A simple guide to health and accident insurance in Switzerland. The amounts shown are those of basic insurance; always check your own policy.
LAMal: compulsory health insurance
Everyone resident in Switzerland must take out health insurance with a health insurer within three months of arriving or being born. Basic insurance (LAMal) covers medically necessary care: consultations, medicines on the official list, physiotherapy on prescription, hospital stays, and so on. Basic benefits are the same at all insurers; premiums and insurance models vary.
Deductible, co-payment and hospital contribution
- Deductible (franchise): the annual amount you pay yourself before the insurer contributes. Adults: from CHF 300 to CHF 2’500 (your choice). Children: CHF 0 by default, or CHF 500 as an option.
- Co-payment (quote-part): 10% of costs above the deductible, capped at CHF 700 per year for an adult and CHF 350 for a child.
- Hospital contribution: CHF 15 per day of hospitalisation for adults.
Pregnant women (during pregnancy and after childbirth) and certain other situations benefit from exemptions.
LAA: accident insurance
Employees are insured against accidents (occupational and, in general, non-occupational) by their employer under the LAA. People without salaried employment, or employed for fewer than eight hours a week with a single employer, must include accident cover in their basic LAMal insurance. In the event of an accident, report it promptly to your employer and your doctor; the rules on deductible and co-payment differ from those under LAMal.
Reimbursement model (tiers garant) and direct billing (tiers payant)
Tiers garant (you pay, then get reimbursed): you receive the invoice, pay it, then send it to your insurer, who reimburses you (after deduction of the deductible and co-payment). This is the default system under LAMal.
Tiers payant (direct billing): the healthcare provider sends the invoice directly to your insurer. You then pay only what remains your responsibility (deductible, co-payment), on an invoice from the insurer. This method is common in pharmacies and for hospital stays, and it can be agreed with a practice. Ask the practice which method it applies before your appointment.
Supplementary insurance
Supplementary insurance (LCA: alternative medicine, private or semi-private room, dental care, etc.) is optional and works according to the terms of each contract.
This information is general and does not constitute legal or insurance advice. For your own situation, contact your insurer or an independent broker. Last checked: October 2026. Source of amounts: Helsana, “Participation aux coûts” (cost sharing).