The three decisions
Franchise: CHF 300–2,500 – higher franchise, lower premium; choose high only if you rarely need care and hold the difference as a buffer. Model: standard, family doctor, HMO or Telmed – alternative models save 10–20%. Insurer: compare every autumn; switching for equal legal benefits is normal here.
What newcomers miss
Premiums are per person including children (with child rates), accident coverage can be excluded if your employer covers it (8+ hours/week), and roughly a quarter of residents qualify for premium reductions – worth checking, not assuming.
Premiums are your #2 fixed cost
After rent, premiums are most households' biggest fixed line – give each person's premium its own budget entry.
Track these costs in your own budget: create your free Swiss budget in BudgetHub – in English, with Swiss categories built in.
What basic insurance covers – and what it does not
Basic insurance (Grundversicherung) covers medically necessary treatment: GP and specialist consultations, hospital care in the general ward of your canton of residence, prescribed medication on the official list, maternity care and a defined set of preventive examinations. The catalogue is set by law, so every insurer covers exactly the same treatments.
What it does not cover surprises most arrivals: routine dental treatment, glasses and contact lenses for adults, most alternative medicine beyond a limited list, private or semi-private hospital rooms, and free choice of hospital outside your canton for non-emergencies.
Those gaps are the entire purpose of supplementary insurance (Zusatzversicherung) – a separate, voluntary contract with health screening, where insurers may decline applicants. This is why the two products must never be cancelled together.
Premiums: what actually drives your figure
Four factors: your canton and premium region, your age group, the franchise you chose, and the insurance model. Nothing else – not your health, not your claims history. Insurers may not price basic insurance by individual risk, which is why comparison is purely about price and service.
Children have their own, much lower premiums, and most insurers grant family discounts from the third child. For young adults there is a separate age band, and the jump when it ends catches many people unprepared.
Premium reduction (Prämienverbilligung) is a cantonal benefit for households below an income threshold. It is not automatic in every canton – several require an application, and unclaimed entitlements are among the most common avoidable losses in Swiss household budgets.
Practical first steps for new arrivals
Insurance is mandatory and must be arranged within three months of arrival – with retroactive cover and retroactive premiums back to your arrival date. Waiting does not save money; it simply produces a larger first invoice.
Choose the franchise deliberately rather than defaulting to the highest: the discount is only worth taking if the money to cover the risk exists. For a first year in a new country, a moderate franchise is often the more sensible choice.
If you already hold health insurance from an EU/EFTA country or a posting arrangement, an exemption may apply – but it must be requested from the cantonal authority within the same three months, and rejection later means retroactive premiums nonetheless.