Healthcare in Switzerland: LAMal, deductibles and reimbursements (cross-border guide)

Context

In a nutshell

The Swiss healthcare system is based on the mandatory LAMal health insurance for residents. Awards vary by canton and region. The canton of Zurich offers adult deductibles from CHF 300 to CHF 2500.

Key facts

What: LAMal health insurance mandatory for residents When: From 2026 Where: Switzerland Who: Residents of Switzerland Amount: CHF 300-2500 deductibles

The Swiss healthcare system is based on the mandatory LAMal health insurance for residents. The canton of Zurich offers adult deductibles from CHF 300 to CHF 2500. Residents of Switzerland are required to take out LAMal health insurance within three months of arrival. The deductible varies by canton and region.

How LAMal works LAMal health insurance is mandatory for all residents in Switzerland. For example, in the canton of Ticino, the average premium for an adult is about CHF 300 per month, while in the canton of Graubünden it is about CHF 400 per month. It is important to note that premiums can also vary depending on the age and health condition of the insured.

Deductibles and refunds The canton of Zurich offers adult deductibles from CHF 300 to CHF 2500. This means that the insured must pay a minimum amount for each medical visit or medical treatment before LAMal will bear the costs. Some examples of adult allowances in the canton of Zurich are:

• CHF 300 for a medical examination of

Operational details

LAMal health insurance is an obligation for residents in Switzerland, as established by the Federal Act of 1996. The canton of Zurich, for example, offers adult deductibles from CHF 300 to CHF 2,500, with a maximum of CHF100,000 per year for medical benefits.

Residents of Switzerland can choose from several sick cases, each with its own premiums and deductibles. The main sick fund is the Kassenärztliche Vereinigung, which covers 75% of medical expenses. Other sickness funds include the Confederal Disease, the Canton Zurich Sickness Fund and the Canton Bern Sickness Fund.

The canton of Zurich also offers a premium reduction for residents who already have health insurance. This means they can save up to 20% on their annual premiums. In addition, the canton of Zurich has introduced a deductible for medical examinations by a general practitioner, which is covered up to CHF 50 per visit.

Here are some concrete examples of how LAMal works:

• A resident of Switzerland living in Zurich has an annual income of CHF 80,000 and health insurance with a deductible of CHF1,000. His annual expenditure for LAMal is CHF 1,500. * A self-employed person with an annual income of CHF 120,000 living in Geneva has health insurance with a deductible of CHF2,000. His annual expenditure for LAMal is CHF 2,500.

It is important to note that premiums for LAMal may vary by region

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Key points

To obtain LAMal health insurance, residents of Switzerland must enter into a contract with one of the authorized health insurance funds. The canton of Zurich offers adult deductibles from CHF 300 to CHF 2500.

Residents of Switzerland can also opt for a premium reduction if they already have health insurance. For example, if a Swiss citizen already has health insurance with a monthly premium of CHF 500, they could get a 20% reduction for a total of CHF 400 per month.

It is important to check the premiums and deductibles of your sick fund before entering into a contract. The Federal Act on Illness (LAMal) states that maximum premiums for an adult may not exceed 7.5% of gross annual income.

The canton of Geneva, for example, offers adult deductibles from CHF 200 to CHF 2000. The Geneva sickness fund also offers a 15% reduction for Swiss citizens who already have health insurance.

Residents of Switzerland can also opt for health insurance with a lower deductible. For example, the Cassa di malato in Bern offers a CHF 100 allowance for adults, while the Cassa di malato in Lausanne offers a CHF 150 allowance.

It is important to note that premiums and deductibles may vary by region and canton. Residents of Switzerland must check the premiums and deductibles of their sick fund before entering into a contract.

Operational checklists

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