Swiss health insurance: how the system works

Who has to take out insurance, and by when?

Everyone resident in Switzerland must be insured within three months of taking up residence or of birth, regardless of nationality (Art. 3 para. 1 KVG). Each family member is insured individually, children included, and not necessarily with the same insurer. Exceptions are governed by Art. 2 KVV, for example for people who are subject to the law of an EU or EFTA state because they work there, or, on application, for people in education or training who have equivalent cover.

For foreign nationals with a permit valid for at least three months, the deadline runs from registration with the residents' registration office (Einwohnerkontrolle); if you join in time, your insurance starts on the date of that registration (Art. 7 para. 1 KVV). The insurer reimburses costs retroactively from the start of the insurance, and you likewise pay the premiums retroactively, calculated to the day. Everything you need to get started: health insurance when moving to Switzerland.

If you join late, you are only insured from the date you join. If the delay is not excusable, a surcharge of 30 to 50% of the premium is added (less in a situation of hardship), for twice the length of the delay, at most five years (Art. 5 para. 2 KVG; Art. 8 para. 1 KVV). Anyone who does not take out insurance in time is assigned to an insurer by the cantonal authority (Art. 6 para. 2 KVG).

What does basic insurance pay for?

Basic insurance pays in the event of illness, maternity and accident, insofar as no accident insurance covers the costs (Art. 1a para. 2 KVG). Its benefits are set by the KVG and the federal ordinance on health care benefits (KLV), and insurers may not cover any other costs (Art. 34 para. 1 KVG): the cover is the same at every insurer.

Unless the insurer and the provider have agreed otherwise, you pay bills yourself and submit them to the insurer for reimbursement (tiers garant); otherwise the insurer pays directly (tiers payant). For inpatient treatment, the insurer always owes its share itself (Art. 42 paras. 1 and 2 KVG).

Two important limits:

• Hospital: your stay is covered to the standard of the general ward (Art. 25 para. 2 let. e KVG); only supplementary insurance covers the semi-private or private ward.
• Dentist: only for a severe, unavoidable disease of the masticatory system, because of a severe general illness or for accident damage (Art. 31 KVG); not for routine dental treatment.

What does health insurance cost?

You pay a premium and, when you have treatment, cost sharing: the deductible as a fixed annual amount, then 10% of further costs as a co-payment (Art. 64 para. 2 KVG). Each insurer sets its own premium, and the Federal Office of Public Health (FOPH) approves it (Art. 61 para. 1 KVG; Art. 16 para. 1 KVAG). It depends on the canton and premium region (42 across Switzerland), age group (children up to 18, young adults 19 to 25, adults from 26), deductible, model and accident cover, not on income or health.

Adults pay at most CHF 1'000 a year in deductible and co-payment (300 + 700) with the CHF 300 deductible and CHF 3'200 (2'500 + 700) with the CHF 2'500 deductible, excluding the hospital contribution and the higher 40% co-payment for certain medicines (Art. 38a KLV). No cost sharing applies to maternity benefits or, between the 13th week of pregnancy and eight weeks after the birth, to general benefits and nursing care in the event of illness (Art. 64 para. 7 KVG); the extension from the start of pregnancy adopted by Parliament is not yet in force (as of 1 November 2026).

For a higher deductible, the premium falls by at most 70% of the additional risk, so with CHF 2'500 instead of 300 by at most CHF 1'540 a year (70% of CHF 2'200; Art. 95 para. 2bis KVV).

Which insurance models are there?

In the standard model, you choose freely among the admitted providers for outpatient treatment (Art. 41 para. 1 KVG). In a model with restricted choice, you first go to the designated point of contact; the insurer only has to cover what the model's providers perform or order, and in return it can lower the premium (Art. 41 para. 4 and Art. 62 para. 1 KVG). The benefits required by law are insured in every case.

With your insurer, you can switch from the standard model to a model at any time; switching from a model back to the standard model or to another model is only possible as of 1 January, with written notice by 30 November (Art. 100 paras. 2 and 3 KVV). What a model requires is set out in the insurer's insurance terms. Since the 2027 premiums, the FOPH has distinguished four categories by the first point of contact:

• PRAXIS: a designated medical practice, such as a family doctor's practice or a medical centre (previously family doctor and HMO models).
• TEL_DIG: first contact by telephone or digitally.
• PHARM: a partner pharmacy of the insurer.
• FLEX: a choice between several first points of contact.

Are accidents covered?

Yes. If you work at least eight hours a week for one employer, you are insured through them under the Accident Insurance Act (UVG) against accidents in your free time too; with fewer hours, only against occupational accidents, including on the way to and from work (Art. 13 UVV). Without full UVG protection, for example if you are self-employed or not in employment, basic insurance covers accidents in the same way as illness, with deductible and co-payment (Art. 28 KVG).

With full mandatory UVG protection, you can have your health insurer's accident cover suspended on written request with proof, from the following month at the earliest; the premium falls by the accident share, by at most 7% (Art. 8 para. 1 KVG; Art. 11 para. 1 and Art. 91a KVV). If your UVG protection ends in full or in part, accident cover applies again; report this to your health insurer within one month of the written information from your employer or the unemployment insurance, otherwise it can claim the premium share plus default interest retroactively (Art. 8 para. 2 and Art. 10 KVG; Art. 11 para. 2 KVV).

What applies to supplementary insurance?

Supplementary insurance is voluntary and governed by the Insurance Contract Act (VVG); there is no obligation to accept you. Depending on the insurer, it covers, for example, the semi-private or private ward, naturopathic treatment or routine dental treatment. It may not insure the cost sharing of basic insurance (Art. 64 para. 8 KVG).

According to the FOPH, the insurer may ask health questions, add reservations, reject the application and set the premium by age and sex; if you conceal or misstate a material fact you were asked about, you risk the insurer terminating the contract (Art. 4 and 6 VVG). So cancel any existing supplementary insurance only after you have the new insurer's written confirmation of acceptance.

How do you compare and switch insurer?

Compare the premium, the model rules and the service; the FOPH advises deciding first on the model that suits your needs. The FOPH's premium calculator at priminfo.admin.ch shows the official premiums. In the easyall calculator, you compare basic and supplementary insurance based on your details and needs; if you have questions, easy, our AI guide, can help.

You can switch basic insurance as of 1 January and, with the standard model and the ordinary deductible, also as of 1 July if your cancellation arrives by 31 March (Art. 7 paras. 1 and 2 KVG; Art. 94 para. 2 and Art. 100 para. 3 KVV). Your current insurer may not cancel your supplementary insurance solely because you switch (Art. 7 para. 8 KVG). For 1 January 2027:

1. 1Register with the new insurer: you do not need a quote, and you do not have to answer health questions for basic insurance.
2. 2Cancel in writing: your cancellation must reach your current insurer by Monday, 30 November 2026. The FOPH recommends sending it by 15 November, by registered mail or “A-Post Plus”.
3. 3Settle arrears: you cannot switch if, by 31 December 2026, you have not paid debt collection costs or the premiums, cost sharing or default interest you received a reminder for by 30 November (Art. 64a para. 6 KVG; Art. 105l para. 2 KVV).