Swiss Health Insurance: LaMal Is a Commodity, So Stop Overpaying for It

Basic health insurance (LaMal in French, KVG in German) is mandatory for every resident within 3 months of arrival. Coverage is defined by federal law and identical at every fund, so the only real variables are franchise (300 to 2500 CHF), model (free choice, family doctor, HMO, Telmed) and canton. Expect 280 to 500 CHF per adult per month. After the franchise you pay 10 percent co-insurance up to 700 CHF/year. Compare premiums on priminfo.admin.ch.

Basic health insurance in Switzerland is a commodity. The federal government defines the product, so every fund sells the same box under a different logo. The only sensible questions are: what is the cheapest premium in your postcode, what franchise matches your health, and which model keeps the friction low. This guide answers those, then shows you how to actually use the system once you have a card in your wallet.

The 3-month rule

The clock starts the day you register at your commune (Anmeldung / annonce d'arrivée). You have 90 days to sign a contract with a Swiss Krankenkasse (French: caisse maladie, Italian: cassa malati). Coverage is backdated to your registration date, so waiting 89 days does not save you a franc. If you miss the deadline entirely, the canton assigns you a fund at the standard adult premium, backdates the invoice and adds a late-payment surcharge. Do it in week one.

LaMal vs LCA: two very different products

The word 'insurance' hides two systems.

LaMal / KVG (basic)

• Compulsory for every resident
• Coverage defined by federal law (KVG), identical at every fund
• Cannot be denied, no health questions
• One-year contracts, cancellable by 30 November
• Premium is per person, adjusted only by canton, age band, franchise and model

LCA / VVG (supplementary)

• Optional, private-market product
• Covers private/semi-private hospital rooms, dental, glasses, alternative medicine, worldwide coverage
• Funds can reject you or charge more based on age and health history
• Longer notice periods (often 3 years for hospital plans)

The single most useful thing to understand: basic coverage is a commodity. Every fund sells the exact same box.

How to compare funds honestly

Use priminfo.admin.ch, the official federal comparison run by the government. Not Comparis, not Bonus.ch, not the pop-ups on your phone. The federal tool has no commercial bias and shows every fund licensed in your canton.

Inputs it will ask for:

• Canton and municipality (premiums differ across communes in the same canton)
• Year of birth (three age bands: 0-18, 19-25, 26+)
• Franchise (300, 500, 1000, 1500, 2000, or 2500 CHF)
• Model (free choice of doctor, family doctor, HMO, Telmed)
• Accident cover yes/no (say no if you work more than 8 hours a week; your employer already covers it)

Franchise: the biggest lever on your premium

The franchise is what you pay out-of-pocket each calendar year before insurance kicks in. After the franchise, you still pay a 10 percent co-payment (up to a 700 CHF cap per adult per year). Then everything is covered.

• Franchise 300 CHF: highest premium, best if you have regular treatment or a chronic condition
• Franchise 2500 CHF: lowest premium, saves 1500 to 1800 CHF/year in premiums for a healthy adult
• Break-even: roughly 1700 CHF of medical spend per year

If you are 30, healthy and see a doctor once every two years, the 2500 CHF franchise is almost always the right answer. If you have kids under 18, keep their franchise at 0 (the default for minors).

Alternative models: cheaper premiums, small trade-offs

• Family doctor (Hausarzt / médecin de famille): you pick a GP, they are your first stop. 10 to 15 percent cheaper.
• HMO: you use a specific medical centre. 15 to 20 percent cheaper.
• Telmed: you call a doctor hotline before any visit. 15 to 20 percent cheaper. Works well until you need a specialist.

For most expats, family doctor is the sweet spot: real savings, minimal friction.

Realistic monthly premiums in 2025

• Adult, Zürich, 2500 franchise, family doctor: 320 to 380 CHF
• Adult, Geneva, 2500 franchise, family doctor: 420 to 500 CHF
• Adult, Ticino, 2500 franchise, family doctor: 340 to 400 CHF
• Child, most cantons: 100 to 130 CHF

Geneva and Basel-Stadt are consistently the most expensive cantons. Appenzell Innerrhoden and Uri are consistently the cheapest. Same product, different pool.

Premium reductions (Prämienverbilligung)

Every canton pays partial premiums for lower-income households. You have to apply; no fund does it for you. Rough thresholds:

• Single adult: taxable income under 55,000 to 70,000 CHF
• Couple: under 90,000 to 110,000 CHF
• Family with 2 children: under 100,000 to 130,000 CHF

Application forms live on your canton's social insurance office (SVA / SPC) website. Turnaround is 4 to 8 weeks; the reduction is paid directly to your fund.

How and when to switch

Once a year, and only for basic coverage. The deadline is a registered letter received by your current fund on or before 30 November, with the new contract starting 1 January. If you have overdue premiums, the fund can block the switch, so pay first, cancel second.

For supplementary insurance, read the notice period in your contract before you cancel basic. Losing a good LCA hospital plan because you cancelled the wrong policy is a common and expensive mistake.

Finding a doctor who speaks English

Most expats do not struggle to find care; they struggle to know where to start. The best first stops are the FMH physician search, the doctors.ch directory, your employer's HR team and the approved-provider list on your insurer's website. In Zürich, Geneva, Basel and Bern, many GPs and specialists speak excellent English.

Your insurance model determines the route:

• Free choice of doctor: go directly to a GP or most specialists. No referral needed.
• Family doctor / HMO model: your GP is the gatekeeper. They refer you to specialists when needed. Ignoring this can mean uncovered bills.
• Telmed model: call the medical hotline first; they direct you to the right care.

Register with a GP early, even if you are healthy. The good ones stop taking new patients.

Pharmacies, emergency numbers and out-of-hours care

Swiss pharmacies are frontline care, not just pill dispensers. A pharmacist can advise on minor illnesses, recommend over-the-counter treatments, flag drug interactions and give flu and travel vaccinations. For small problems, they are faster and cheaper than a doctor's appointment.

• Emergency ambulance: 144
• Police: 117
• Fire: 118
• Poison emergency: 145

For urgent but non-life-threatening issues outside office hours, search your canton plus Notfallpraxis / permanence / guardia medica. In the bigger cities these walk-in clinics handle everything from infections to stitches without a hospital visit.

What to do in the first two weeks

• Compare and buy basic insurance on priminfo.admin.ch within 3 months of registration.
• Choose your franchise: 2500 CHF if you are healthy, 300 CHF if you expect regular treatment.
• Pick a model: family doctor for the best balance of savings and freedom.
• Register with a GP near your home, even before you are sick.
• Note the emergency numbers in your phone and locate the nearest pharmacy.

Basic health insurance in Switzerland is one of the few areas where the government-run comparison tool tells you the truth and the private ones do not.

Health insurance is the second recurring bill of Swiss life, after rent. If you are still weighing whether the salary covers it, see is 100k/120k/150k enough. If you have just arrived, the full sequence lives in the moving-to-Switzerland checklist.