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El sistema sanitario suizo

El sistema sanitario suizo

Entender el seguro de salud básico, las franquicias, los modelos de seguro y el acceso a la atención médica.

El sistema sanitario suizo está reconocido como uno de los mejores del mundo, con rápido acceso a la atención, infraestructuras de vanguardia y libertad de elección de médico. Sin embargo, los costes son elevados: las primas del seguro de salud representan un importante gasto para cada hogar. Entender cómo funciona el seguro básico LAMal, las franquicias, los modelos de seguro y los circuitos de atención te permitirá tomar las decisiones correctas y controlar tus gastos sanitarios.

LAMal basic insurance: compulsory for everyone

Anyone residing in Switzerland must take out basic health insurance (LAMal) within 3 months of their arrival or birth. Affiliation is retroactive to the first day of residence. You freely choose your health insurance from among the sixty approved insurers, and can change each year.

Basic insurance covers an identical catalog of services regardless of the insurer: medical consultations, hospitalizations in a common ward, medications appearing on the list of specialties, laboratory analyses, prescribed physiotherapy, maternity (without excess or co-payment) and emergency care abroad (limited amount).

Premiums vary greatly depending on the canton of residence, the insurance model chosen and the deductible. In 2026, the average monthly premium will be around CHF 380 for an adult, but can range from CHF 250 in the cheapest cantons to more than CHF 500 in Geneva or Basel.

  • Affiliation deadline: 3 months after arrival (retroactive coverage)
  • Libre choix de la health insurer
  • Identical catalog of services for all insurers
  • Change of fund possible each year (deadline: November 30)
  • Cantonal subsidies available for low incomes

Deductible and co-payment: how it works

The deductible is the annual amount you pay out of pocket before the insurance begins to reimburse. You choose your excess when subscribing, between CHF 300 (minimum) and CHF 2,500 (maximum) for adults. A high deductible reduces your monthly premium, but increases your co-payment in the event of care.

Once the deductible is reached, you still pay a 10% share of the healthcare costs, capped at CHF 700 per year for adults and CHF 350 for children. Beyond that, insurance covers 100% of the costs.

The maximum annual cost payable by you (excluding premiums) is therefore: deductible + maximum co-payment. Choosing the deductible is an important financial decision that depends on your state of health and your foreseeable medical consumption.

Annual franchiseMax shareMax cost at your expenseRecommended profile
CHF 300CHF 700CHF 1,000Families, chronic illnesses, planned pregnancy
CHF500CHF 700CHF 1,200Moderate medical consumption
CHF 1,000CHF 700CHF 1,700Good health, occasional consultations
CHF 1,500CHF 700CHF 2,200Good health, young adults
CHF 2,000CHF 700CHF 2,700Very good health, few consultations
CHF 2,500CHF 700CHF 3,200Excellent health, optimization of premiums

Family doctor and specialists

The family doctor (general practitioner or internist) is the gateway to the Swiss health system. He knows you, coordinates your care and directs you to specialists if necessary. Choosing a family doctor is recommended as soon as you arrive, even if you are in good health.

In Switzerland, you in principle have the free choice of doctor, unless you opt for a restrictive insurance model (family doctor, HMO or Telmed). Direct access to specialists is possible but often more expensive without referral from the general practitioner. Waiting times are generally short: a few days for a general practitioner, 1 to 4 weeks for a specialist.

To find a doctor, consult the online directories Docteur.ch (Romandie) or Doctolib.ch. Doctors saying “accepting new patients” are your target. In large cities, some group practices and medical centers (Medbase, Permanence) accept patients without an appointment.

Emergencies and hospitals

In the event of a life-threatening emergency, dial 144 (ambulance), 145 (poisoning) or go to the nearest hospital emergency room. For non-vital emergencies, medical hotlines and on-call services offer an alternative to hospital emergencies, often with shorter waiting times.

Hospitalization in a common ward (room with 2 or 4 beds) is covered by basic insurance. For a semi-private or private room, additional insurance is required. Free choice of hospital exists within your canton of residence and for hospitals appearing on the LAMal list of your canton.

The university hospitals (HUG in Geneva, CHUV in Lausanne, USZ in Zurich, Inselspital in Bern) offer cutting-edge care and are accessible to all residents.

  • 144 — Ambulance (vital emergencies)
  • 145 — Poison control center (poisoning)
  • 143 — The Outstretched Hand (urgent psychological help)
  • 1811 — Doctor on call (outside opening hours)
  • 112 — European emergency number

Pharmacies and medicines

Swiss pharmacies play a role of first recourse advisor. Pharmacists can treat minor ailments, dispense certain medications without a prescription and provide basic services (blood pressure measurement, COVID test, vaccination in certain cantons).

Medicines are classified into several categories: by prescription only (list A), by prescription or advice from the pharmacist (list B), over the counter in pharmacies (list C) and over the counter outside pharmacies (list D). The medicines reimbursed appear on the FOPH’s List of Specialties.

Generics are systematically offered by pharmacists and allow a saving of 20% to 60% compared to the original medication. Since 2024, the share on originals for which a generic exists has been increased to 40% (compared to 10% for the generic), which provides a strong incentive to accept the generic.

Alternative insurance models

Beyond the standard model (free choice of doctor), health insurance companies offer alternative models which reduce your premium in exchange for a restriction of your freedom of choice. The saving can reach 10% to 25% of the premium depending on the model and the insurer.

The family doctor model requires you to first consult your referring general practitioner, who coordinates all of your care. The HMO model attaches you to a group medical center that manages all of your services. The Telmed model requires a telephone call to a medical center before any physical consultation, except in an emergency.

ModelPrincipleSavings on premiumRecommended for
StandardFree choice of doctorNone (reference bonus)People with regular specialized monitoring
Family doctorMandatory visit to the general practitioner10% to 15%Families, people with attending physician
HMOCare in a group medical center15% to 25%People in town with HMO center nearby
TelmedPhone call before any consultation10% to 20%Young adults, people comfortable on the telephone

Preguntas frecuentes

¿Cómo cambiar de aseguradora de salud?
Puedes cambiar de aseguradora cada año. La carta de rescisión debe llegar a tu aseguradora actual a más tardar el 30 de noviembre para que sea efectiva el 1 de enero. Compara las primas en plataformas oficiales como priminfo.admin.ch o comparis.ch. La nueva aseguradora no puede rechazarte para el seguro básico, independientemente de tu edad y estado de salud. Atención: los seguros complementarios no se transfieren automáticamente y están sujetos a un cuestionario de salud.
¿Qué seguro de salud para mis hijos?
Los niños deben asegurarse individualmente desde el nacimiento. La prima infantil es significativamente más baja que la del adulto (alrededor de CHF 100 a CHF 150 al mes de media). La franquicia infantil va de CHF 0 a CHF 600. Recomendamos una franquicia de CHF 0 para los niños pequeños, ya que las consultas pediátricas son frecuentes. Puedes asegurar a tus hijos con una aseguradora diferente a la tuya para beneficiarte de las mejores primas.
¿Cómo funciona el seguro de salud durante el embarazo?
El embarazo y el parto están totalmente cubiertos por el seguro básico, sin franquicia ni participación en costes, desde la semana 13 de embarazo y hasta 8 semanas después del parto. Los controles prenatales, la ecografía, el parto (hospital o maternidad) y los cuidados posparto están cubiertos. Una comadrona puede también realizar el seguimiento en domicilio tras el parto. Para una habitación privada o un parto en un hospital fuera del cantón, es necesario un seguro complementario.

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