LAMal Guide 2026: obligation, cash and deductible (cross-border guide)

Context

In brief

• Mandatory health insurance for those residing in Switzerland
• Three months to register after arrival
• Minimum deductible CHF 300 per year, maximum CHF 2,500
• Cantonal subsidies reduce premiums based on income

Key facts

• What: Mandatory health insurance (LAMal)
• When: Within 3 months of taking up residence in Switzerland
• Where: Every canton (including Zurich) has its own premiums and subsidies
• Who: All residents of Switzerland, regardless of citizenship
• Amount: Deductibles from CHF 300 to CHF 2,500 per year

The LAMal system in Switzerland

Health insurance is one of the cornerstones of Swiss social protection. Unlike many European countries, there is no single national fund: the system is managed by private insurers operating at cantonal and regional level, with premiums that vary significantly from one area to another.

Anyone moving to Switzerland must take out a health insurance contract within three months of arrival. It is neither a tax nor a salary contribution: it is a private premium paid directly to the insurer, calculated on a per-capita basis. This means that each family member pays an individual premium, regardless of the family's income.

Deductible and coinsurance

The deductible is the amount the patient pays out of pocket before the health fund starts reimbursing. The options vary: CHF 300, CHF 500, CHF 1,000, CHF 1,500, CHF 2,000, CHF 2,500 per year. A higher deductible results in a lower monthly premium; a lower deductible means a higher premium. Once the deductible is reached, the patient shares medical costs (coinsurance) at rates defined by federal law.

The cantonal subsidy reduces the premium for those with low or medium incomes. Each canton, including Zurich, has its own eligibility criteria and subsidy amounts, reflecting local fiscal choices.

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Operational details

Practical implications: the weight of the premium on the family budget

The choice of the deductible has a direct impact on the annual budget. Those who opt for the minimum deductible (CHF 300) will pay a higher monthly premium than those who choose CHF 2500. For a family with children, this decision is multiplied: three deductibles from CHF 300 cost more than three from CHF 1000, but the initial financial sacrifice is less. The logic is simple: set aside more money each month for more covered insurance, or risk paying more at the time of medical recourse.

Cantonal subsidy: eligibility and procedure

The premium subsidy is calculated based on your family's net income. In the canton of Zurich, as in the other cantons, eligibility depends on a fixed income threshold that varies annually. Those who are eligible can apply directly to the cantonal authorities, often online. The subsidy is calculated as a percentage of the gross premium and paid directly to the polizza di assicurazione.

Not applying for the subsidy when you are entitled means losing public money intended precisely to cover health costs for those with less ability to pay. Many do not know that the subsidy must be actively applied for — it is not awarded automatically. Applications are usually submitted in the spring, before the deadline of late May or early June, although the exact deadlines vary per canton.

Comparison between cantons: the same prize

Useful tools to protect your net income

To reduce FX leakage, compare CHF-EUR exchange options and banks for cross-border workers.

Key points

How to register for LAMal: the practical steps

Anyone who has just arrived in Switzerland has 3 months to take out a health insurance contract. The procedure is simple but requires prompt action.

Step-by-step

1. Gather your documents: passport/ID, residence permit, cantonal registration certificate of your address (obtainable from the municipal office). 2. Choose a fund: use the cantonal online comparison tools (e.g. the Canton of Zurich portal) to compare premiums for your age and deductible. 3. Fill in the application: the registration form (paper or online) requires personal details, coverage start date, and type of deductible. 4. Pay the first premium: the fund sends an invoice. The first payment must be made within the deadline set by the contract (usually 30 days). 5. Coverage confirmation: the fund issues an insurance card and a coverage document. Only from that moment are you insured.

If you do not take out insurance within 3 months, the cantonal authority can assign you to a fund ex officio (default registration). In that case, you will pay premiums at the full rate with no choice of fund for the following twelve months, and you will have to reimburse any medical costs incurred in the previous 3 months.

Tools and resources available

Each canton makes available online premium comparison tools (with filters by age, type of coverage, deductible), registration forms (downloadable or digitally fillable), and a cantonal helpline for clarification on subsidies and premiums. In the Canton of Zurich, the official cantonal portal provides access to the comparison tool and up-to-date information. Do not rely on unverified third-party websites: information changes every year and only official portals guarantee accurate data.

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