Swiss health insurance: three months' thinking time that is no postponement

The Swiss healthcare system resembles the Dutch one — private insurers, a compulsory basic package, an excess — but on three points it works out so differently that it determines your monthly outgoings. This is what you need to know before your move.

The three-month deadline is an invoice, not thinking time

Everyone who settles in Switzerland must take out insurance no later than three months after arrival. That sounds like room to compare calmly, and it is — but not financially. If you sign up in time, the cover starts on your date of settlement, not on the date of your signature. And because the insurer also reimburses the healthcare costs of those intervening months, you still have to pay the premiums for those same months. Whoever signs in the third month gets a bill for three months.

Waiting therefore gains nothing, and being late costs money: then the cover only starts on the day you join (you bear the costs before that yourself) and the insurer may charge a premium surcharge. Sort it out in your first weeks.

What it costs: per person, and children count

Swiss premiums are not income-related and there is no employer contribution — you pay a fixed amount yourself, per person. For 2026 the official averages are:

	Premium per month (2026)
Adult (from 26)	CHF 465.30
Young adult (19–25)	CHF 326.30
Child (0–18)	CHF 122.50

Watch one figure that often goes wrong in Dutch reporting: you sometimes read that the average Swiss premium is CHF 393.30. That is the average across all insured persons including children — not what an adult pays. Count on CHF 465.30 per adult.

And unlike in the Netherlands, where children up to eighteen are insured free of charge with their parents, every child has its own premium. A family with two adults and two children therefore sits at around CHF 1,175 per month in bare premium — before the excess. That is the biggest fixed cost of this corridor, and the reason to put it in your budget early.

The premium differs per insurer, per place of residence and per chosen model. You compare on the government's official premium comparison tool, not on commercial sites.

Franchise and co-payment

The excess is called the Franchise and is set at CHF 300 per year for adults by default. You may voluntarily raise it to 500, 1,000, 1,500, 2,000 or 2,500 in exchange for a lower premium. Children have no franchise by default.

On top of the franchise you pay 10% of the remaining costs (the Selbstbehalt), up to a maximum of CHF 700 per year for adults and CHF 350 for children. For a hospital stay CHF 15 per day is added. In the worst case a year therefore costs you CHF 1,000 in own costs at the standard franchise — plus the premium.

One pitfall with medicines: if you choose an original product while a generic alternative exists, your co-payment rises to 40% instead of 10%, unless your doctor expressly prescribes the original.

You're always accepted — but not for everything

The basic insurance has a hard duty to accept: every insurer must take you on, without reservation, without a waiting period, regardless of your age or health. An existing condition is therefore no problem at all for your basic cover.

For the supplementary insurance the reverse applies. It's voluntary, falls under different law, has a health questionnaire — and the insurer may refuse you. If you want supplementary cover for the dentist, glasses, alternative medicine or a free choice of hospital, arrange that while you're healthy, and don't cancel a current supplementary policy without a replacement.

What gives you a fright: you pay the doctor yourself first

In outpatient care Switzerland usually works with tiers garant: the doctor sends the bill to you, you pay, and you then submit it to your insurer. Reimbursement usually follows within thirty days — and the part that falls within your franchise you don't get back at all. In hospitals and pharmacies it usually does run directly between provider and insurer.

Practical consequence: keep working capital on hand. Whoever chooses a high franchise to save on premium must genuinely be able to advance that amount.

Two things that soften the bill

Cantons have an income-related premium reduction (Prämienverbilligung) for whoever lives in modest circumstances. Some cantons grant it automatically, others require an application — so find out what your canton does, because there is no national counter. For newcomers this is extra relevant: you can ask to be assessed on your current income instead of on an old assessment.

And you can choose a cheaper model: a fixed GP as first point of contact, an HMO practice, or compulsory telephone consultation first. The discount on that is legally capped at 50% relative to the standard model with free choice of doctor — a real saving, then, but no miracle.

And your Dutch insurance?

It stops on your moving date; report the move to your insurer yourself. If you're going to work in Switzerland, you are compulsorily insured there — the country-of-work principle also applies under the agreement between Switzerland and the EU, and your non-working family members follow you. If you move with a Dutch pension or benefit, the treaty route via the CAK exists, with an S1 document with which you register in Switzerland. One warning there: the country-of-residence factor for Switzerland stands at 1.000 — the highest value there is. Unlike with Spain or Portugal, you therefore get no discount via that route; you pay the full Dutch contribution.