Swiss Health Insurance (KVG) Explained: Franchise, Models and Deadlines

• Compulsory within 3 months of arrival, backdated to arrival. No grace, no gap.
• Benefits are identical by law. Every insurer sells the same basic cover — only the price and service differ.
• Franchise choices: CHF 300, 500, 1,000, 1,500, 2,000 or 2,500 for adults.
• Plus 10% co-payment above the franchise, capped at CHF 700 a year for adults (CHF 350 for children).
• Models cut premiums: Telmed and HMO save roughly 8–20% versus free choice of doctor.
• Switching window: notice by 30 November for a 1 January start.

Compare real premiums for your canton and age band with our health insurance tool, and see where insurance sits in your first-90-days sequence in the just-arrived checklist.

Swiss healthcare is private delivery with mandatory purchase. There is no employer plan and no national health service: you buy a policy as an individual, from a private insurer, and the state defines exactly what it must contain.

Basic insurance (KVG / LAMal) covers: GP and specialist treatment, hospital in the general ward in your canton of residence, maternity, medication on the federal list, physiotherapy on prescription, emergency care, and a limited amount of preventive care.

It does not cover: adult dentistry, glasses and lenses for adults, private or semi-private hospital rooms, free choice of hospital across Switzerland, most complementary medicine, gym memberships, and elective treatment abroad. Those live in supplementary insurance (VVG), which is genuinely optional — and which insurers can decline or price up based on a health questionnaire. If you want it, apply while you are young and healthy.

Two more essentials for new arrivals:

• Every family member needs their own policy, including babies — register a newborn within three months of birth so cover is unconditional.
• Accident cover is included in KVG, but if you are employed for eight hours or more per week your employer's UVG accident insurance takes over. Tell your insurer and drop the accident element to shave a few francs off the premium.

A jargon-free walk-through of the whole system is in the Swiss healthcare system explained.

1. Arrive and register at your Gemeinde — see Gemeinde registration. The municipality logs your arrival date; that date is the clock.
2. Compare premiums for your postcode, age and franchise. Prices vary by canton and even by region within a canton.
3. Apply online with your permit or registration confirmation. Basic insurance cannot be refused, and there is no health questionnaire.
4. Get the policy backdated to your arrival date and pay the accrued months.
5. Send proof to your municipality if it asks — several cantons chase this automatically.

If you do nothing, the canton assigns you an insurer at a standard franchise and free choice of doctor: the most expensive combination on the market. That is the real penalty — no fine, just a permanently worse contract until the next switching window.

The franchise (deductible, Franchise/franchise) is what you pay yourself before the insurer contributes. Above it you still pay a 10% co-payment (Selbstbehalt) up to CHF 700 a year, plus CHF 15 a day for hospital stays.

Take a 30-year-old in Zurich as a worked example with typical 2026 premiums:

Read the pattern rather than the rows: the high franchise saves you a guaranteed ~CHF 1,380 every healthy year and costs you at most ~CHF 820 in a catastrophic one. Break-even sits around CHF 1,000–1,100 of annual medical spend. Unless you already know you will exceed that — planned surgery, pregnancy, chronic medication — the high franchise is the mathematically better bet, provided you can actually produce CHF 2,500 in cash if the bad year arrives.

Children are the exception: their franchise options run from CHF 0 to CHF 600, and CHF 0 is usually sensible because kids generate small, frequent bills. The full deductible breakdown, including hospital day contributions, is in Swiss health insurance deductibles explained.

Every model still exempts genuine emergencies, and most exempt gynaecology, paediatrics for your children and eye tests — check the small print of the specific product. The catch is procedural, not medical: if you skip the gatekeeper on a Telmed or HMO plan, the insurer can refuse to pay that bill. Estimate your own savings with the HMO vs Telmed model guide.

Premiums depend on canton, region, age band (0–18, 19–25, 26+), franchise, model and insurer. Rough 2026 monthly adult premiums at a CHF 2,500 franchise with a Telmed model:

Levers that genuinely move the number:

• Premium subsidies (Prämienverbilligung). Every canton subsidises households below an income threshold — commonly relevant up to roughly CHF 55,000–75,000 of taxable income for a single person, more with children. Many expats qualify in year one and never apply. Ask your canton directly.
• Pay annually or half-yearly for a discount of about 1–2% with many insurers.
• Drop accident cover if your employer's UVG applies (8+ hours a week).
• Switch every autumn. Premium rankings reshuffle each year; loyalty pays nothing because the product is identical.
• Keep basic and supplementary with different insurers if that is cheaper — bundling is a sales argument, not a legal requirement.

Premiums are not tax-deductible in full, but they feed into the insurance deduction on your tax return; and if you are taxed at source, see how that works in Quellensteuer vs regular assessment. To see the full monthly picture next to rent and tax, run the salary calculator and cost of living tool.

1. Compare in October, once the approved premiums for the coming year are published.
2. Apply to the new insurer first and get the acceptance confirmation.
3. Send registered written notice to your current insurer so it arrives by 30 November.
4. Keep supplementary insurance separate — VVG contracts often have longer notice periods (frequently three months to year-end) and can refuse a new application.
5. Check the new policy documents in January for the correct franchise, model and accident status.

Special case: if your insurer notifies a premium increase, you have a 30-day right to cancel regardless of the November date, as long as your outstanding premiums are paid. A head-to-head of the major insurers is in Swiss health insurance compared.

Sign up inside three months, take the CHF 2,500 franchise with a Telmed or HMO model unless you have a known medical need, check whether your canton owes you a premium subsidy, buy supplementary cover only for what you will genuinely use, and re-shop every single autumn. Those five decisions are worth well over CHF 1,500 a year to an average expat household.

Next step: open the free HowToSwiss canton checklist — it tracks your insurance deadline alongside registration, permits and taxes, tuned to your canton. Pick yours on the canton hub.