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Understanding Swiss Health Insurance in 2025/2026

Switzerland’s mandatory health insurance system ensures universal access to quality healthcare. Understanding the various options for deductibles, insurance models, and cost-sharing mechanisms can help you optimise your healthcare costs.

Mandatory Health Insurance in Switzerland

Everyone residing in Switzerland must have basic health insurance within 90 days of arrival or birth. While all insurers offer the same basic benefits mandated by law, premiums can vary significantly between providers and cantons.

Understanding Deductibles (Franchise)

The deductible is the amount you pay out-of-pocket each year before your insurance begins covering costs. In Switzerland, you can choose from several deductible levels.

Adults (26+ years)

• CHF 300: Standard deductible, highest premiums
• CHF 500: Slightly reduced premiums
• CHF 1’000: Moderate premium reduction
• CHF 1’500: Significant premium reduction
• CHF 2’000: Large premium reduction
• CHF 2’500: Maximum deductible, lowest premiums

Co-Payment (Retention)

After reaching your deductible, you still pay 10 percent of remaining costs (co-payment) up to a maximum:

• Adults: CHF 700 maximum per year
• Children: CHF 350 maximum per year

This means your maximum out-of-pocket costs (excluding premiums) are:

• CHF 300 deductible: CHF 1’000 maximum (300 + 700)
• CHF 2’500 deductible: CHF 3’200 maximum (2’500 + 700)

Insurance Models

Switzerland offers several insurance models beyond the standard free-choice model. These managed care models provide premium discounts in exchange for certain restrictions.

Standard Model

Complete freedom to choose any doctor or specialist. No restrictions, but highest premiums.

Family Doctor Model (Hausarzt)

You choose a designated family doctor who serves as your first point of contact. Premium discount of approximately 10-15 percent.

HMO Model

You must visit a designated HMO medical centre as your first point of contact. Premium discount of approximately 15-25 percent.

Telmed Model

You must contact a telemedicine hotline before seeking in-person medical care. Premium discount of approximately 20-30 percent – the highest savings.

Cantonal Premium Differences

One of the most significant factors affecting your health insurance premium is your canton of residence. Premiums can vary dramatically between cantons – sometimes by more than 77 percent!

2026 Premium Overview by Canton

Highest Premium Cantons:

• Geneva: Approximately CHF 562/month
• Ticino: Approximately CHF 555/month
• Basel-Stadt: Approximately CHF 540/month

Lowest Premium Cantons:

• Zug: Approximately CHF 317/month – LOWEST premiums
• Appenzell Innerrhoden: Approximately CHF 335/month
• Uri: Approximately CHF 358/month

Major Health Insurance Companies

Switzerland has over 50 health insurance companies. While all insurers must offer identical basic insurance benefits mandated by law, they differ in premiums, customer service quality, and digital tools.

Top Insurers by Customer Numbers:

• CSS Insurance – Largest health insurer in Switzerland
• Helsana – Second-largest with extensive national network
• Assura – Known for competitive premiums
• SWICA – Consistently ranks number 1 for customer satisfaction
• Concordia – Strong focus on families
• Sanitas – Known for innovation and digital solutions

Best for English-Speaking Expats:

• SWICA: Excellent English customer service
• Sanitas: Strong English support and documentation
• CSS: Good English services, largest network
• Helsana: Comprehensive English support

Cost Optimisation Strategies

• Annual payment discount: Pay premiums annually for approximately 2 percent discount
• Compare annually: Premiums vary significantly between insurers
• Choose right deductible: Only CHF 300 or CHF 2’500 make sense
• Select appropriate model: Telmed offers highest savings for healthy individuals

What is Covered by Basic Insurance

• Doctor visits and consultations
• Hospital stays (general ward)
• Medications on the official list
• Laboratory tests and analyses
• Physiotherapy (prescribed)
• Maternity care and childbirth
• Emergency care
• Preventive examinations

What is NOT Covered:

• Dental care (except accident-related)
• Eyeglasses and contact lenses
• Private or semi-private hospital rooms
• Most alternative medicine
• Cosmetic procedures

Changing Your Insurance

Cancellation Deadlines:

• Standard deadline: Cancel by 30 November for 1 January change
• Special termination right: Within 30 days of receiving premium increase notification

Common Mistakes to Avoid

• Choosing middle deductibles: CHF 500-2’000 deductibles rarely make financial sense
• Not comparing annually: Premium differences of CHF 1’000+ per year are common
• Missing deadlines: Late cancellation means waiting another year
• Ignoring model requirements: Violating model rules can result in denied claims

Resources and Tools

Official Government Resources

Priminfo.ch – Federal Premium Comparison Tool

Website: www.priminfo.ch

The official premium comparison tool operated by the Federal Office of Public Health (FOPH). Enter your postal code, age, and desired coverage to see all approved insurance premiums for your specific location. Available in German, French, and Italian. This is the most authoritative source for comparing premiums as all insurers must submit their rates here.

Federal Office of Public Health (FOPH/BAG)

Website: www.bag.admin.ch

The Swiss federal authority responsible for health insurance regulation. Provides official information on:

• Annual premium announcements and statistics
• Changes to health insurance law
• List of approved insurance companies
• Benefits covered by basic insurance
• Patient rights and complaint procedures
• Official premium data downloads

Independent Comparison Platforms

Comparis.ch

Website: en.comparis.ch/krankenkassen

Switzerland’s leading independent comparison service with English interface. Features include:

• Premium calculator with all deductible and model options
• Customer satisfaction ratings (Comparis Label)
• Detailed insurer profiles and reviews
• Supplementary insurance comparison
• Educational articles and guides
• Direct application through the platform

Bonus.ch

Website: www.bonus.ch

Independent comparison platform particularly strong in French-speaking Switzerland. Offers:

• Comprehensive premium comparisons
• Annual customer satisfaction surveys
• Savings calculator showing potential annual savings
• News about premium changes and reforms
• Free switching assistance

Moneyland.ch

Website: www.moneyland.ch/en

Comprehensive financial comparison service with excellent English content. Provides:

• Interactive premium calculator
• Deductible optimisation tool
• Detailed guides on insurance models
• Customer satisfaction rankings
• Articles explaining Swiss health insurance system
• Comparison of supplementary insurance options

Cantonal Resources

Premium Reduction Subsidies by Canton

Each canton administers its own premium reduction (subsidy) programme for low and middle-income residents. Contact information for major cantons:

• Zürich: SVA Zürich – Social Insurance Office
• Bern: GEF Bern – Health and Welfare Directorate
• Geneva: République et Canton de Genève
• Vaud: Canton de Vaud
• Basel-Stadt: Kanton Basel-Stadt

To find your cantonal authority, search for “Prämienverbilligung” (German), “réduction de primes” (French), or “riduzione dei premi” (Italian) along with your canton name.

Additional Helpful Resources

ch.ch – Swiss Government Portal

Website: www.ch.ch/en/health

Official Swiss government information portal with clear explanations in English about:

• How the Swiss health insurance system works
• Your rights and obligations
• How to switch insurance companies
• What to do if you cannot afford premiums

Santé Info Droits – Patient Rights

For questions about patient rights, medical bills, or disputes with insurers, various cantonal patient advisory services are available. Search for “Patientenstelle” (German), “bureau des patients” (French), or “ufficio dei pazienti” (Italian) in your canton.