The Swiss health insurance system explained

The system at a glance

If you move to Switzerland from Germany, France, the United Kingdom or the United States, you will find a system that is neither state-run nor purely private. The rules are set by the Federal Health Insurance Act (KVG), the system is run by approved health insurers, and each person takes out their own insurance.

The system has two storeys. At the bottom is compulsory basic health insurance: the same statutory benefits at every insurer, acceptance without a health questionnaire. On top of this sits voluntary supplementary insurance under the Insurance Contract Act (VVG), for example for a semi-private hospital ward or dental treatment. There, the insurer decides whom it accepts.

Step by step: from arrival to policy

1. Note the deadline. You have 3 months from arrival, or, if you need a permit, from registering with your municipality. If you miss the deadline, you are only insured from the day you join and risk a surcharge. Details in the article Registered too late.
2. Compare premiums for your municipality. Insurers set their premiums per canton and premium region. The premium calculator shows all offers for your municipality.
3. Choose a deductible. It determines how much you first pay yourself each year.
4. Choose a model. The standard model with free choice of doctor, or a cheaper model with a first point of contact.
5. Sign up and clarify accident cover. If you are employed and fully insured against accidents through your employer, you can suspend the accident cover of your health insurance (Art. 8 para. 1 KVG).
6. Look into supplementary insurance. Voluntary, with health questions. It is not as urgent as basic health insurance.

What basic health insurance covers

Basic health insurance pays for services used to diagnose or treat an illness and its consequences (Art. 25 para. 1 KVG): outpatient and inpatient treatment by doctors, analyses and medicines prescribed by a doctor, maternity benefits and, where no accident insurance pays, accidents too. Exactly which benefits are covered is set out in the law and ordinances, and it is the same for all insurers.

What it does not pay for, or only in exceptional cases, surprises many newcomers: it only covers dental treatment if it is caused by a serious illness or an accident (Art. 31 KVG). A single or double room in hospital, free choice of hospital throughout Switzerland or cover for travel outside Europe are matters for supplementary insurance.

Premium: a flat per-person premium instead of a salary contribution

The premium is a flat per-person premium: the insurer charges all its insured persons the same premium (Art. 61 para. 1 KVG), graded only by canton and premium region, because costs differ there (Art. 61 para. 2 and 2bis KVG), and by three age groups (Art. 61 para. 3 KVG). Children are those up to 18, young adults those aged 19 to 25; your age on 31 December is what counts (Art. 16a KVG). Your income plays no role.

Premiums 2026, municipality of Zurich (region 1), with accident cover; source FOPH:

For adults with a CHF 300 deductible, the gap between the lowest and highest premium is CHF 206.30 per month, for the same statutory benefits. How large the differences between cantons are is shown by comparing the same age group and deductible: in Aarau, the median in 2026 is CHF 518.60, in Lugano CHF 675.60 (adults, born 1990, CHF 300 deductible, with accident cover; source FOPH). The FOPH publishes next year’s premiums at the end of September.

If your income is low, the canton helps: it reduces the premiums of insured persons on modest incomes (Art. 65 para. 1 KVG), and for children from households with lower and middle incomes by at least 80 % (Art. 65 para. 1bis KVG). You can find the rules of your canton under Premium subsidy.

Co-payment: deductible, retention fee, hospital contribution

In addition to the premium, you contribute to the cost of every treatment (Art. 64 para. 2 KVG):

• Deductible (Franchise): you pay the first costs in each calendar year yourself. The standard deductible for adults is CHF 300 (Art. 103 para. 1 KVV); you can choose CHF 500, 1,000, 1,500, 2,000 or 2,500 (Art. 93 para. 1 KVV). Children have no standard deductible (Art. 64 para. 4 KVG) and can choose CHF 100 to 600.
• Retention fee (Selbstbehalt): above the deductible, you pay 10 % of the costs, up to CHF 700 a year, and up to CHF 350 for children (Art. 103 para. 2 KVV).
• Hospital contribution: during a hospital stay you pay CHF 15 per day. Children, young adults in education and women giving birth are exempt (Art. 104 KVV).

How you pay the bill depends on the agreement between the insurer and the service provider. Under the “tiers garant” system, you owe the bill yourself and claim the money back from your insurer; under the “tiers payant” system, the insurer pays directly and bills you for your share (Art. 42 para. 1 and 2 KVG).

Sample calculation: a year with medical costs

Example with fictitious people. Tom, 36, lives in Zurich. In one year, he has outpatient costs of CHF 4,000, with no hospital stay. He compares the median offers for adults from the table above.

Which deductible works out for you depends on your expected costs. This is a calculation, not a recommendation; you can run your own figures in the deductible calculator.

Insurance models: whom you contact first

In the standard model, you choose your doctor freely. Insurers also offer models with restricted choice, for which they may lower the premium (Art. 62 para. 1 KVG):

• GP model: you first go to the GP practice you have chosen, which refers you on if necessary.
• HMO: your first point of contact is a health centre with employed doctors.
• Telemedicine: before seeing a doctor, you call a medical advice line.

The details, for example what applies in an emergency, are set out in the insurer’s conditions. You can switch to a model with restricted choice at any time; switching back or to another model is possible at the end of a calendar year (Art. 100 para. 2 and 3 KVV). You can find an overview of all models under Insurance models.

Changing insurer: the key dates

You are not tied to your first choice:

• At the end of the year: after you have been notified of the new premium, you can switch with one month’s notice to the end of December (Art. 7 para. 2 KVG). Your notice of cancellation must reach the insurer by 30 November at the latest; in 2026, that is a Monday.
• At the end of June: with three months’ notice, so received by 31 March, this is only possible with the standard deductible in the standard model (Art. 7 para. 1 KVG, Art. 94 para. 2 and Art. 100 para. 3 KVV).
• Without a gap: your old insurance only ends once the new insurer has confirmed that you are insured with it without interruption (Art. 7 para. 5 KVG).

You can only choose a higher deductible from the start of a calendar year (Art. 94 para. 1 KVV). The page Switching health insurer explains the process, and the deadline calculator shows the dates.

Special cases for newcomers

Short stays. With an L permit of less than 3 months, separate rules apply. They are covered in the article Short-term residents.

Family members in the EU. If you work in Switzerland as an EU or EFTA national, according to the FOPH your family members who do not work and live in an EU state, Iceland or Norway must also take out insurance in Switzerland.

Studies and postings. Students and posted workers may, under certain conditions, stay in their home system or be exempted. This is explained in the article Exemption from compulsory health insurance.

Supplementary insurance. The insurer may ask health questions, add a reservation or refuse you. You may take out basic and supplementary insurance with different insurers. The general terms and conditions (AVB) and the information from the insurer are decisive.

Common mistakes

• Trying to insure the family under one policy. Every person needs their own basic health insurance.
• Counting on the employer to pay the premium. The employer does not contribute to health insurance, but it does pay for accident insurance. You can then suspend the accident cover of your health insurance.
• Looking only at the premium. Deductible, retention fee and model determine what a year with doctor’s visits really costs you.
• Assuming dental treatment is covered. Basic health insurance only pays for it in exceptional cases.
• Missing the switching date. What counts is the date your notice of cancellation reaches the insurer, not the postmark.

You can find key figures and contact details for all insurers in the health insurer profiles. If you have already missed the deadline, read Registered too late. All topics around moving to Switzerland are collected in the theme New in Switzerland.