You have found a flat, signed a contract and booked the removal van. Then someone mentions that you must also choose a health fund within three months. Health insurance in Switzerland surprises many Europeans because it is compulsory, private and chosen by you, rather than tied to your employer or the state. The principle is simple once you see it, and the deadline is the only part that needs attention.
How does health insurance work in Switzerland?
Under the Federal Health Insurance Act (LAMal in French, KVG in German), everyone who lives in Switzerland must take out basic health insurance with a recognised insurer, called a fund (caisse-maladie, Krankenkasse). Funds are private companies, but basic cover is the same everywhere: they must offer the same benefits, and the differences lie in price and in the model you pick. You choose the fund yourself, and you can change it.
Premiums depend on three things:
- the fund;
- your canton and region of residence;
- the deductible you select (see Swiss health insurance deductible).
The FOPH's official comparison site is priminfo.ch. Use it before you sign, since basic cover is identical and the price is what varies.
What is the three-month rule?
You have three months after taking up residence, or after the birth of a child in Switzerland, to join a fund. The deadline comes from article 3, paragraph 1 of the law.
- Within three months: cover is retroactive to the day you arrived. If you come to work, it starts when you begin your activity.
- After three months: cover starts only on the date you join, and an additional premium can be charged for an unjustified delay. The canton monitors compliance and can assign you to an insurer if you do nothing.
The most common trap is to think that registration at the commune fixes your domicile. For LAMal, domicile is where you live with the intention of settling; registration is not the only criterion. If in doubt, join a fund early rather than late.
Does the EHIC cover you at first?
Before you leave, take your European Health Insurance Card. It covers necessary care in your first weeks. It is not a substitute for Swiss insurance once you live here, it does not cover private care and it does not pay for repatriation. British citizens can use the GHIC for temporary stays, but not as a replacement either.
How do you join a fund and start health insurance in Switzerland?
- Register at your commune (see moving to Switzerland: the step-by-step guide).
- Compare funds on priminfo.ch, choose a deductible and a model.
- Apply to the fund. You need ID and proof of domicile, such as your permit or a commune certificate. Each fund lists the documents on its form.
- Insure your family: spouse, children under 18 and older children who are dependent.
- Receive your insurance card. Your AHV number appears on it (see AHV number in Switzerland).
If you do not work and want a B permit, the SEM requires that you hold health and accident insurance covering all risks, and Swiss insurance for stays over three months.
If you are in one of the unusual cases, such as a posted worker, a pensioner paid from another EU country or a cross-border worker, the right answer depends on European forms like the S1. Moovy can help you identify the form to ask for and the authority to approach, though the canton decides if you are exempt.
Who can be exempt from Swiss health insurance?
The law recognises exceptions, mostly based on European coordination rules. The main ones:
- Seconded workers, who keep the cover of their home country using the European forms.
- Certain cross-border workers, in the cases the law provides (the G permit is explained in Swiss residence permit for EU citizens).
- Pensioners paid by an EU country (or Iceland, Norway or the UK) who have no entitlement to a Swiss pension: they are not subject to Swiss insurance and remain insured by the pension country, with form S1. The canton, which controls affiliation, will ask you for it (article 2 of the health insurance ordinance, OAMal).
Ask for the exemption from your cantonal authority, or from the Common Institution LAMal in cantons where it deals with this (online request, decision announced in three working days). Do not simply skip insurance: if you have neither affiliation nor exemption, the canton can enrol you with an insurer.
How do you choose a fund and a model?
Because basic cover is the same, you compare three things: the monthly premium, the deductible and the insurance model. The FOPH notes that models which restrict your choice of doctors, for instance a family-doctor model, can lower the premium, but it advises you to read the terms carefully before choosing one. The discount compared with the ordinary model cannot exceed 50%.
A simple method: enter your canton, age and the deductible you think you can afford on priminfo.ch, sort by price, then look at the three or four cheapest funds and check how each describes its model. Do not forget that supplementary insurance is a separate contract with separate rules from the compulsory basic cover. Basic cover does not include everything you may expect, so ask what your plan pays before you need it.
How do you change fund later?
You can change fund every year. The notice of cancellation must reach your current insurer by 30 November; the postmark does not count, so the FOPH suggests registered mail or A-Post Plus by mid-November. Sign up with the new insurer at the same time and do not wait for confirmation. You cannot change if you still owe money to your current insurer on 31 December and received a payment reminder by 30 November. Funds must tell members their premiums for next year by 31 October, which gives you a month to compare. Mid-year changes are possible only for the standard model with the CHF 300 deductible, with notice received by 31 March.
What about accident cover?
Accident cover sits inside the basic policy unless you are covered by your employer. According to ch.ch and the FOPH, employees who work at least eight hours a week for one employer are insured against accidents through that employer. In that case you can ask your health fund to exclude accident cover from your policy. Below eight hours a week, non-work accidents are not covered by the employer, so keep the accident cover in your policy. Insurers must still charge at least 50% of the ordinary premium for the age group and region, whether or not accident cover is included.
What does health insurance in Switzerland cost?
You pay a monthly premium, then a share of your care costs yourself. The FOPH states that after your deductible is used up, you pay 10% of the costs, capped at CHF 700 a year for adults and CHF 350 for children and adolescents. In hospital you also pay a contribution of CHF 15 per day. The standard deductible is CHF 300 for adults and nothing for children. For 2027, the FOPH announced an average premium of CHF 412 a month, up 5.0%; your own premium depends on your canton, fund and choices. Cantons may grant premium reductions to people with modest incomes.
What mistakes should you avoid?
- Letting the three months go by. You lose the retroactive effect.
- Counting on the EHIC. It is for visits.
- Skipping the check for accident cover when you work for an employer.
- Choosing by price alone. Look at the deductible and the model that comes with the price.
- Forgetting the family. Spouse and children need cover too.