Compulsory health insurance
Compulsory basic health insurance covers health expenses in the event of illness or maternity (consultation, hospitalisation, medicine…).
It is ruled by the Health Insurance Act (acronym “LAMal” in French or Italian, or “KVG” in German).
Private insurance companies provide the service. There is no centralised, state-run system. The employer is not involved.
Every person residing in Switzerland for more than 3 months is obliged to take out a compulsory basic health insurance policy.
You need one contract per person; there are no family or couple contracts.
You can take out supplementary insurance for additional benefits. These insurances are not subject to the same law and are not compulsory. The information provided on this page does not concern supplementary insurance.
As a newly arrived person, you have a 3-month period from the date of your arrival in Switzerland to take out a health insurance. Health insurance companies are obliged to:
- insure you without reservation, whatever your age, health condition or gender;
- apply the same rates to all persons they insure, according to three tariff groups (child – young adult – adult)
- provide the identical scope of benefits, as mandated by law.
If you meet the 3-month deadline, the insurance cover and the premiums will be retroactive to the first day of your residence in Switzerland (according to the date shown on your residence/work permit).
If you miss the 3-month deadline, insurance cover and premiums will start on the date you took out the insurance policy. In fact, you’ll have to pay a fine which is often as expensive as the insurance premiums for the period not covered.
If you fail to take out a policy on time, and after several reminders, the SAM (Service de l’assurance maladie – or Health Insurance Service) will carry out a compulsory affiliation (in French “affiliation d’office”). In other words, it will ask a randomly selected insurance company to insure you. It is very difficult to cancel a compulsory affiliation.
You can modify your contract or change company each calendar year for the following calendar year without any consequences. The choice you make on arrival is therefore not definitive and will only commit you for one year.
Please note special cases:
How to take out a health insurance contract?
You can request a quote online from most insurance company websites. Below you’ll find sites with insurance premium calculators and links to the companies. Please note that some companies require you to validate your quote online. This validation binds you.
If the “third-party payment” option at the pharmacy is important to you, check this point before accepting an offer. In general, the least expensive companies do not offer third-party payment. This means you will have to pay for your medicine at the pharmacy and claim the reimbursement from your insurance company.
Insurance companies reimburse the same benefits as defined by the law (LAMal), so an expensive company will reimburse the same as a cheaper one.
Occasionally, some of the less expensive companies have a reduced customer service or longer reimbursement times.
The amount of the monthly premium depends on:
- the company,
- place of residence,
- the age of the insured person (3 age-related fares: child – young adult – adult),
- the deductible (see below),
- certain restrictions on your freedom of choice (see below).
What medical expenses will you pay?
There will be 2 types of co-payments:
Deductible: Each year, you pay the first medical expenses up to a certain limit. The minimum deductible for an adult is CHF 300/year.
You can choose to voluntarily increase the deductible up to CHF 2,500/year to reduce your insurance monthly premiums.
Retention fee: When the deductible is reached, the insurance reimburses 90% of subsequent bills. You are responsible for a further 10%, known as the retention fee.
When the cumulative amount of the retention fee reaches CHF 700, the insurance reimburses 100% of the invoices.
This system is reset each calendar year.
Good to know
Restricting your freedom of choice allows you to reduce the monthly premium. There are various models: HMO (network of doctors), family doctor, etc.
For example, with the family doctor model, you can only consult a specialist if prescribed by your family doctor first (except for gynecology and ophthalmology).
Dental expenses are not covered by compulsory basic insurance, except in the event of an accident, if the accident option is included.
Glasses/contact lenses are not reimbursed for adults.
Maternity-related services are not subject to co-payment. Furthermore, women are exempt from co-payment for general medical services from the 13th week of pregnancy until 8 weeks after childbirth. This means that 100% of their medical expenses are reimbursed (as long as they are covered according to the LAMal)
If you are not employed by a company in Switzerland, you must add the accident option to your health insurance (child, scholarship holder, volunteer staff, homemaker, etc.).
It is possible to apply for an insurance subsidy. This is a financial assistance granted by the cantons.
Insurance premium calculator
Official website: PrimeInfo (in French, German and Italian)
Unofficial site : Comparis (in English and Swiss national languages) (with explanations for newcomers to Switzerland)
Advice: the “NPA” is the postal code or zip code.
If you don’t know your address in Geneva yet, enter Geneva or postal code 1201, and the result will be the same no matter where you live in Geneva.
If you wish to live in the Canton of Vaud, there are 3 fare zones. Indicate your future place of residence. If you don’t know your future address yet, enter Lausanne or 1001.
For further information
Explanatory brochure on compulsory basic insurance.
Information for Geneva:
Information for the Canton of Vaud :
- General information (in French only)
- Information to reduce premium costs (in Fench)
- Insurance premiums by company and region (in French)
Articles 24 et seq. of the Federal Health Insurance Act (LAMal) deals with benefits.
- In French – German and Italian (language option on the upper right corner)
Description of benefits summarized on an unofficial website
- In English – French – German and Italian (language option on the upper right corner)