What LAMal/KVG is and why it matters from day one

Swiss basic health insurance — called Grundversicherung or obligatorische Krankenpflegeversicherung (OKP) in German, assurance-maladie obligatoire or LAMal in French, and assicurazione malattia obbligatoria in Italian — is mandatory for every person who lives in Switzerland. The legal basis is the Federal Health Insurance Act (KVG/LAMal).

Unlike the insurance systems of many other countries, Swiss basic cover is purchased individually from a private insurer, not provided by an employer or the state. There are over 50 authorised insurers. Every insurer must accept every applicant — they cannot reject you, charge you more because of your health, or exclude pre-existing conditions from the basic cover.

The coverage is standardised by federal law. Every basic policy covers the same catalogue of medical treatments: outpatient doctor visits, hospital stays in your canton's general ward, prescribed medicines, maternity care, physiotherapy, emergency treatment abroad in limited cases, and some preventive measures. No insurer offers more or less basic cover — only the premium, service speed, and supplementary products differ.

The 3-month deadline: when the clock starts and what happens if you miss it

When you register as a Swiss resident with your commune, the three-month countdown begins. You must have cover in place within 90 days of your official residency start date. The cover is then backdated to your registration date — you owe premiums from the day you became a resident, not only from when you signed the contract.

Missing the deadline does not prevent you from obtaining insurance — insurers cannot refuse basic cover — but the cantonal authority may assign you to an insurer and may impose a premium surcharge of up to 50% for the period of non-compliance. You will also owe all back premiums from your residency start date.

For newborns, the registration window is three months from birth. For people moving between cantons, you keep your insurer but the premium adjusts to the new canton's rate, and you usually have a brief window to switch plans within the same insurer.

For cross-border workers and posted employees, different rules may apply. EU/EFTA cross-border commuters who are insured in their country of residence generally do not need Swiss basic insurance, but they must carry a valid EHIC (European Health Insurance Card). The cross-border worker tax guide covers related insurance and tax topics.

Franchise, co-pay, and managed-care models: how your choices change the premium

The premium you pay is not just set by the insurer — your own choices change it substantially. The largest lever is the annual deductible, called the Franchise (German), franchise (French), or franchigia (Italian).

Adults can choose a Franchise of CHF 300, 500, 1,000, 1,500, 2,000, or 2,500 per year. A lower Franchise means a higher monthly premium and vice versa. The rule of thumb: if you expect many doctor visits, the CHF 300 Franchise keeps your out-of-pocket costs capped early in the year. If you are healthy and rarely visit a doctor, choosing a CHF 2,500 Franchise can save CHF 80 to 160 per month in premium.

Above the Franchise, you pay 10% co-insurance on each medical bill, capped at CHF 700 per year for adults (CHF 350 for children). The maximum you pay out of pocket in any year — Franchise plus co-insurance — is CHF 3,200 for adults and CHF 350 for children. Beyond that, the insurer covers 100%.

Managed-care models reduce premiums further. A family-doctor model (Hausarztmodell) requires you to always consult your registered GP first, typically cutting your premium by 10 to 15 percent. A telemedicine model (Telmed) requires a phone consultation before any specialist visit, with similar savings. An HMO model requires all care through a specific group practice. These restrictions are acceptable for most healthy adults but should be considered carefully for families or people with ongoing conditions.

The official premium comparison tool at priminfo.admin.ch lets you compare all insurers side by side for your specific canton, age, Franchise, and model combination.

2026 premiums: what to expect by canton, age, and coverage level

Premiums in Switzerland vary dramatically by canton. In 2026, an adult aged 26 or older with a CHF 300 Franchise and the standard model pays roughly CHF 340 to 550 per month depending on the canton and insurer. Geneva (GE) and Basel-Stadt (BS) are consistently among the most expensive. Rural cantons such as Appenzell Innerrhoden (AI) and Uri (UR) tend to be the least expensive.

Children's premiums are significantly lower: roughly CHF 80 to 140 per month for the same CHF 0 Franchise (children have no minimum Franchise by default) depending on the canton. Young adults aged 19 to 25 pay a reduced adult rate in most cantons.

Premiums are not income-based. A CEO and a student in the same canton with the same insurer, Franchise, and model pay exactly the same premium. This is a key difference from tax-funded health systems and is the reason why Switzerland has a premium-subsidy system.

Premiums typically increase each autumn for the following calendar year. Insurers announce next year's rates by October, and you have until 30 November to switch basic insurance for the following year. Switching is straightforward: the new insurer handles the cancellation of the old policy.

Premium subsidies (IPV/Prämienverbilligung): who can get help with the cost

Because premiums are not linked to income, cantons provide means-tested premium reductions — called individuelle Prämienverbilligung (IPV) in German, réduction individuelle des primes in French, and riduzione individuale dei premi in Italian.

Eligibility thresholds and the amount of support vary by canton. In most cantons, a household whose basic premiums exceed 8 to 12% of taxable income qualifies for a subsidy. Some cantons, such as Vaud and Ticino, offer generous subsidies. Others have tighter thresholds. The subsidy is usually paid directly to the insurer, reducing your monthly bill.

You must apply through your cantonal compensation office — it is not automatic. Applications are typically submitted with your tax return or through a separate cantonal form. Missing the application deadline usually means you lose the subsidy for that year, even if you were otherwise eligible.

Low-income pensioners receiving supplementary benefits (EL) receive automatic premium subsidies and should not need a separate application. The same applies to recipients of daily unemployment or disability benefits in many cantons.

Supplementary insurance (VVG): dental, private ward, and what is optional

Supplementary hospital and outpatient insurance is governed by a separate law — the Federal Insurance Contract Act (VVG/LCA). Unlike basic insurance, supplementary cover is not mandatory, insurers can reject applicants based on health status, and premiums are risk-based rather than community-rated.

The most common supplementary products are: semi-private or private hospital ward coverage (allowing you a two-bed or single room and choice of senior doctor), dental insurance (usually with annual caps around CHF 2,000 to 5,000), and complementary medicine coverage (acupuncture, osteopathy, and traditional Chinese medicine beyond what basic insurance pays).

For most healthy expats, supplementary insurance is not urgent upon arrival. Set up the mandatory cover first, within the 3-month deadline. Supplementary cover can be added later, but the insurer may require a health questionnaire and can impose exclusions or reject the application. Some expats choose international cover that combines Swiss-mandatory basic insurance with global private coverage — check with a specialised broker for cross-border suitability.

A special case is accident coverage. If you work at least eight hours per week for the same Swiss employer, your employer's accident insurance (UVG) covers both work and non-work accidents, and you can opt out of the accident rider on your basic cover — reducing your premium by roughly 7%. If you work fewer hours, you must keep the accident rider on your basic policy.

How premiums interact with your Swiss taxes

Basic insurance premiums, supplementary insurance premiums, and accident insurance premiums are all partially deductible from your taxable income. The deduction ceiling varies by canton and covers premiums, interest on savings, and certain other personal deductions together.

For a detailed explanation of deduction limits, cantonal variations, what counts as a medical expense, and how to claim deductions on your tax return, see our dedicated guide on claiming Swiss insurance deductions. The deduction can be especially valuable for expats who switch from tax at source to ordinary tax assessment.

For families, each child's premiums are deductible separately, and the overall deduction ceiling increases with the number of dependants. The exact amounts are published annually in the cantonal tax booklets and by the Federal Tax Administration.

Practical steps for expats arriving in Switzerland

Step one: register at your commune of residence and receive your residency confirmation. The three-month insurance clock starts from this date.

Step two: within the first two weeks, visit priminfo.admin.ch and use the premium calculator for your canton, age, and preferred Franchise. Compare at least five insurers for the same coverage level.

Step three: choose a managed-care model if the premium saving is attractive and you are comfortable with the restriction. For most newcomers, a telemedicine model offers a good balance of savings and flexibility.

Step four: apply for the insurance online or by phone. Have your residence permit or confirmation of registration and your AHV number ready. Most insurers offer English-language service, but some only operate in German, French, or Italian.

Step five: within three to six months of arrival, assess whether supplementary dental or private-ward insurance is worth the cost for your situation. Do not let a broker pressure you into supplementary products before your mandatory cover is settled.

If you are leaving Switzerland permanently, basic insurance ends when you deregister. Notify your insurer and your cantonal compensation office in writing. The exit Switzerland checklist covers the full departure workflow, including insurance, tax, and pension steps.