Obligation and principles
Since 1996, anyone residing in Switzerland must take out basic LAMal insurance within 3 months of arrival. This insurance covers healthcare in case of illness and maternity, partially accidents (if not covered by employer via UVG).
Fundamental principles:
- Freedom of choice: you choose your insurer among more than 50 funds
- Identical catalogue: all insurers offer the same basic benefits
- No medical selection: your health does not influence the premium
- Risk equalisation: insurers with low-risk populations transfer to those with high-risk
- Annual change possible: termination with notice before 30 November for effect 1 January
Premium structure
Your monthly premium depends on four parameters:
- Age: 3 categories (0-18, 19-25, 26+), with a sharp increase at 26
- Canton and region: premiums vary by 1x to 2x between cantons
- Chosen deductible: CHF 300 to 2,500/year for adults
- Insurance model: standard, family doctor, telemedicine, HMO
Example: for a 30-year-old adult in Geneva, the monthly premium oscillates between CHF 350 (economy model, CHF 2,500 deductible) and CHF 600 (standard model, CHF 300 deductible).
Choosing your deductible
The deductible is the amount of medical expenses you pay yourself each year before insurance takes over. Adult options:
- CHF 300: the lowest, highest monthly premiums
- CHF 500
- CHF 1,000
- CHF 1,500
- CHF 2,000
- CHF 2,500: the highest, lowest premiums
Beyond the deductible, you still pay 10% of costs (coinsurance), capped at CHF 700/year.
Rule of thumb: if you consume little care (< 2 visits/year), a high deductible (CHF 1,500 to 2,500) is advantageous. If you consume regularly, opt for CHF 300 or 500.
Alternative models
Alternative models offer 10 to 20% premium discounts in exchange for a guided care path:
- Family doctor: you must consult a referenced family doctor first before any specialist
- Telemedicine: you must call a phone platform before any consultation
- HMO (Health Maintenance Organization): you consult exclusively in a designated practice
- Care network (PPN): less strict variant of family doctor model
These models are advantageous for healthy people who rarely consult and accept the path constraint.
Supplementary insurance
Basic insurance covers essentials but not everything. The most useful supplements:
- Semi-private or private hospitalisation: single room, free choice of doctor (CHF 250 to 800/month)
- Alternative medicine: osteopathy, acupuncture, homeopathy (CHF 30 to 60/month)
- Dental care: coverage of routine or orthodontic care (CHF 50 to 150/month)
- Death and disability capital: payment to loved ones in case of misfortune
- Costs abroad: useful for cross-border workers or frequent travellers
Supplements are not mandatory and may be refused for medical reasons (risk selection).
Individual premium reduction (RIP)
If your income is modest, the canton grants you an automatic or on-request premium reduction:
- In French-speaking Switzerland, thresholds vary between CHF 70,000 and 110,000 of determining income for a family
- The amount can reach 40 to 60% of the premium depending on situation
- The request goes through the cantonal social insurance service
- Young adults in training often benefit from specific aid
Check your eligibility even if you think you do not qualify: many people fail to apply unnecessarily.
Optimise and compare
Good practices:
- Compare every year via Priminfo.ch (official, free) or Comparis (private)
- Switch insurers without fear: basic insurance is identical everywhere
- Adapt the deductible: a lifestyle change (intense sport, baby project, etc.) should trigger a review
- Negotiate supplements: some accept rebates for bundling
- Keep receipts: keep all statements for tax deduction
A 30-minute annual review can save CHF 500 to 1,500 per year for a household.
