Swiss basic health insurance — called KVG in German (Krankenversicherungsgesetz), LAMal in French, and LAMalin Italian — is compulsory for everyone living in Switzerland. It's not employer-provided, it's not government-provided, and it's not optional. You buy it yourself from a private insurer, and you pay the full premium out of pocket.
This sounds expensive — and it is. But here's the important part: the benefits are identical across every insurer in the country. By law. So while your neighbor might pay CHF 340 per month and you pay CHF 290, you're both covered for exactly the same things. This article explains how the system works, how to choose a provider, and how to lower your premium without losing coverage.
Mandatory within 3 months
What KVG covers
The Federal Health Insurance Act defines a mandatory catalog of benefits that every KVG policy must cover. This includes:
- Visits to general practitioners and specialists
- Emergency care and hospital stays (general ward)
- Pregnancy, childbirth, and postnatal care
- Prescription drugs on the official list
- Preventive care (vaccinations, cancer screenings)
- Physiotherapy (with a doctor's referral)
- Basic dental care — but only for specific conditions
- Mental health treatment (therapy, psychiatry)
- Medical aids like crutches, hearing aids, wheelchairs
What KVG does NOT cover
Several things people assume are covered are actually not:
- Routine dental work (cleanings, fillings, implants)
- Glasses and contact lenses (for adults)
- Private or semi-private hospital rooms
- Free choice of hospital outside your canton (with limits)
- Alternative medicine (unless your policy specifically includes it)
- Cosmetic procedures
- Gym memberships and fitness benefits
For these, you need supplementary insurance (Zusatzversicherung) — a separate, optional product that insurers can price individually based on your health.
How the Franchise (deductible) works
The Franchise is the amount you pay out of pocket each calendar year before your insurance kicks in. You choose your level when you sign up, and you can change it every December for the following year.
| Franchise | Annual savings on premium | Best for |
|---|---|---|
| CHF 300 (standard) | Baseline | Frequent doctor visits, chronic conditions |
| CHF 500 | ~CHF 140 | Occasional visits |
| CHF 1,000 | ~CHF 390 | Mostly healthy adults |
| CHF 1,500 | ~CHF 500 | Very healthy, rare doctor visits |
| CHF 2,000 | ~CHF 600 | Same |
| CHF 2,500 (maximum) | ~CHF 750 | Maximum out-of-pocket savings |
After the Franchise, you still pay a 10% co-payment (Selbstbehalt) on bills up to an annual cap of CHF 700. Children have a lower cap of CHF 350 and can choose a zero-Franchise option.
How to choose your Franchise
Insurance models: save up to 20% on premium
By agreeing to see a specific doctor or network first, you can lower your premium. These are called "alternative models."
Standard model
Free choice of any doctor, specialist, or hospital in Switzerland. The most expensive option, but maximum flexibility.
Hausarzt (family doctor)
You choose a family doctor and always see them first before specialists. Saves around 10–15%. Good for people who prefer consistency.
HMO (health maintenance organization)
You're registered at a specific group practice. You always go there first. Saves 15–20%. Downsides: limited to one location, may have longer waits.
Telmed (telemedicine)
You must call a 24/7 medical hotline before seeing any doctor. They'll advise over the phone or refer you. Saves 12–18%. A good balance for healthy people who rarely need care.
Emergency exceptions
How to choose a provider
Since benefits are identical, price and service are the only real differentiators. Your approach should be:
- Go to Priminfo.admin.ch, the official federal comparison tool. Enter your postal code, age, and desired Franchise. You'll see every insurer ranked by price.
- Filter by model (Telmed, HMO, Hausarzt) if you're willing to trade flexibility for savings.
- Check reviews for customer service. Cheaper insurers sometimes have slower claims processing. Popular choices include Assura, KPT, Helsana, CSS, and Swica.
- Sign up directly on the insurer's website or through a broker. Brokers don't cost you anything — they earn a commission from the insurer.
How to switch providers
You can change KVG providers every year, but the deadlines are strict:
- Standard switch: give written notice by November 30, switch effective January 1.
- Premium increase switch:if your current insurer raises rates, you can switch by November 30 even if you're mid-contract.
- Send the cancellation by registered post (Einschreiben). The insurer must receive it by the deadline — a postmark isn't enough.
You can only switch afteryour new insurer has confirmed they'll accept you (they must, by law, for basic KVG). Don't cancel the old policy until the new one is confirmed in writing.
Premium reductions (subsidies)
If your taxable income is below certain thresholds, you may qualify for a cantonal premium reduction (Prämienverbilligung). The income cutoff and amount vary by canton — in Zurich a single person earning under CHF 45,000 may qualify, while in Geneva it's closer to CHF 50,000. Apply through your cantonal tax authority.
Next steps
KVG is complicated the first time you deal with it, but straightforward once you understand the levers: canton, age, Franchise, and model. Get comfortable with those four and you'll save hundreds of francs per year.
Not sure which model fits your situation? Our free risk analysis factors in your age, health profile, and usage patterns to recommend the right Franchise and model for you.