Mandatory Health Insurance
A Requirement for Every Resident of Switzerland
In Switzerland, obtaining health insurance is legally required. This applies to all individuals residing or working in Switzerland. You have the freedom to choose your health insurance company, where the so-called mandatory health insurance or basic insurance ensures that everyone living in Switzerland is fundamentally covered in case of illness, accident, as well as during pregnancy and maternity.
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What Conditions Apply in Mandatory Health Insurance?
Since 1996, the Health Insurance Law (KVG) mandates that every person residing or working in Switzerland must have basic insurance, which covers essential medical services. Insured individuals typically pay upfront for treatments and medications and subsequently receive reimbursement from their health insurance. Hospitals often settle accounts directly with the health insurance companies.
Coverage Includes
- Essential medical services
- Illness and accident coverage
- Pregnancy and maternity care
- Treatment and medication reimbursement
- Direct hospital billing
An individual insurance contract is necessary for each family member, as they are not automatically covered.
How Much Are Health Insurance Premiums?
Premiums for basic insurance are paid monthly and vary according to income, residential region, and age group, according to the premium regions and age categories set by the Federal Office of Public Health (FOPH). Currently, there are 43 such regions in Switzerland.
Monthly Payment
Premiums are paid monthly and vary based on income, residential region, and age group.
Premium Regions
There are currently 43 premium regions in Switzerland, each with different pricing structures.
Deductibles in Basic Insurance
In addition to the premium, there is a deductible, consisting of the annual deductible and a co-payment. The deductible is an amount up to which insured individuals cover their medical expenses themselves. Once your treatment costs exceed the set annual deductible, your health insurance covers the additional costs.
Standard Deductibles
- Adults: 300 Swiss Francs
- Children: 0 Swiss Francs
- Can be increased for premium savings
Higher Deductibles
- Adults: up to 2,500 Swiss Francs
- Children: up to 600 Swiss Francs
- Reduces monthly premiums
Co-payment Requirements
A co-payment of ten percent of the costs applies after the deductible is met.
For Adults
Maximum co-payment of 700 Swiss Francs per year.
For Children
Maximum co-payment of 350 Swiss Francs per year.
Important Notice
Although insurance is mandatory, citizens are free to choose their health insurance from a variety of approved providers. All health insurance companies offer the same legally required services, albeit at different premiums.