Question 1

Is health insurance mandatory in Switzerland?

Accepted Answer

Yes. Everyone resident in Switzerland must take out basic insurance (OKP) within 3 months. This applies from birth and to foreign nationals after they move here.

Question 2

Are the benefits the same at every insurer?

Accepted Answer

Yes. Basic-insurance benefits are set by law (KVG). Whether you are with CSS, Helsana, SWICA or Assura, you get exactly the same benefits, only the premium and the service differ.

Question 3

Does the insurer have to accept me?

Accepted Answer

Yes. Every insurer must accept you for basic insurance regardless of age, health or pre-existing conditions. No health check, no waiting period and no rejection is possible.

Question 4

What does basic insurance cover?

Accepted Answer

It covers doctor's visits, hospital stays in the general ward, medicines on the specialities list, lab tests, physiotherapy, pregnancy and birth, emergency care and psychiatric treatment. It does not cover dental treatment (except after accident or serious illness), glasses and contact lenses, most alternative medicine, or a private room in hospital.

Question 5

What are the different insurance models?

Accepted Answer

There are four main models: standard (free choice of doctor, dearest premium), family doctor (see your GP first, 10 to 15% off), Telmed (call a medical hotline first, 10 to 20% off) and HMO (treatment at an HMO centre, 15 to 25% off). Benefits are identical in every model.

Question 6

What is the difference between basic and supplementary insurance?

Accepted Answer

Basic insurance is compulsory, defined by law and identical at every insurer. Supplementary insurance is voluntary, benefits vary and a health assessment is required.

Question 7

How high is the average premium in 2026?

Accepted Answer

The average monthly premium across all age groups in 2026 is CHF 393.30 (+4.4% on 2025). Young adults (19-25): CHF 326.30 on average. Adults (26+): CHF 465.30. Children (0-18): CHF 122.50.

Question 8

Why do premiums vary by canton?

Accepted Answer

Healthcare costs differ by region. Geneva and Basel have more doctors, more specialists and higher costs than rural cantons, so premiums are higher in urban cantons. Cheapest canton: Appenzell Innerrhoden; most expensive: Geneva and Basel-Stadt.

Question 9

Do premiums rise every year?

Accepted Answer

Usually, but not always by the same amount. Recent changes: 2022 +0.1%, 2023 +6.6%, 2024 +8.7%, 2025 +6.0%, 2026 +4.4%. In the canton of Zug premiums even fell 14.7% for 2026.

Question 10

What determines my premium?

Accepted Answer

Five factors: your canton and municipality, your age band (0-18, 19-25, 26+), your chosen deductible (CHF 300 to 2'500), your model (standard, family doctor, Telmed, HMO) and your insurer (different prices for identical benefits).

Question 11

What are my maximum costs per year?

Accepted Answer

Your maximum yearly contribution is the premium plus the deductible (CHF 300 to 2'500) plus the excess (max CHF 700 for adults, CHF 350 for children). With a CHF 2'500 deductible, maximum out-of-pocket is CHF 2'500 + CHF 700 = CHF 3'200 a year, on top of premiums.

Question 12

What is the deductible (Franchise)?

Accepted Answer

The deductible is the amount you pay yourself each calendar year before the insurer steps in. You can choose from six levels: CHF 300, 500, 1'000, 1'500, 2'000 or 2'500 (children: CHF 0 to 600). The higher the deductible, the lower the monthly premium.

Question 13

What is the excess (Selbstbehalt)?

Accepted Answer

Once your deductible is used up, you pay a 10% excess on all further costs, up to a maximum of CHF 700 a year (children: CHF 350). After that the insurer pays 100%.

Question 14

Which deductible should I choose?

Accepted Answer

Rule of thumb: less than CHF 2'200 in yearly treatment costs means the CHF 2'500 deductible (saves CHF 1'500 to 2'300 in premiums). Regular visits or medication mean the CHF 300 deductible.

Question 15

Can I change my deductible?

Accepted Answer

Yes: increase it from 1 January (apply by 30 November) or lower it from 1 January (apply by 30 November). Changes during the current year are not possible.

Question 16

Does the deductible apply per person or per family?

Accepted Answer

Per person. Each family member has their own deductible and excess. Some insurers do offer family discounts on the premium.

Question 17

By when can I switch health insurer?

Accepted Answer

Main date: cancel by 30 November to switch on 1 January. Second date: with the CHF 300 deductible and standard model you can also cancel by 31 March to switch on 1 July. We recommend sending your cancellation by registered post by 15 November.

Question 18

Do I lose benefits when I switch?

Accepted Answer

No. Basic insurance is identical at every insurer. The new insurer must accept you with no health check and no waiting period. Note: supplementary insurance is not automatically transferable.

Question 19

How much can I save by switching?

Accepted Answer

On average CHF 426 a year, and up to CHF 3'800 where the price gap is large. The switch itself takes about 15 minutes.

Question 20

How do I switch health insurer?

Accepted Answer

Four steps: 1) compare premiums, 2) send your cancellation to your old insurer by registered post, 3) apply online to the new insurer, 4) done, the switch happens seamlessly on 1 January.

Question 21

Can the new insurer reject me?

Accepted Answer

No. Basic insurance has a duty to accept. But supplementary insurance can involve a health assessment and rejection. Tip: apply for supplementary insurance at the new insurer first, and only then cancel your basic insurance.

Question 22

Which supplementary plans are there?

Accepted Answer

Three main categories: hospital cover (semi-private/private: single room, chief physician, free hospital choice, CHF 50 to 400+ a month), outpatient add-ons (glasses CHF 150 to 300 a year, alternative medicine, fitness contributions, from CHF 10 to 40 a month) and dental insurance (check-ups, fillings, orthodontics for children, from CHF 8 to 30 a month).

Question 23

Do I need dental insurance?

Accepted Answer

Dental treatment is not covered by basic insurance (except after accident or serious illness). A check-up plus dental hygiene costs CHF 200 to 400 a year. Dental insurance is worth it above all for children (orthodontics) and people with frequent treatment.

Question 24

Is there a health assessment?

Accepted Answer

Basic insurance: no (duty to accept). Supplementary insurance: yes. You complete a health questionnaire and, depending on pre-existing conditions, are accepted, accepted with reservations, or rejected. Tip: take out supplementary insurance while young and healthy.

Question 25

Can I cancel supplementary insurance separately?

Accepted Answer

Yes. Basic and supplementary insurance are independent. You can switch your basic insurance and keep your supplementary plan (or vice versa). But because of bundle discounts, a package at the same insurer can be worthwhile.

Question 26

Which supplementary insurance is most worthwhile?

Accepted Answer

For most people: dental insurance (teeth are expensive and not covered by basic insurance) and outpatient cover (glasses, alternative medicine). Hospital cover only if a single room and chief-physician treatment matter to you.

Question 27

Who is entitled to a premium reduction?

Accepted Answer

People in modest financial circumstances. Income thresholds vary widely by canton (CHF 40'000 to 55'000 for single people). Children get at least an 80% reduction and young adults in education at least 50%. Almost 30% of all insured people in Switzerland receive a premium reduction.

Question 28

How do I apply for a premium reduction?

Accepted Answer

Apply to your cantonal social-insurance office (online or by form), enclosing proof of income and assets and, for students, proof of education. Many cantons set a deadline of 31 March. The reduction is paid directly to your insurer.

Question 29

How high is the premium reduction?

Accepted Answer

It depends on the canton. Example Zurich: your own share is 8.4% of income (single people) or 10.5% (married), with the canton covering the difference to the premium. On an income of CHF 35'000 with a CHF 400 monthly premium, that is about CHF 155 a month.

Question 30

Is the premium reduction paid automatically?

Accepted Answer

No. In most cantons you have to apply for it actively. Some cantons (e.g. Zurich from 2026) check automatically using tax data and notify those eligible.

Question 31

What can I do if my insurer will not pay?

Accepted Answer

Three steps: 1) request a written ruling (a reasoned decision), 2) file an objection with the insurer within 30 days, 3) if unsuccessful, appeal to the cantonal insurance court.

Question 32

What is the health insurance ombudsman?

Accepted Answer

A free, neutral mediation body for problems with your insurer (tel. 041 226 10 10, Mon-Fri 9 to 11.30). The ombudsman reviews your case and intervenes with the insurer if a decision is wrong.

Question 33

Can my insurer cancel my basic insurance?

Accepted Answer

No. Basic insurance cannot be cancelled, by you or the insurer (except when switching to another insurer). If premiums are unpaid, however, the insurer can suspend benefits.

Question 34

What happens with unpaid premiums?

Accepted Answer

Reminders, then debt collection, then suspension of benefits (the insurer only pays for emergencies). The canton covers 85% of the losses, but you remain on the defaulters' list. Tip: apply for a premium reduction early or arrange instalments.

Swiss health insurance, frequently asked questions (FAQ) 2026

Basic insurance (OKP), frequently asked questions

Premiums and costs, frequently asked questions

How much are you overpaying?

Deductible and excess, frequently asked questions

Switching health insurer, frequently asked questions

Switch now and save

Supplementary insurance, frequently asked questions

Premium reduction, frequently asked questions

Problems and complaints, frequently asked questions

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