Updated: April 2026

Unlike LAMal (basic insurance, mandatory, acceptance without conditions), complementary insurance is governed by the LCA (Insurance Contract Act). The insurer can refuse a candidate, impose reservations for pre-existing conditions, or apply waiting periods. These rules fundamentally change subscription logic.

What LAMal Does Not Cover (and Complementary Insurance May)
  • Semi-private or private hospital room, not covered by basic.
  • Routine dental care (cleaning, fillings, crowns), excluded except accident.
  • Alternative medicines (homeopathy, acupuncture, osteopathy), partially depending on insurer.
  • Glasses and contact lenses, reimbursement limited to CHF 180/3 years for adults via basic.
  • Hospitalization abroad, basic reimburses maximum double the equivalent Swiss rate.
  • Certain off-list medications (LAMal specialty list).

Hospitalization: General, Semi-Private, Private Wards

The most frequently subscribed complementary distinction in Switzerland is hospital insurance, which determines ward type (room type and attending physician choice).

Chosen hospital ward only applies to planned or non-urgent hospitalizations. In emergencies, patients are treated in general ward regardless of coverage. Upgrade to semi-private or private applies to scheduled hospitalizations: elective surgery, deliveries, planned surgery.

Often-ignored point: out-of-canton hospitalizations are covered by basic LAMal only if the hospital is on the insured person's cantonal list. For hospitalization in a hospital not on the list, the rate difference between cantons is patient-charged, unless "whole Switzerland" supplementary insurance is purchased.

Dental Insurance: The Costliest Gap

In Switzerland, routine dental care (cavities, cleaning, crowns, implants) is not covered by LAMal. Dental health is considered individual responsibility, a unique position among OECD countries with mandatory health insurance.

Complementary dental insurance generally reimburses 75-90% of expenses within annual limits (CHF 500 to CHF 3,000 depending on product). For an adult without particular dental issues, annual dental insurance cost (CHF 300-600/year) may exceed reimbursed amounts. For families with children in orthodontics, or adults with foreseeable dental needs, dental insurance is typically worthwhile.

Insurers often apply 3-6 month waiting periods before dental care coverage, and exclude treatments already begun or planned before subscription. Subscribing in good dental health is the only way to optimize coverage.

Comparing Insurers: Practical Criteria

Major insurers active in Switzerland in 2026 for complementary: CSS, Helsana, Swica, Groupe Mutuel, Assura, Visana, Sympany. Available official comparators: comparis.ch (independent third party, FOPH-certified data) and priminfo.admin.ch (FOPH, official data).

Comparison criteria:


Frequently Asked Questions

Can you subscribe to complementary insurance at any time of year?

Yes for subscription, but the insurer can refuse or impose reservations after health status examination (medical questionnaire). Unlike LAMal, there is no mandatory annual opening period. Thus possible to subscribe mid-year, but caution applies: don't wait for a health event to request complementary coverage.

What exactly does basic LAMal cover for hospitalization abroad?

LAMal reimburses emergency care abroad within double the rate that would be charged in Switzerland for the same treatment. In practice, in high medical-cost countries (USA, Japan, Australia), this ceiling is quickly reached. "World" complementary or travel insurance covers this gap for temporary stays. For expatriates permanently leaving Switzerland, LAMal no longer applies.

Is it possible to change complementary insurers?

Yes, respecting contract cancellation terms (generally 3 months before annual deadline). But the accepting insurer must conduct new medical examination, and can refuse or impose reservations the previous insurer didn't apply. Changing complementary is riskier than switching basic (where acceptance is mandatory and unconditional).

Do cross-border workers have access to Swiss complementary insurance?

Cross-border workers subject to LAMal (some cantons allow exemption for those with equivalent French coverage) can subscribe to Swiss complementary. But coverage only has practical utility for Swiss care, cross-border workers primarily treated in France have little interest in Swiss hospital complementary.

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