Health insurance in Switzerland: a comprehensive guide for expats

Starting a new life in Switzerland comes with many tasks: applying for a residence permit, finding a place to live, opening a bank account. And sooner or later, after your first visit to the doctor, another important question arises: how does health insurance work in Switzerland?

The answer is straightforward: if you live in Switzerland, you must take out health insurance with an approved provider within 90 days. This obligation applies to all residents, regardless of nationality, age or employment status. Ignoring it can lead to being assigned a provider by the authorities, as well as retroactive premium payments – sometimes with a surcharge.

This guide will help you, as an expat, understand the essentials: how the Swiss insurance system is structured, which providers you can choose from, what costs you can realistically expect, and how to reduce them through smart choices.

An overview of the Swiss health insurance system

The system is based on the Federal Health Insurance Act (KVG/LAMal), which governs the mandatory basic health insurance covering essential medical services.

In short:

• Everyone living in Switzerland must be insured.

• Coverage includes illness, maternity and, in some cases, accidents (if no separate accident insurance exists).

• Health insurance is not tied to your employer – you choose your own provider.

Unlike in many other countries, health insurance in Switzerland is not arranged through your job. Instead, each individual selects their own provider. Around 60 private, non-profit insurers offer the legally required basic coverage. Benefits are the same across all providers – differences lie only in monthly premiums, the insurance model you select, and the quality of customer service.

In addition to basic insurance, you can take out optional supplementary insurance. This may cover dental treatment, alternative medicine or semi-private hospital stays. Unlike basic insurance, these policies are not regulated by the KVG and typically require a medical questionnaire. Some conditions or treatments may be excluded.

Compulsory cover and deadlines for expats

The insurance requirement applies to nearly everyone living in Switzerland – and that includes you as an expat. Once you arrive, you have 90 days to take out a basic policy. If you miss this deadline, the relevant authority can assign you a provider. In such cases, you must pay premiums retroactively – sometimes with a surcharge.

Are there exceptions? Yes, but they’re rare. Exemptions may apply to:

• Staff of international organisations or diplomatic missions

• Students with equivalent foreign coverage

• Cross-border commuters with EU/EFTA insurance

• Individuals receiving exclusive foreign pensions

For all other expats, the rule is clear: if you live in Switzerland, you must take out a basic policy with a recognised provider – even if you already hold a foreign policy.

Basic and supplementary insurance: what’s required and what’s optional?

Basic insurance covers a broad range of medical services, including doctor visits, hospital stays (general ward), prescription drugs, maternity care, and certain preventive measures like vaccinations and check-ups.

If you want broader coverage (e.g. more hospital choices, alternative medicine or coverage abroad), you can take out supplementary insurance. This is optional and designed by each insurer individually. A health check is usually required, and pre-existing conditions may lead to exclusions.

As an expat, you should only consider supplementary insurance if you genuinely need it – every extra policy comes with extra cost. For many people, basic insurance is enough for everyday needs.

Premiums, deductibles and co-payments: understanding the costs

Monthly premiums vary based on several factors, especially your age, place of residence, insurance model and deductible. The higher your deductible (known as the franchise), the lower your monthly premium – but you’ll pay more out of pocket when you need treatment.

The minimum deductible for adults is 300 CHF per year. At the other end, the maximum deductible is 2'500 CHF – which significantly lowers your premium but means you must pay that amount before your insurance covers anything. After reaching your deductible, a co-payment of 10% applies to further costs, capped at 700 CHF per year for adults (or 350 CHF for children). There’s also a fixed hospital fee of 15 CHF per day during inpatient stays.

In 2024, the average adult premium was around 357 CHF per month. In Zurich, for instance, a 30-year-old with a 300 CHF deductible would pay between 300 and 420 CHF, depending on the provider. With the maximum deductible, this drops to about 200 to 250 CHF.

Note: These figures are for illustrative purposes only. Actual costs vary depending on your canton, age, deductible, insurance model and personal situation. For accurate quotes, contact providers directly or use the official comparison tool at priminfo.admin.ch. Alpian does not offer health insurance products or provide specific recommendations.

Insurance models: flexibility or savings?

In Switzerland, the insurance “model” refers to how you access medical care – in other words, who you must contact first when you’re unwell. The benefits are the same across all models, but the route to treatment and your premium can vary.

1. Standard model: You have full freedom to consult any doctor directly, without prior approval. This flexibility comes at a cost – the standard model usually has the highest premiums.

2. Family doctor model: You agree to contact your chosen general practitioner first in case of illness. They coordinate your treatment and refer you to specialists if needed. Ideal for those who already trust their GP, this model offers premium reductions of around 10–20%.

3. HMO model (Health Maintenance Organisation): All treatment is provided within a defined network of doctors. While choice is more limited, the system is efficient and premiums are often lower than in the family doctor model.

4. Telmed model: Treatment begins with a phone consultation. You speak to a medical advice service first, and only after that – if necessary – are you referred for in-person care. This model suits people who prefer to discuss issues by phone and offers premium savings without compromising care quality.

Choosing the right provider: more than just price

Although all health insurers offer the same range of benefits under the basic plan, there are several important differences between them. As an expat, you should pay particular attention to service quality, digital processes and multilingual customer support. Some providers even offer dedicated programmes for international policyholders, including advice in English and simplified digital onboarding.

Among the largest and most well-known Swiss insurers are CSS, Helsana, SWICA, Sanitas, Assura, Groupe Mutuel and Visana. All of them are approved by FINMA (the Swiss Financial Market Supervisory Authority) and operate throughout the country.

To compare providers, you can use the federal comparison platform priminfo.admin.ch. Run by the government, this portal offers a transparent overview of premiums, insurance models and franchise options—without any commercial bias.

Reducing your healthcare costs

Choosing the right franchise is one of the most effective ways to manage costs. If you rarely need medical care, opting for a high franchise can be more economical, even if you end up paying more out of pocket in specific cases. If you require regular medical attention, a low franchise may be the better choice, avoiding thousands of francs in personal expenses each year.

Your choice of insurance model is another important factor. By selecting an alternative model such as the family doctor, HMO or Telmed approach, you can reduce your monthly premium by up to 20%, without sacrificing essential healthcare.

If you're employed and work more than eight hours per week, it’s also worth excluding accident coverage from your health insurance. In such cases, your employer provides mandatory accident insurance, allowing you to reduce your premium by around 7–10%.

Depending on your income and the canton where you live, you may also be eligible for premium subsidies. These are government contributions designed to help households with low or middle incomes. Applications must be submitted to the cantonal compensation office and are generally based on the previous year’s tax return.

One final tip: premiums change every year. By reviewing your policy regularly and comparing providers, you could save several hundred francs annually. Switching insurers is straightforward—just make sure to cancel by 30 November.

What about foreign insurance policies?

Many expats wonder whether their existing policy from abroad is still valid. In most cases, the answer is no. Once you become a resident in Switzerland, you are subject to compulsory health insurance, and foreign policies do not replace the basic coverage required under Swiss law.

If you already have a private international insurance policy, you may be able to keep it as a complement—for example, for worldwide coverage or specific treatments. However, it does not exempt you from taking out a Swiss basic insurance plan.

Conclusion: smart choices for solid protection

Switzerland’s healthcare system is complex, but also highly structured. As an expat, health insurance represents a financial commitment—but also offers access to one of the best healthcare systems in the world.

By understanding your options, you can keep costs under control without compromising on quality. A well-considered choice of franchise, model and provider—along with regular comparisons—can result in long-term savings.