Swiss basic health insurance (KVG/LaMal), explained for expats
Basic insurance is mandatory for everyone living in Switzerland - you have three months from arrival to sign up, and cover is backdated to your first day. Here's exactly what it covers, what it costs, and how to choose well without overpaying.
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What basic insurance (KVG/LaMal) is
Basic insurance is Switzerland's compulsory, universal health cover - identical benefits at every insurer, guaranteed acceptance, and no health- or income-based pricing.
Basic health insurance is regulated by the Federal Health Insurance Act - Krankenversicherungsgesetz (KVG) in German, Loi sur l'assurance-maladie (LaMal) in French. Every person resident in Switzerland must hold a policy within three months of arriving, regardless of nationality, permit type or employer.
Cover is sold by around 40 private insurers, but the benefit catalogue is fixed by law and identical everywhere. That means an MRI, a hospital stay or a course of physiotherapy is reimbursed the same way whether you're insured with CSS, Helsana, Sanitas, SWICA or Assura. Only the price you pay and the service around it differ.
Acceptance is guaranteed: no medical questionnaire, no rejection, no surcharge for pre-existing conditions, and no discount for being wealthy or healthy. As of 2025 this makes Swiss basic insurance one of the fairest access systems in the world - and also one of the more expensive, which is why smart comparison matters.
What basic insurance covers
KVG/LaMal covers medically necessary outpatient, hospital, maternity, medicine, accident and emergency care - the everyday medical basics, in full quality, everywhere.
Basic insurance includes:
- Outpatient GP and specialist treatment
- Hospital treatment in the general ward of a hospital on your canton's list
- Prescription medicines on the approved list (Spezialitätenliste)
- Maternity care and childbirth, with no cost-sharing
- Accidents, if you're not already insured through your employer
- Emergency treatment, in Switzerland and, in a limited way, abroad
What basic insurance does not cover well: private or semi-private hospital rooms, most dental care, glasses and contact lenses for adults, most alternative medicine, and planned (non-emergency) treatment abroad. These gaps are typically closed with supplemental insurance (VVG), which is optional and priced individually.
Is it covered by basic insurance?
Tap an item to see the status and a short note.
GP & specialist visits
CoveredCovered after your franchise + 10% retention.
Estimates as of 2025. Details differ by canton and plan.
How cost-sharing works: franchise + 10%
You pay an annual franchise first, then 10% of what comes after (capped), plus a small hospital contribution - the insurer covers the rest.
Swiss basic insurance uses a three-part patient contribution designed to keep everyday care affordable while nudging people to use it thoughtfully:
- Franchise (deductible) - an annual amount you pay before the insurer contributes. Adults choose between CHF 300 and CHF 2,500; children between CHF 0 and CHF 600.
- 10% retention (Selbstbehalt) - once your franchise is used up, you pay 10% of further costs, capped at CHF 700 per year for adults and CHF 350 for children.
- Hospital contribution - a small daily contribution of CHF 15 towards hospital stays.
Everything above these caps is paid by the insurer. Because a higher franchise trades a lower premium against more out-of-pocket risk, the right level depends on your expected use. See Choosing your franchise for the break-even maths.
What it costs and why premiums vary
Premiums are billed per person and set by insurer, canton, region, age group, franchise and accident cover - identical benefits, very different prices.
Switzerland doesn't do a family rate for basic insurance: everyone in the household - including babies - has their own premium. Those premiums are recalculated each autumn and depend on six factors:
- The insurer and the care model you choose
- Your canton and premium region (typically 1-3 within a canton)
- Age group: child (0-18), young adult (19-25) or adult (26+)
- Your chosen franchise
- Whether accident cover is included
- Any small policy add-ons (e.g. bonus programmes)
Because the cover is identical and never depends on your health, the levers to lower cost are simple:
- Compare and switch insurers, ideally every year
- Raise your franchise if you're healthy and rarely see a doctor
- Choose an alternative care model - family doctor, HMO or telemedicine - in exchange for a lower premium
- Drop accident cover if your employer already insures you for accidents (mandatory from eight hours per week)
Lower-income residents may also qualify for cantonal Prämienverbilligung (premium reductions). Every canton runs its own scheme, and many expat households qualify in their first year without realising it.
The three-month deadline (and what happens if you miss it)
You have three months from your commune registration to enrol, but cover is backdated to your arrival date - so choose promptly, and the canton won't choose for you.
The typical order of events for a newcomer looks like this: register your address at the commune within 14 days of arrival, gather quotes across insurers for the same profile, and enrol before the three-month deadline. Your policy start date will be set to your arrival date, so you owe premiums for that time in any case.
Miss the window and your canton will assign you to an insurer directly. That insurer is rarely the cheapest in your region, and you still owe the back-premiums to your arrival date. Enrol newborns immediately - their cover also runs retroactively, so a late enrolment doesn't save any money and can cause administrative pain.
How to choose your basic insurance
Pick a franchise, pick a care model, compare across insurers, and review yearly - then add supplemental cover only where it earns its keep.
The practical steps, in order:
- Pick a franchise that matches your expected use. See Choosing your franchise.
- Choose a care model: standard (free doctor choice), family doctor, HMO or telemedicine. Alternative models lower your premium in exchange for agreeing a first point of contact.
- Compare across insurers. Same cover, big price spread. Start with Compare premiums.
- Review each year. Premiums move; the best insurer for you can change annually. See Switching insurer.
- Add supplemental cover where it clearly earns its keep - dental, semi-private, worldwide. Supplemental insurance.
Cross-border commuters follow their own rules - see Cross-border commuters for the Optionsrecht and how to decide.
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Is Swiss basic health insurance mandatory for expats?
Yes. Anyone living in Switzerland must take out basic insurance (KVG/LaMal) within three months of arriving. Cover is backdated to your registration date, so there's no gap - and you generally can't opt out (limited exceptions apply, such as some cross-border commuters and posted workers).
How long do I have to sign up?
Three months from the day you register in Switzerland. Once you enrol, cover starts retroactively from your arrival, so you're insured from day one.
Does the coverage differ between insurers?
No. The basic benefit catalogue is fixed by law and identical at every insurer. Only the premium, the service and the optional extras differ - so comparing is purely about price and service, not cover.
Can an insurer reject me or charge more for my health?
Not for basic insurance. Acceptance is guaranteed and premiums never depend on your health or income. Supplemental insurance is different - there, insurers can ask health questions.
Why are the premiums so different?
Premiums vary by insurer, canton, region, age group, your chosen franchise and whether accident cover is included. For identical cover you can pay hundreds of francs less a year just by comparing and switching.
How can I lower my premium?
Choose a higher franchise if you're healthy, pick a family-doctor, HMO or telemedicine model, drop accident cover if your employer insures you, and compare insurers every year. Lower-income residents can also apply for cantonal premium reductions.
What if I miss the three-month deadline?
Your canton assigns you an insurer, often not the cheapest, and you still owe premiums back to your arrival date. It's much better to choose within the window.
Not sure which basic insurance to pick?
Run the free comparison for your postcode, or talk it through with an expat advisor - whichever suits you better. Both are free and non-binding.