Health insurance in Switzerland (LAMal): expat guide 2026
Health insurance in Switzerland is mandatory, individual (not employment-linked), and chosen from a list of approved private insurers. There is no state-run health service equivalent to the NHS: every resident must buy their own LAMal policy within 3 months of arrival, and the premiums are paid directly, not deducted from salary. For expats arriving from France, the UK, or countries with employer-sponsored health plans, the Swiss system is a significant adjustment, both in the administrative setup and in monthly budget impact. This guide covers the essentials.
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.
- Mandatory: must be subscribed within 3 months of arrival in Switzerland.
- Individual: each family member requires a separate policy (including children).
- Premium: varies by canton, insurer, age, and deductible chosen (CHF 300–10,000/year). Adult average in Geneva: ~CHF 600–750/month.
- Deductible (franchise): choose between CHF 300 (full premium) and CHF 2,500 (reduced premium). Lower deductible = higher monthly premium.
- Coverage: covers medical consultations, hospitalisation (semi-private ward in canton of residence), emergency, maternity, and chronic conditions.
- Comparison tool: priminfo.ch or comparis.ch; compare all approved insurers.
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.
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 services website. Many expats with moderate incomes miss out on significant subsidies simply because they don't know to apply.
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 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.