LAMal Grisioni: premiums, deductibles and reduction (cross-border guide)

Context

In a nutshell

• LAMal is mandatory health insurance for all Swiss residents
• Premiums vary by canton, region and insurer
• Adult allowances available: CHF 300, 500, 1000, 1500, 2000, 2500
• Cantonal subsidies reduce costs for those with modest incomes

Key facts

• What: LAMal is the private compulsory health insurance
• When: To be stipulated within 3 months of the transfer of residence
• Where: In all cantons, including Graubünden
• Who: All Swiss residents
• Deductibles: CHF 300, 500, 1000, 1500, 2000, 2500 for adults
• Premium reduction: Cantonal subsidy based on income and family situation

Health insurance in the canton of Graubünden, as in every Swiss canton, is based on a compulsory system of private coverage. Anyone who is a resident of Graubünden — whether a Swiss citizen or a residence permit holder — must have LAMal coverage within three months of changing residence. Unlike other countries, Switzerland does not have a public health insurance managed directly by the State. Each person must choose a recognized private insurer, which offers the mandatory basic package plus any additional coverages.

LAMal premiums are set by each insurer independently and vary at cantonal and regional level. In Graubünden, as in the other cantons, the monthly premium depends on three factors: the insurer chosen, the age class of the insured and the

Operational details

How Deductibles Work

The deductible is the first element of the partecipazione ai costi sanitari. If a person spends CHF 200 on doctor's visits and has chosen a deductible of CHF 300, these CHF 200 are not covered: they remain entirely at the patient's expense. Only expenses exceeding CHF 300 begin to be covered (partially) by the insurance, until the annual deductible is reached.

After reaching the deductible, the insured continues to pay 10% of the additional medical costs (so-called ticket) up to a maximum of CHF 700 per calendar year. After that limit is exceeded, the insurance covers 100% of the costs. This model is standard throughout Switzerland, including Graubünden, and allows you to contain rewards for those who are in good health, while ensuring protection against catastrophic medical expenses.

Alternative insurance models

In addition to the basic model with a choice of deductible, Graubünden and the other Swiss cantons offer alternative models such as HMO (Health Maintenance Organization) and models with a mandatory primary care physician. These models have slightly lower premiums than the basic model, in exchange for limitations in access to specialist doctors, who must be chosen within the insurer's network or sent by the treating doctor.

The choice between basic model, HMO or general practitioner depends on personal needs and health consumption habits. Those who change specialists often prefer the basic model; those who

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Key points

Subscription procedure and subsidy request

Those who reside in the canton of Graubünden and need LAMal health insurance must follow this procedure:

Step 1: Find out about the available prizes. Contact the active insurers in the canton (lists available on the administration's website) to compare the average premiums for Graubünden and the different deductibles. Each insurer publishes a transparent statement with the monthly costs.

Step 2: Choose the insurer and deductible. Evaluate the ratio between premium and deductible according to your health needs and economic capacity. Those who know they will have frequent medical examinations can choose low deductible (CHF 300-500); those who accept more personal costs opt for high deductible (CHF 1500-2500) and pay lower premium.

Step 3: Sign the contract. Complete the form online, by mail, or in person at the insurer's local agency. The start date of coverage is chosen by the insured (generally the first of the following month).

Step 4: Keep the documentation. Keep copy of confirmation of coverage for future use (required for medical visits, medications, hospital care).

Request for premium reduction subsidy

If the household income is below the cantonal thresholds, apply for subsidy:

Step 1: Check the income thresholds. Consult the site of the cantonal administration of Graubünden for the current thresholds for the current year.

Step 2: Fill in the

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