Guide to health insurance in Switzerland

The LAMal system in brief

The LAMal (Federal Health Insurance Law) requires all Swiss residents to take out basic insurance within 3 months of their arrival. The services covered are identical regardless of the fund chosen: medical consultations, hospitalizations, medications on the list of specialties, laboratory analyses, prescribed physiotherapy, home care, maternity (without excess or co-pay).

Only premiums and customer service differ from one fund to another. You are free to choose your insurer from more than 50 funds. The funds cannot refuse you for basic insurance, regardless of your age or state of health.

• • Affiliation deadline: 3 months after arrival in Switzerland
• • Identical services at all funds
• • Obligation of acceptance by the insurer (no medical selection)
• • Coverage throughout Switzerland and emergencies in Europe
• • Maternity covered without deductible or co-payment

Understanding deductibles and co-payments

The deductible is the annual amount you pay out of pocket before the insurance begins to reimburse. It ranges from CHF 300 (minimum deductible, higher monthly premium) to CHF 2,500 (maximum deductible, lower premium). Beyond the deductible, you pay another 10% of medical costs (co-payment) up to an annual ceiling of CHF 700 for adults and CHF 350 for children.

The choice of deductible is strategic: if you rarely see a doctor, a high deductible reduces your premiums by CHF 100 to 200 per month. If you have regular treatments, the deductible of CHF 300 is more economical in total.

Alternative models

To reduce your premiums without increasing your deductible, you can opt for an alternative model which limits your freedom of choice of doctor in exchange for a reduction of 10 to 25% on premiums.

The family doctor model requires you to see your GP first, who then refers you to a specialist if necessary. The HMO model directs you to an integrated health center. The telemedicine model requires an initial telephone contact (e.g. Medgate, Medi24) before any physical consultation.

Supplementary insurance (LCA)

The LAMal does not cover everything. The most notable gaps concern routine dental care (only emergency treatments are covered), glasses and lenses (very limited package), alternative medicine (acupuncture, osteopathy), choice of hospital (private room, hospital outside the canton), care abroad beyond emergencies.

Supplementary insurance (LCA) fills these gaps. Please note: unlike the LAMal, insurers can refuse your application or apply reservations based on your state of health. It is therefore crucial to take out the supplements as soon as you arrive, when your health questionnaire is favorable.

• • Complementary outpatient care: alternative medicine, glasses, transport
• • Complementary hospital: private room, free choice of hospital
• • Dental insurance: routine care and orthodontics
• • Supplementary accident insurance: better coverage than the LAA
• • Daily allowance insurance: coverage in the event of long-term illness

Optimize your premiums every year

LAMal premiums change every year on January 1st. The OFSP (Federal Office of Public Health) publishes the new premiums at the end of September. You have until November 30 to change fund with effect from January 1. Compare premiums on priminfo.admin.ch (official site) or comparis.ch.

Changing fund does not change your basic benefits in any way. The old fund cannot object to this or retain your file, even if you have current invoices. The potential savings by changing funds can reach CHF 1,000 to 2,000 per year and per person.

Premiums by canton: the differences

Premiums vary considerably between cantons, reflecting differences in regional healthcare costs. The canton of residence has a major impact on your annual health budget.