Health insurance in Switzerland (LAMal): expat guide 2026

LAMal (Loi fédérale sur l'assurance-maladie) is the Swiss mandatory basic health insurance scheme. Every person residing in Switzerland must subscribe within 3 months of establishing residency. Unlike most European health systems, LAMal is not funded through payroll taxes: premiums are paid monthly by the individual directly to the insurer. The insurer cannot refuse to cover you for the basic LAMal policy regardless of your health status, age, or prior conditions. What varies between insurers is the premium amount and the quality of complementary insurance (LCA) offered alongside the mandatory basic policy.

How premiums work: franchise and cost-sharing

The LAMal premium structure has two cost-sharing elements: the annual deductible (franchise) and the co-payment (quote-part). The franchise is the amount you pay yourself before insurance kicks in, from CHF 300 to CHF 2,500 per year. Once you have paid your franchise for the year, insurance covers 90% of costs and you pay 10% (the quote-part/Selbstbehalt), up to an annual maximum of CHF 700 for adults. Choosing a high franchise (CHF 2,500) significantly reduces your monthly premium (by approximately CHF 150–200/month), but you pay more if you need healthcare that year. If you are young and healthy, the high franchise is typically financially optimal. If you are older or have ongoing medical needs, the low franchise is usually better.

Complementary insurance (LCA)

Beyond the mandatory LAMal, many residents subscribe to complementary insurance (assurance complémentaire / Zusatzversicherung) governed by the LCA (Loi sur le contrat d'assurance). Key options:

• Semi-private or private room hospitalisation: LAMal covers only a standard (general) ward in your canton. Semi-private (shared room) or private (single room) coverage requires supplementary insurance: cost CHF 50–200/month.
• Medical treatment nationwide: LAMal covers hospitalisation in your canton only. For treatment anywhere in Switzerland without surcharges, a "libre circulation" supplement is useful.
• Dental: Dental care is NOT covered by LAMal (except for illness-caused dental problems). Separate dental insurance (CHF 30–80/month) or out-of-pocket payment is the norm. Dental costs in Switzerland are high: CHF 300–600 for a simple consultation and filling.
• Alternative medicine (médecine naturelle): Acupuncture, homeopathy, phytotherapy are partially covered under some complementary policies.

Frontaliers and expats from France: special rules

Cross-border workers ("frontaliers") who live in France and work in Switzerland have a choice: subscribe to Swiss LAMal or opt out in favour of French CMU/PUMA coverage (if eligible). This option (known as "droit d'option") must be exercised within 3 months of starting work in Switzerland. The choice has significant financial and practical implications: Swiss LAMal premiums are high but coverage is comprehensive; French PUMA for frontaliers is cheaper but has significant limitations for care obtained in Switzerland. The droit d'option decision is largely irreversible: choose carefully based on where you expect to receive most of your healthcare.

The droit d'option is a one-way door: pick LAMal or French PUMA based on where you'll actually get sick, not on which premium looks cheaper today.

Subsidies: LAMal is income-tested

Residents with lower incomes are entitled to premium subsidies (subsides LAMal / IPV) from their canton. Eligibility thresholds vary by canton and family situation. In Geneva, subsidies cover up to 100% of the premium for low-income households. In Vaud, partial subsidies apply up to a moderate income level. If your income is below approximately CHF 60,000–80,000 gross (depending on canton and family situation), check your eligibility on the cantonal social security and health services website. Many expats with moderate incomes miss out on significant subsidies simply because they don't know to apply. Note that LAMal premiums are deductible from taxable income in Switzerland; see our guide on taxes for expats in Switzerland for details.

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Frequently asked questions

When do I need to subscribe to Swiss health insurance?

Within 3 months of establishing residence in Switzerland. Coverage is backdated to your arrival date: you are insured from day one even if you subscribe on day 89. If you miss the 3-month deadline, the cantonal authority assigns you to a default insurer and you have no choice of franchise.

Can I use my European Health Insurance Card (EHIC) in Switzerland?

Switzerland is not an EU member, so the EHIC has limited applicability. EU/EFTA citizens have certain reciprocal agreements that may cover emergency treatment, but once you are a resident in Switzerland, you must subscribe to LAMal regardless. The EHIC applies only to temporary stays, not residence.

Does my employer pay for health insurance in Switzerland?

No. Unlike most European countries, Swiss health insurance is entirely individual. Employers are not required to contribute to LAMal premiums. Some employers in Switzerland voluntarily contribute a fixed amount (CHF 100–300/month) as a benefit, but this is not standard and must be specified in your employment contract.

Are LAMal premiums deductible from Swiss income tax?

Yes, partially. Swiss tax law allows you to deduct a capped flat amount for health insurance premiums, not the actual amount paid. The deduction ceiling varies by canton and filing status (typically CHF 1,700–3,500 per adult per year). If you are subject to withholding tax or file a standard return, consult our guide on taxes for expats in Switzerland to understand how the deduction applies to your situation.

Is Swiss health insurance linked to the pension system?

No, LAMal and the Swiss pension system are separate. Health insurance is funded entirely through individual monthly premiums. The pension system operates on three pillars: AVS/AHV (state pension), the occupational pension fund (LPP, 2nd pillar), and voluntary private savings (pillar 3a). For a full overview of how retirement contributions interact with your salary, see our guide on the Swiss pension system.