Expat Savvy · Annual index · 2026 edition · Basic insurance (KVG)
The Expat Health Insurance Index 2026 — a decade of Swiss basic insurance premiums, analysed
The Expat Health Insurance Index 2026.
A decade of every officially approved Swiss premium — 2016 to 2026, six cantons, every insurer — analysed for the questions internationals actually have: what your postcode really costs, why "cheapest" never lasts, and what a yearly review is worth.
Every figure computed from the approved tariff files the Federal Office of Public Health publishes as open data · tariff years 2016–2026 · no estimates, no interpolation
What this index measures
Basic insurance is identical by law. The price is not.
Mandatory basic insurance buys the same legal benefits at every insurer — so everything that varies is pricing: canton, premium region, insurer, franchise, model, and the year you last looked. We measured all of it, over eleven tariff years.
tariff years of approved premiums, 2016–2026
spread in decade increases between Zürich insurers
the Zürich city line — region 1 vs region 2, identical coverage
average reign of a "cheapest" insurer in Zürich
Your postcode prices you twice
Once by canton — Geneva's median premium runs CHF 113 a month above Zürich's — and once by premium region within it: Zürich region 1 is the city alone, and crossing the city line to Horgen or Küsnacht is worth CHF 57 a month at the median.
"Cheapest" is a temporary title
In Zürich the crown changes hands every 2.75 years on average; the 2016 winner slid to mid-table within five years of losing it. Zug's crown moved five times in seven years. Only Geneva kept one cheapest insurer all decade.
They do not raise premiums the same
Across 27 Zürich insurers present all decade, increases range from +26.8% to +94.6%. The cheap insurers of 2016 raised hardest; the expensive ones barely moved. Yesterday's bargain quietly became today's median.
The switching prize has shrunk — we say so
The cheapest offer sat 26% below the Zürich median in 2016; today it is 6.8%. Chasing cheapest is worth a third of what it was — which is exactly why a review now looks at model, franchise and region before it looks at the logo.
Where you live, part one
Six cantons, one decade.
Median approved premium for the reference adult, by tariff year. Toggle the cantons you care about; hover a line to isolate it.
Zug 2026 is not a market signal. The canton covers 99% of inpatient hospital costs for 2026–27, so premiums fell 14.7% — the only decrease in the dataset. Through 2025, Zug had the highest decade increase of the six (+51.7%).
Vaud's decade increase — the fastest, with Bern (+49.7%) and Zürich (+47.3%) just behind
Basel-Stadt — the slowest riser of the six, barely two thirds the pace of Vaud
the Geneva–Zug gap by 2025, up from CHF 202 — where you register is a four-figure annual decision
Against everything else you buy
Premiums against inflation.
Everything re-based to 2016 = 100: the six cantonal premium medians against the official Swiss consumer price index. The dashed line is your groceries, rent and everything else.
Cantonal lines: median approved premium, reference profile, indexed to 2016. Dashed: BFS Landesindex der Konsumentenpreise, yearly averages (2026: published months to July). Zug’s 2026 dip is the cantonal hospital-cost subsidy.
Where you live, part two
The Zürich city line.
Canton Zürich has three premium regions — and region 1 contains exactly one municipality: the city itself. Winterthur, Horgen, Thalwil, Küsnacht and Uster are all region 2.
Median premium per region, reference profile. Region 2 includes Winterthur and the lake municipalities; region 3 is the countryside.
The insurers
They do not all rise the same — check yours.
All 27 insurers present in Zürich for the full decade, one grey line each; the dashed line is the market median. Pick an insurer to see its actual path — increases from 2016 to 2026 range from +26.8% to +94.6%, a spread of 67.8 percentage points.
Monthly premium, reference profile, Zürich region 1. The pattern across all 27: the insurers that were cheap in 2016 raised hardest, the expensive ones converged down toward the pack — the cheapest 2016 insurer started CHF 134 a month below the flattest riser and finished above it. The year you last compared matters more than the logo on your card.
The crown
"Cheapest" is a temporary title.
Who held the cheapest approved premium in Zürich region 1, year by year — and how long a reign lasts.
Monthly premium of the cheapest qualifying offer, reference profile. Several of the small funds that take the crown are licensed only in parts of Switzerland — cheapest-in-canton is not available-to-everyone, which is its own trap.
average reign; the 2016 winner held five years, then slid to rank 15 of 29 by 2025
the most volatile crown — five changes in seven years; one winner ranked 20 of 27 three years later
the exception: one insurer cheapest every single year — canton context changes the advice
Your arrival, your habits
Slide to your arrival year — then choose how often you really review.
The scenario every newcomer lives: you arrive, sign with that year's cheapest insurer, and then review as often as real life allows. Three paths on real approved tariffs: yours, the yearly review, and the median payer.
more than the yearly review, cumulated since arrival
what the median payer gave up over the same window — the cost of never comparing at all
switches your strategy made — each one is one letter before 30 November
The lottery of your arrival year — cost of never reviewing, per cohort
Whether "never looking again" cost you CHF 82 or CHF 1'766 depends on which insurer happened to win your arrival year — pure luck, only visible in hindsight. The yearly review removes the lottery.
Simulation on the officially approved tariffs of the 27 insurers present in Zürich region 1 for the whole decade (every year's cheapest is among them). "Review" = move to the cheapest at your cadence, hold in between; the yearly path is the same with cadence one. List prices, reference profile.
This chart, run on your actual policy — including the model, franchise and subsidy questions the tariff files cannot see — is the first half of a review. .
The shrinking prize, canton by canton
Annual saving from moving off the median offer to the cheapest, 2016 against 2026. The loss-leader era ended — which is exactly why a review is about model, franchise and region before it is about the logo.
The market
Who is the biggest — and what size did to prices.
Insured people per insurer group (2024 business year, BAG data), with each group's decade of Zürich increases alongside. Size and price behaviour turn out to be different questions.
people in mandatory basic insurance — the whole country, by law
of the market held by the ten biggest groups; the two largest were the gentlest on increases
insurers offering our reference profile in Zürich over the decade — consolidation is the quiet backdrop
† Groupe Mutuel = Mutuel + Avenir + Philos; Visana Group = Visana + sana24. Increase shown is the group's main entity. The cross-reading worth keeping: the giants CSS (+30.4%) and Helsana (+28.8%) drifted least, while the cheap-entry books — Assura +94.6%, Groupe Mutuel +70.2% — raised hardest. Big does not mean expensive; standing still does.
The fine mechanics
Franchise and model — what the tariff files actually say.
The franchise discount is pinned — stop shopping for it.
The premium reduction for the CHF 2'500 franchise is legally capped at 70% of the extra risk you carry (Art. 95 Abs. 2bis KVV): CHF 1'540 a year. In 2026, 21 of 27 Zürich insurers file exactly CHF 1'539.60 — the cap on the filing grid — and the total spread across all 27 is CHF 19.20 a year. There is nothing to optimise between insurers here.
CHF 2'011the break-even: below this expected annual medical spend, the CHF 2'500 franchise wins; above it, CHF 300 does.
Model discounts held for eleven years — and grew in francs.
Hausarzt, HMO and Telmed discounts are regulatorily anchored and have barely moved as percentages — HMO sat at 16–17% in every single year. But because premiums grew, the franc savings grew with them.
| Model | Discount 2016 | 2026 | Saves in 2026 |
|---|---|---|---|
| Family doctor | 13.7% | 13.9% | CHF 874/yr |
| HMO | 17.0% | 16.4% | CHF 1'083/yr |
| Telmed | 15.0% | 16.0% | CHF 992/yr |
Median discount against the same insurer's own standard model, Zürich region 1. The constraint that matters: the model must fit your GP and your tolerance for gatekeeping — which is a fit question, not a price question.
Where the data ends
What the index cannot see.
Four things that decide what you actually pay — and never appear in a tariff file. This is the working list of a first review.
The accident toggle almost every newcomer misses
Employed 8 hours a week or more? Accidents are covered by your employer's insurance — yet arrivals routinely pay for accident cover twice. Excluding it from basic insurance saves a median CHF 421 a year in Zürich (we computed it across all 27 insurers in this index). It is the first thing we check on any new arrival's policy.
The subsidy nobody claims
Everything above is a list price. Every canton reduces premiums below income thresholds (IPV) — and internationals in their arrival year, with partial-year income, qualify more often than they think. The application is cantonal paperwork with its own deadlines; checking eligibility is a standard part of our review.
Two deadlines carry the whole plan
Three months to register after arrival — premiums accrue retroactively either way. Then 30 November, every year, to switch for January. A decade of analysis is only worth money to someone who acts on the calendar; we run it for clients every autumn.
The two layers don't have to share one logo
Your basic and supplementary insurer can be different companies. Basic is a commodity that should follow price every year; supplementary is underwritten and often shouldn't move at all. Splitting them lets each layer be optimal — it is why we publish two indexes, and why bundling for a small discount is so often the wrong trade.
Methodology
How the index was built.
- What is measured
- Mandatory basic health insurance (KVG/LAMal) — the layer whose benefits are identical by law at every insurer. Supplementary insurance has its own index.
- Source
- The officially approved tariff files the Federal Office of Public Health publishes as open data (dataset "Krankenversicherungsprämien", opendata.swiss), tariff years 2016–2026 — every insurer, canton, premium region, age class, franchise and model.
- Reference profile
- Adult (26+), accident cover included, CHF 2'500 franchise, standard model with free choice of GP; per insurer its cheapest qualifying tariff. City premium regions (Zürich region 1; single-region cantons as filed).
- Averages
- Medians are unweighted medians of the offers on the market that year — a market description, not an enrolment-weighted average, so they will not match the BAG's published "mittlere Prämie".
- Verification
- Every headline number was spot-checked against the raw tariff rows with independent parsers; regional assignments were validated against the EDI premium-region ordinance (SR 832.106), and the extraction reproduces the legal 15% regional cap to the rappen.
Before you cite it
Known limitations.
- Offers, not people. Medians describe the market of available offers; what the average person pays depends on where enrolment sits.
- A shrinking panel. Insurers offering the reference profile in Zürich fell from 46 to 27 over the decade; year-to-year medians ride that consolidation.
- Zug 2026 is political. The canton covers 99% of inpatient hospital costs for 2026–27; Zug's decade trend is honest only on a 2025 endpoint.
- Small-fund availability. Several cheapest-in-canton winners are small funds licensed only in parts of Switzerland; cheapest-in-canton is not available-to-everyone.
- One profile. The reference adult with CHF 2'500 franchise is the analytical anchor; your age class, franchise and model shift the levels, though rarely the patterns.
- List prices. Premium subsidies (IPV) and mid-year corrections are out of scope.
Source: BAG, dataset "Krankenversicherungsprämien" (opendata.swiss / opendata.bagnet.ch), tariff years 2016–2026 · insurer names per the BAG Verzeichnis der zugelassenen Krankenversicherer, January 2026 · premium regions per V. des EDI über die Prämienregionen (SR 832.106) · franchise cap per Art. 95 Abs. 2bis KVV, model cap per Art. 101 Abs. 3 KVV · analysis Expat Savvy, August 2026. Cite as: The Expat Health Insurance Index 2026, Expat Savvy. Not financial advice.
Common questions
Frequently asked.
How much do basic insurance premiums differ within one canton?
Do all Swiss insurers raise premiums by the same amount?
Is the cheapest insurer a safe long-term choice?
Which franchise should I choose — CHF 300 or CHF 2'500?
Do Telmed, HMO and family-doctor models still pay off?
Who is the biggest health insurance provider in Switzerland?
How do premium increases compare to inflation?
How much can I save by switching basic insurance today?
The index says what the market did. A review says what you should do.
Canton, region, model, franchise, insurer — read against your life, once a year, in English.
Free · 45 minutes · In English · With Robert or Hans
Your arrival year is on the chart. The simulator shows the market. A 45-minute review runs it on your actual policy — model, franchise, region, subsidies included.
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