Basic Health Insurance in Switzerland
Understanding mandatory health insurance (KVG/LAMal) in Switzerland. Learn about coverage, costs, and choosing the right insurance model.
Understanding Basic Insurance
Basic health insurance (KVG/LAMal) is mandatory for everyone living in Switzerland. This requirement ensures that all residents have access to high-quality healthcare without facing excessive financial burdens.
The basic insurance package is standardized across all insurance providers, meaning the coverage is identical regardless of which insurer you choose. What differs are the service quality, premium costs, and available insurance models.
What's Covered?
✓ Included in Basic Insurance
- Doctor visits and treatments
- Hospital stays (general ward)
- Emergency treatment
- Prescription medications
- Pregnancy and childbirth
- Preventive care
- Vaccinations
- Mental health care
- Rehabilitation
✗ Not Included
- Dental care (except accidents)
- Vision care (glasses/contacts)
- Alternative medicine
- Private hospital rooms
- Cosmetic surgery
- Non-prescription medications
Insurance Models
Standard Model
Free choice of doctors throughout Switzerland
- Choose any doctor in Switzerland
- Direct specialist access
- No restrictions on medical providers
- Maximum flexibility
Family Doctor
Designated family doctor as first point of contact
- Personal relationship with doctor
- Coordinated care
- Specialist referrals when needed
- Lower premiums
HMO
Health Maintenance Organization model
- Care through group practice
- Integrated healthcare
- Significant premium savings
- Coordinated specialist care
Telmed
Initial consultation via phone/video
- 24/7 medical advice
- Convenient access
- Professional triage
- Lower premiums
Deductibles & Cost Sharing
Your deductible (franchise) is the amount you pay for medical expenses before insurance coverage begins. Higher deductibles mean lower monthly premiums.
Adults
| Deductible (CHF) | Premium Savings |
|---|---|
| 300 | 0% |
| 500 | 8% |
| 1000 | 12% |
| 1500 | 16% |
| 2000 | 20% |
| 2500 | 25% |
Children
| Deductible (CHF) | Premium Savings |
|---|---|
| 0 | 0% |
| 100 | 5% |
| 200 | 8% |
| 300 | 10% |
| 400 | 12% |
| 500 | 15% |
| 600 | 18% |
Premium Ranges
By Region
| Region | Monthly Premium (CHF) | Example Areas |
|---|---|---|
| Region 1 | 380-550 | Urban centers like Zurich, Geneva, Basel |
| Region 2 | 340-480 | Mid-sized cities, suburban areas |
| Region 3 | 300-420 | Rural areas, smaller towns |
By Age Group
| Age Group | Monthly Premium Range (CHF) |
|---|---|
| Children (0-18) | 90-140 |
| Young Adults (19-25) | 250-380 |
| Adults (26+) | 300-550 |
Accident Coverage
Who Needs Accident Coverage?
- Self-employed individuals
- Part-time workers (< 8 hours/week)
- Unemployed persons
- Retired persons
- Students without employment
Who's Already Covered?
- Full-time employees (via employer)
- Part-time workers (≥ 8 hours/week)
- Unemployment insurance recipients
- Disability insurance recipients
Frequently Asked Questions
- When do I need to get basic health insurance?
- You must obtain basic health insurance within 3 months of arrival in Switzerland or birth. Coverage is retroactive to the arrival/birth date.
- Can I be rejected for basic insurance?
- No, insurers must accept everyone for basic insurance regardless of age, health status, or pre-existing conditions. This is mandated by Swiss law.
- How do I choose between different insurance models?
- Consider factors like premium savings, preferred doctors, and flexibility needs. Standard models offer full choice but cost more, while restricted models (family doctor, telemedicine) offer savings.
- What happens if I don't pay my premiums?
- Unpaid premiums can lead to debt collection and your canton may restrict you to emergency-only care. It's important to contact your insurer immediately if you have payment difficulties.
- Can I switch insurance providers?
- Yes, you can switch basic insurance providers by giving notice by November 30th for changes effective January 1st. Special termination rights exist when premiums increase.
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