Swiss Health Insurance (Krankenkasse) Explained (2026)

How KVG (LAMal) works

The Krankenversicherungsgesetz (KVG) — LAMal in French, LAMal/Lamal in Italian — creates a universal mandatory health insurance system administered by ~50 private insurers. Every resident must hold a basic insurance policy (Grundversicherung) within 90 days of moving in, and coverage backdates to arrival. Insurers cannot refuse anyone or charge a different premium for health status: pricing varies only by canton, age band (0–18, 19–25, 26+) and franchise.

Basic benefits are defined federally: hospital care in your canton's general ward, outpatient care, prescription medicines on the approved list, maternity, mental health, basic dental for accidents. Anything outside this — private hospital room, dental routine care, gym, glasses — sits in the supplementary VVG market where insurers may refuse and charge as they like.

Average premiums by canton in 2026

The Federal Office of Public Health (BAG/OFSP) publishes premiums every September. For 2026, the national adult average rose ~6% to CHF 380/month on the standard CHF 300 franchise. Highest cantons: Geneva (CHF 460), Basel-Stadt (CHF 440), Ticino (CHF 420), Vaud (CHF 410). Lowest: Appenzell Innerrhoden (CHF 280), Uri (CHF 295), Nidwalden (CHF 305).

Children's premiums are roughly 25% of adult premiums (CHF 95–140), and young adults 19–25 pay 70–80% of full adult rates. Premiums always rise faster than inflation — typical annual increases of 3–8% — making the choice of model and franchise an important annual exercise.

Franchise (deductible) choices

You may pick a franchise of CHF 300, 500, 1,000, 1,500, 2,000 or 2,500 per year. Below your franchise you pay 100% of treatment costs. Above it, you pay 10% co-insurance up to an annual cap (CHF 700 adult / CHF 350 child). The standard CHF 300 franchise carries the highest premium; the CHF 2,500 franchise reduces the annual premium by CHF 1,540 on average.

Maths: choose CHF 2,500 only if your expected annual treatment cost is under approximately CHF 2,000. For most healthy adults under 50 with no chronic condition, the high franchise is rational and saves CHF 1,000+ per year on average. Switch back to a lower franchise the year you know expensive care is coming (planned surgery, pregnancy, dental orthognathic).

Alternative insurance models

Beyond the standard 'free choice of doctor' model, every insurer offers 10–20% premium discounts via:

Family doctor (Hausarzt) model: you nominate a GP who must refer all specialist visits. HMO model: similar but treatment goes through a managed-care group practice. Telmed: first contact with a telemedicine hotline before any in-person visit. Pharmacy model: certain conditions can be assessed at a partner pharmacy first.

For young, healthy people who rarely see specialists, these models save real money with little inconvenience. The exception is anyone with a chronic condition needing periodic specialist visits — the friction of every referral makes the standard model worth its higher premium.

VVG supplementary insurance

Supplementary VVG policies cover what KVG doesn't: semi-private or private hospital rooms, dental routine care, alternative medicine, gym subsidies, glasses, dental orthodontics, travel insurance, accident-abroad coverage. Unlike KVG, VVG insurers may refuse coverage based on health questionnaires and increase premiums based on claims.

Worth-buying: hospital semi-private (CHF 60–150/month adult) is often worth it if you value choice of surgeon; basic dental (CHF 20–40/month) rarely pays for itself unless you have specific predictable needs. Alternative medicine bolt-ons are popular but often add CHF 20–40/month for limited per-treatment caps. Always read the small print on age-based premium ramps — VVG premiums often double after age 45 or 60.

How to switch insurer

The standard switching window closes on 30 November each year for the next January 1, but practically you must send a registered letter (Einschreiben/recommandée) so it arrives by 31 October. Use comparis.ch or priminfo.admin.ch to compare quotes for your canton and franchise.

Switching is administratively simple: send written cancellation, your new insurer handles enrolment, the old insurer must close at year-end. You may switch franchise within the same insurer once per year (deadline also 30 November). If your insurer announces a premium increase above the cantonal average, you can also switch with one month notice at any time during the year.

Prämienverbilligung subsidies

Each canton operates a Prämienverbilligung (réduction de prime / riduzione premi) scheme funded jointly with the federal government. Thresholds vary widely: a single in Vaud qualifies up to ~CHF 50,000 net income; in Bern up to ~CHF 65,000; in Geneva up to ~CHF 95,000 for a single, CHF 130,000+ for families.

Subsidies are calculated on the prior year's tax assessment, so apply as soon as your first Swiss tax bill is issued. In some cantons subsidies are deducted directly from your premium; in others they're paid out separately. Apply even if you think you're above the threshold — many families are surprised. Apply annually; eligibility can change.