Swiss Health Insurance (KVG): 3-Month Deadline, Franchises & Models Explained

Basic health insurance (KVG / LAMal) is legally mandatory in Switzerland. Everyone taking up residence must enroll with an approved Swiss health insurer within 3 months (90 days) of arrival, and coverage applies retroactively from the exact date of entry.

1. Select insurer, model & franchise: Because the statutory basic benefits catalog is identical across all Swiss providers, your choice comes down to regional monthly premiums, care models (Standard free choice, Family Doctor/GP, HMO group practice, or Telmed telemedicine), annual franchise, and digital customer service.
2. Exclude accident coverage if employed 8+ hours/week: Anyone working at least 8 hours per week for a single Swiss employer is automatically insured worldwide against occupational and non-occupational accidents via the employer (UVG) and can remove the accident module from KVG basic insurance—saving roughly 7% to 10%.
3. Submit application & file proof with your municipality: Once approved, your insurer issues the insurance certificate/policy required by your residential municipality (Einwohnerkontrolle) or cantonal health authority as proof of mandatory coverage.

• Waiting inside the 90-day window saves CHF 0: Municipal registration is due within 14 days, while KVG health insurance grants 3 months. However, if you sign up in month three, premiums are billed retroactively back to day one of arrival. Missing the 3-month deadline without valid justification leads to compulsory municipal assignment plus a statutory premium surcharge of 30% to 50% for double the duration of the delay.
• Cleanly terminating foreign coverage (GKV / PKV / national schemes): Foreign statutory or private policies do not cancel automatically upon moving. Submit your Swiss KVG policy confirmation together with your municipal deregistration certificate to avoid double contributions; if leaving private insurance (such as German PKV), review a dormancy option (Anwartschaft) before canceling so health underwriting and aging reserves remain protected.
• Cross-border commuters (Permit G): Commuters living in Germany, France, Italy, or Austria generally hold a formal 3-month option right (Optionsrecht) from starting work to either enroll in Swiss KVG commuter tariffs or apply for formal exemption via an approved policy in their country of residence.

Mandatory basic insurance (KVG) covers outpatient medical care, general ward hospitalization in your residential canton, maternity, and listed prescription drugs. For important coverage gaps, residents combine KVG with voluntary supplementary policies (VVG)—which you can hold with a completely different provider than your basic insurer:

• Hospital upgrades: Free choice of hospital across all of Switzerland, semi-private (two-bed) or private (single-bed) comfort, and senior physician choice.
• Emergency transport & abroad protection: Basic KVG caps Swiss ambulance transport at 50% up to CHF 500/year and rescue at 50% up to CHF 5,000/year—supplementary plans close high emergency and worldwide travel treatment gaps.
• Outpatient & dental benefits: Contributions toward adult dental care, orthodontics for children, eyeglasses/contact lenses, preventive check-ups, fitness memberships, and complementary medicine.

Important: Unlike basic KVG (which must accept every applicant regardless of health), VVG supplementary insurers conduct medical underwriting and may add exclusions or decline applications—never cancel existing supplementary coverage before written acceptance is in hand. Request a personal comparison →

Under basic KVG insurance, out-of-pocket cost sharing consists of two annual components per calendar year (maternity services are exempt from cost sharing):

• Annual Franchise (CHF 300 to CHF 2,500 for adults): The fixed annual amount you pay yourself toward medical bills before the insurer begins reimbursing. Adults can choose CHF 300, 500, 1,000, 1,500, 2,000, or 2,500. In practice, the intermediate tiers rarely optimize total cost: healthy adults expecting low annual medical bills (< ~CHF 1,700–1,800) typically choose CHF 2,500 (keeping a CHF 3,200 cash reserve), while those with recurring treatments choose CHF 300.
• 10% Deductible (Selbstbehalt): Once your chosen franchise is exhausted, the insurer pays 90% of further covered bills and you pay 10%, capped at CHF 700 per year for adults (CHF 350 for children). Your maximum annual KVG co-payment is therefore Franchise + CHF 700 (plus CHF 15/day hospital meal contribution for adults without young children).

Monthly KVG premiums depend on your residential municipality (premium region), age group (child 0–18, young adult 19–25, adult 26+), model, and franchise—never on salary. Below are indicative entry-level monthly adult benchmark values (in CHF) across all 26 cantons comparing a CHF 300 vs. CHF 2,500 franchise:

Note: Benchmark figures are orientation values only; exact premiums vary by municipality, birth year, tariff year, and care model. Always verify current federal tariffs via Priminfo linked below.

• No free family co-insurance: Unlike statutory family insurance in countries such as Germany, every resident in Switzerland—including non-working spouses, children, and newborns (within 3 months of birth; prenatal registration is recommended for supplementary plans)—must hold an individual policy.
• Child premiums & CHF 0 franchise: Children benefit from substantially reduced monthly premiums (roughly CHF 80 to CHF 170/month depending on canton, plus multi-child discounts at many insurers) and usually choose a CHF 0 annual franchise.
• Individual customization & cantonal subsidies (IPV): Each family member can choose a tailored franchise and model. Families and individuals on moderate budgets relative to household size should check cantonal individual premium reductions (Prämienverbilligung / IPV).