20,000. Her basic health insurance premium is above the average premium. The figures are fictitious; the rates are statutory (as of 2026).

Item	Amount per year
General living costs, single	CHF 20,670
Rent incl. service charges (below the maximum of CHF 18,900)	CHF 16,800
Lump sum for basic health insurance, ZH region 1, adults	CHF 7,680
Recognised expenses	CHF 45,150
AHV pension	CHF 24,000
Occupational pension	CHF 6,000
Share of assets counted (assets below CHF 30,000)	CHF 0
Countable income	CHF 30,000
Annual supplementary benefit	CHF 15,150

The calculation is simplified: other income such as interest and items such as maintenance payments are left out. The decision of the responsible office is binding. But the example shows why the choice of health insurer still matters with supplementary benefits: if Ruth’s premium is higher than the average premium, she pays the difference herself. Switching to a cheaper insurer or a GP model reduces her own share, as long as the new premium does not fall below the lump sum. The premium calculator shows which offers are available in her municipality.

What this means for you

If you receive an AHV or IV pension and money is tight, have your entitlement checked:

1. Apply early. Supplementary benefits are only paid from the month you apply. If you wait six months, you lose six months. When entering a care home or hospital, you have six months.
2. Have your documents ready. Pension decisions, tenancy agreement, bank statements, tax documents and your current health insurance premium bill.
3. Submit illness costs. Send receipts for the deductible, retention fee, dentist or Spitex to the supplementary benefits office, usually within a deadline set by the canton.
4. Keep an eye on your premium. Supplementary benefits cover at most the average premium. If your insurer is expensive, you pay the difference yourself. So compare offers every year and consider an alternative insurance model. Key figures on the insurers are available under health insurers.
5. Report changes. You must report a move, entering a care home, an inheritance or a new pension immediately; otherwise you may have to repay benefits.

If you do not receive a pension but have a low income, the cantonal premium subsidy is the right route. Check your entitlement with the premium subsidy check.

Common mistakes

• Applying too late. Supplementary benefits are not paid retroactively from the start of your pension, only from the month you apply.
• Believing that owning your home rules out supplementary benefits. A property you live in does not count towards the CHF 100,000 asset threshold; when assets are counted as income, only the value above CHF 112,500 is taken into account.
• Not submitting illness costs. The deductible and retention fee are not reimbursed automatically. No receipts, no money.
• Staying with an expensive insurer. Supplementary benefits only cover the premium up to the average premium. A more expensive insurer strains your budget every month.
• Giving away assets. Assets you give away voluntarily are still counted in the calculation as if you still had them.