Switzerland relocation: health insurance requirements, public KVG/LAMal vs private & IPMI

Who must enrol in Swiss mandatory basic health insurance (LAMal/KVG)

For most expats, the position is fairly clear: if you become resident in Switzerland, you are generally required to take out Swiss compulsory basic health insurance (KVG/LAMal) within three months of taking up residence.^[1] The system is sometimes described as “compulsory, but private”: cover is required, but it is provided by approved insurers within a regulated legal framework.^[3]

Two practical points matter straight away for families: each family member must be insured individually, and your timing can affect whether your cover is dated from your start date (and whether eligible costs are reimbursed retrospectively).^[1]

The baseline rule for residents

The Federal Office of Public Health (FOPH) explains that anyone settling in Switzerland must take out health insurance within three months of taking up residence. If insurance is obtained on time, cover takes effect from the beginning of residence and costs incurred since that start date can be reimbursed retrospectively (with premiums payable from that date as well).^[1]

ch.ch (official life-in-Switzerland guidance) sets out the same principle in plain language: if you have moved to Switzerland, you have three months to arrange health insurance cover. The same deadline applies to newborns; you or your baby are already covered during this three-month period.^[2]

Where the answer can vary (common expat profiles)

Start and end of compulsory insurance (why this matters for a 3–10 year plan)

The FOPH explains that compulsory insurance essentially applies to people resident in Switzerland, and that cover ceases when you are no longer subject to compulsory insurance—such as when you leave Switzerland to take up residence in another country (with exceptions under certain international agreements).^[1]

Over a three-to-ten-year horizon, this is why you should plan your likely “exit route” as well as your arrival: if you leave Switzerland in year three, five or ten, your next system may not start on the same day unless you plan for overlap and proof requirements.

How and when to enrol

The Swiss enrolment process is straightforward, but it is time-sensitive. You typically have a three-month window from the start of compulsory insurance—often from the date you take up residence—to take out basic insurance.^[1] Leaving it until “later” is how families end up with avoidable stress, cost, or a compliance headache.

What enrolment looks like in practice

It helps to think about enrolment as three parallel tracks: (1) registering with your commune, (2) confirming your insurance obligation and putting cover in place, and (3) coordinating with employment-related insurance (particularly accident cover).

If you enrol late (why effective dates matter)

The FOPH draws a clear distinction between enrolling within the legal period and enrolling late: enrol on time and cover can begin from your start date (with reimbursement of eligible costs incurred since then, and premiums due from that date). Enrol late and cover generally only takes effect from the date you enrol, with a surcharge unless the delay is justified.^[1]

For cross-border commuters, the FOPH is particularly explicit: not registering can lead to automatic assignment to an insurer and (if the delay can’t be justified) a premium surcharge—while you may have to pay treatment costs incurred prior to enrolment yourself.^[13]

First 90 days timeline (and the 3–10 year lens)

Common pitfalls (what tends to cost expat families the most)

• Missing the three-month enrolment deadline: enrolling within the deadline can mean cover is dated from your start date; late enrolment can affect effective dates and may trigger surcharges (and in cross-border cases can leave you paying earlier costs yourself).^[1][13]
• Assuming your employer enrols you into basic insurance: ch.ch emphasises that health insurance is compulsory but private—meaning you normally arrange it yourself, even if you are working.^[3]
• Choosing the franchise/deductible based on premium alone: co-payment is structured (deductible + 10% retention fee up to a cap + hospital daily contribution). Your out-of-pocket exposure can still be meaningful even where the monthly premium looks low.^[5][6]
• Mixing up basic and supplementary insurance: supplementary is optional and can be declined; it usually requires a health questionnaire and can include exclusions—unlike basic insurance acceptance rules.^[7][2]
• Paying twice for accident risk (or being uninsured for accidents): accident cover often depends on employment status; above an eight-hour/week threshold, your employer is generally obliged to provide accident insurance.^[3][4]
• Overlooking the “abroad gap”: outside the EU/EFTA/UK, emergency reimbursement is capped (up to twice the Swiss amount; inpatient reimbursement no more than 90% of comparable Swiss hospitalisation costs). In high-cost countries, basic insurance may be insufficient.^[12]
• Cancelling old cover too early: the gap risk is often administrative, not just medical. Build in overlap until the new structure is confirmed and effective.

Switching note: ch.ch states basic insurance can generally be changed at year-end if your written cancellation reaches your insurer by 30 November. It also describes a mid-year cancellation option in specific circumstances (for example, the standard model with a CHF 300 deductible, with three months’ notice). Always check your specific situation and contract terms.^[2]

What basic cover includes

Swiss compulsory basic insurance (KVG/LAMal) provides a legally defined set of benefits. The FOPH summarises these benefits as cover for illness, accident and maternity, including examinations and treatment from doctors and in hospital, nursing and some non-medical services, plus medical prevention measures.^[4]

A key system point: insurers that offer compulsory basic insurance must offer the same scope of benefits as mandated by law and must ensure equal treatment of insured persons; they are not allowed to include additional “voluntary” services within the basic package.^[4]

Cost-sharing in plain English (premium vs what you pay yourself)

In Switzerland, your monthly premium is only part of the picture. The FOPH explains that co-payment generally includes: a deductible (standard CHF 300 for adults; children under 18 are exempt from the standard deductible), a retention fee of 10% of costs above the deductible up to a maximum (CHF 700 for adults; CHF 350 for children/adolescents), and a CHF 15/day contribution for hospital stays, with exemptions for certain groups (including children/adolescents and maternity services).^[5][6]

Premiums: why they vary (and what you can meaningfully compare)

The FOPH explains that insurers set premiums and (unless the law says otherwise) broadly charge the same premiums for policyholders, but premium levels vary based on cost differences within cantons and depend on where you live. Insurers may also charge different premiums for different regions (with standard premium regions defined by the FOPH), and premiums are payable in advance, usually monthly.^[5]

Premiums for compulsory health insurance are approved and published by the FOPH, and the official premium overview/calculator is available via Priminfo.^[10] If you’re comparing options, compare like-for-like (same canton/region, age group, model and deductible).

If you are in modest economic circumstances, premium reductions may be available. The FOPH explains that cantons reduce premiums for eligible residents and each canton sets eligibility, process and payment arrangements (some require an application; others may grant reductions automatically).^[11]

Insurance models: standard vs GP/HMO/Telmed

Basic insurance is often offered under different “models” that can affect how you access care. Alongside the standard model (free choice), the FOPH describes common reduced-premium models such as GP (family doctor), HMO and Telmed models.^[7] ch.ch explains these in practical terms and notes model changes are typically aligned with year-end switching deadlines.^[2]

The broader logic is also described by the FOPH: you can reduce premiums by limiting the choice of provider in agreement with the insurer, by choosing a higher deductible, or via bonus insurance structures (availability can vary, and special types may not be available to all categories such as policyholders resident in EU/EFTA/UK corridors).^[8]

Accidents: coordinating health and accident insurance

Basic insurance provides benefits in the case of accident, but the FOPH notes that the health insurer steps in only if the insured person has no other coverage.^[4] ch.ch explains that if you work more than eight hours per week, your employer is obliged to insure you for accidents (with the contribution deducted from salary). If you work less than eight hours a week, you may need private accident insurance.^[3]

Care outside Switzerland (and why expats should check this early)

Many expats only discover late that “abroad” rules are specific. The FOPH explains that: within the EU/EFTA/UK, the European Health Insurance Card (EHIC) entitles medically necessary treatment during a stay, with co-payment based on the country of treatment and generally payable directly; those amounts generally do not count towards your Swiss deductible/retention fee.^[12]

For temporary stays outside the EU/EFTA/UK, the FOPH states that emergency treatment costs will be reimbursed up to a maximum of twice what the insurer would have paid for treatment in Switzerland, and for inpatient treatment the insurer will reimburse no more than 90% of comparable Swiss hospitalisation costs. It also notes that medical costs can be very high in some non-EU/EFTA/UK countries (for example, the US, Canada and Japan) and basic insurance benefits may be insufficient to cover the costs; other medical treatment abroad is not generally covered under compulsory insurance.^[12]

This is one of the main reasons expats explore supplementary “abroad” extensions or IPMI—especially if they expect frequent travel or future relocations. Always verify the geography, reimbursement method and any caps in writing before relying on them.^[12]

Private supplementary plans

In Switzerland, “public vs private” is an easy shorthand, but it can be misleading. It’s often clearer to think in layers: compulsory basic insurance (standardised benefits) plus optional private supplementary insurance for additional benefits and comfort. Supplementary cover can be useful, but it is governed by different rules from basic insurance.

What supplementary insurance is (and what it isn’t)

The FOPH’s FAQs explain the distinction: basic insurance is compulsory and insurers must accept everyone subject to compulsory insurance without reservation or waiting period, regardless of age and state of health. Supplementary insurance is different—insurers may refuse to insure you after a health check or exclude you from certain benefits.^[7]

At a high level, supplementary insurance can cover services not included in basic insurance. The FOPH’s FAQ gives examples such as semi-private/private hospital wards, routine dental treatment, preventive check-ups, and treatment by naturopaths (examples vary by product and insurer).^[7]

Underwriting, exclusions, and “waiting periods” (what to expect)

ch.ch is very clear on the practical reality: as a rule, you have to complete a health questionnaire before an insurer approves supplementary insurance, and the insurer can refuse the application. It also warns that you should answer the questionnaire truthfully, because incorrect information can lead to bills not being paid later or cover being cancelled.^[2]

Some supplementary policies can also include staged benefits or waiting periods for certain categories (product-specific). That’s why you should request the full terms and check effective dates and exclusions before assuming a benefit is available from day one.

Regulatory split: why supplementary behaves differently

FINMA explains that health insurance is regulated by two separate bodies: the FOPH is responsible for compulsory health insurance, while FINMA is responsible for supplementary health insurance under the Insurance Contract Act. FINMA also notes that basic and supplementary insurance are separate contracts and can be taken out independently.^[20]

Cancellation terms: why supplementary isn’t always “calendar-year simple”

FINMA highlights that supplementary insurance is private insurance and the contract terms matter. It notes that, following the revision of the Insurance Contract Act, policyholders can cancel their supplementary contract in writing after three years with three months’ notice to the end of the insurance year, even if a longer term was originally agreed. It also notes that the insurance year does not necessarily end on 31 December—your contract documentation is what counts.^[21]

Coordination choices: same insurer or split?

Both ch.ch and FINMA confirm you can hold compulsory basic insurance and voluntary supplementary insurance with different insurers.^[2][20] FINMA notes a trade-off: having two providers can mean you need to be clear about who handles which costs, but the ability to switch basic insurance to a cheaper provider may be financially helpful.^[20]

FINMA also highlights a point many expats miss: some providers may only offer discounts on supplementary insurance if you also hold basic insurance with them, and they may charge administration fees or apply minimum premiums if you no longer hold basic insurance with them. It’s sensible to ask about this before splitting providers.^[20]

IPMI vs Swiss plans

IPMI (international private medical insurance) is generally a mobility-first product category—designed for people living and working across borders. Mercer describes IPMI as international health coverage that can be valid across multiple countries and designed to provide comprehensive coverage, unlike local health insurance designed for a local healthcare environment.^[24]

That can make IPMI a good fit for some expats—but it can also create confusion in Switzerland, where you may still be required to take out Swiss compulsory basic insurance once you become subject to KVG/LAMal rules.^[1]

A simple way to compare (systems, not brochures)

It helps to compare what each layer is designed to do: Swiss basic insurance is a regulated foundation for Switzerland-centred care, with defined cost-sharing and standardised benefits across insurers. Supplementary is an optional layer under private contract rules. IPMI is a cross-border continuity tool that can be strong for mobility and travel exposure—but it should not be assumed to replace Swiss compulsory obligations.^[4][20][24]

How IPMI typically works in practice (service model)

Many IPMI plans are built around provider networks and settlement routes (direct billing vs reimbursement), with pre-authorisation requirements for planned hospital treatment. BIG’s explainer on direct billing vs reimbursement highlights that networks and approvals can determine whether you can access cashless treatment or whether you’ll need to pay up front and claim back.^[26]

For globally mobile families, this matters because the “worst day” scenario is often a large hospital bill in a country where you don’t have a smooth billing pathway. If your life involves high-cost countries or multiple relocations, how you use the plan can be as important as what the brochure lists.

Where IPMI can fit alongside Switzerland (typical fit patterns)

Where IPMI usually does not replace Swiss compulsory insurance

The default rule for residents remains: anyone settling in Switzerland must take out health insurance within three months of taking up residence.^[1] Exemptions exist in certain categories (for example, some students with equivalent cover, posted worker cases, cross-border “option” procedures), but these typically involve formal steps with cantonal authorities and equivalence requirements.^[15][14][13]

How to decide (a calm decision framework)

Instead of asking “public vs private”, ask questions that still make sense in a few years’ time:

• Will most of your care be Switzerland-centred (GP, paediatrics, routine care), or do you expect multi-country treatment?
• How often will you be outside the EU/EFTA/UK—and which countries? (Basic reimbursement caps outside the EU/EFTA/UK can be material.)^[12]
• Are you optimising for the lowest monthly premium or the lowest total cost (premium + expected out-of-pocket + travel risk)?^[5]
• If a new medical condition develops, would you regret having to go through new underwriting to add supplementary cover or IPMI later?^[2]

Long-term strategy (cross-border living, return to home country)

The costliest insurance decisions are often made under time pressure. A calmer approach is to treat your move in phases: (1) compliance and enrolment, (2) arrival logistics and real-world access to care, and (3) a longer-term structure that still works when your life changes.

Three horizons: 3-year / 5-year / 10-year thinking

Cross-border living and commuting (high-level)

If you live outside Switzerland and work in Switzerland, the FOPH states that you are generally required to take out Swiss health insurance, with some exceptions depending on country of residence and nationality. It also notes that EU/EFTA/UK cross-border commuters (G permit holders) are subject to compulsory insurance from the start of employment, with three months to register.^[13]

The FOPH also explains that Switzerland has agreements with neighbouring countries so that people with EU citizenship living in certain neighbouring countries can have an option to obtain insurance in the country of residence—but this is procedural and must be exercised formally within three months by applying to the relevant cantonal authority. It also references case law indicating that “tacit” exercise of the option does not have legal force, so formal steps matter.^[13]

ch.ch similarly summarises the cross-border approach: as a cross-border commuter, you may have the choice of taking out health insurance where you work (Switzerland) or where you live, and if you do not want Swiss health insurance you must apply for an exemption with the relevant cantonal authority within three months of starting your job.^[2]

Return to home country (and “don’t cancel too early” logic)

The FOPH explains that cover ceases when you leave Switzerland to take up residence in another country, unless an international agreement requires you to remain insured in Switzerland.^[1] In practice, that means your return plan should be structured like a handover: confirm your new cover and effective date before terminating Swiss cover, and plan for common proof needs (policy certificates, effective dates, prior coverage confirmations).

Budget planning: Switzerland is high-cost (why cost-sharing strategy matters)

Switzerland is a high-cost healthcare environment. The MonAM health cost indicator (FOPH/Obsan) reports estimated 2024 healthcare costs of CHF 97.1 billion, around CHF 10,783 per capita, representing 11.8% of GDP.^[22] In that context, relatively small plan-structure choices (deductible level, model, supplementary layering) can have a noticeable impact on predictable budgeting.

This is not a reason to “buy everything”. It’s a reason to map your total exposure and keep the ability to adapt as your circumstances change.

Annual optimisation without self-sabotage

• Compare premiums properly: premiums are approved/published by the FOPH; use Priminfo for official comparisons.^[10]
• Track switching deadlines: ch.ch states cancellation must reach your insurer by 30 November for year-end switching and notes model-change timing is similar.^[2]
• Deductible changes are calendar-year decisions: the FOPH notes deductible changes take effect at the beginning of the calendar year, and insurers are not required to offer every deductible level.^[9]
• Don’t assume supplementary will be available later: underwriting and acceptance risk is real.^[7]

Checklists for registration and arrival

Use the checklists below as a practical project plan. They are deliberately general because Swiss processes can vary by canton, commune and status. If your situation is non-standard (cross-border commuter, posted worker, student exemption), treat “verify with the relevant authority” as a required step, not a footnote.^[13][15]

Arrival admin checklist (first two weeks)

Basic insurance setup checklist (first 30–60 days)

Documents/proof commonly requested (not a definitive list)

Requirements vary. Think in categories and bring originals where possible. ch.ch examples for work-related residence steps include a valid ID/passport and employment confirmation/contract.^[3] For moving/commune registration, ch.ch suggests documents can include civil status documents (e.g., certificate of origin), a family record document if you have children, and your health insurance card or proof of your current policy.^[18]

Continuity checklist: “don’t cancel old cover too early”

If you want a lower-stress relocation, treat administration timelines as part of healthcare planning—not an afterthought.

Broker’s role

A broker’s role isn’t to “pick a brand” for you. It’s to help you build a cover structure that is compliant, cost-aware, and still workable over a three-to-ten-year horizon. In Switzerland, that often means reducing avoidable mistakes: missed deadlines, an unsuitable deductible/model, confusion between basic and supplementary cover, and gaps created during a move.

How we typically support expats (practical, not hype)

• Status mapping: help you frame your likely category (resident vs cross-border vs student/posting) and identify where formal verification is needed.^[1][13]
• Structure design: LAMal/KVG as the foundation, then evaluate whether supplementary and/or IPMI makes sense for your travel and longer-horizon plans—without assuming you need “more cover”.^[7][24]
• Total-cost thinking: help you model premiums + cost-sharing exposure (deductible + co-payment + hospital daily contribution), not premium alone.^[5]
• Policy literacy: translate key terms you’ll actually see (franchise/model restrictions, exclusion wording, geography, reimbursement caps).^[12]
• Planning for change: annual reviews, relocation planning, and reducing “coverage cliff edges” when moving countries or returning home.^[1]

What we cannot do (and shouldn’t promise)

• We cannot change Swiss legal obligations or cantonal procedures.
• We cannot guarantee acceptance into supplementary insurance or IPMI (underwriting rules apply and may vary by insurer and product).^[2]
• We cannot guarantee claims outcomes; entitlements depend on policy wording and the specific facts of a claim.

Get Started

If you’re planning a move to Switzerland and you want a calm second opinion on your health insurance structure—LAMal/KVG setup, supplementary considerations, and when IPMI may fit for mobility—we can help you map your situation and reduce avoidable mistakes.

Start here: Individual & Families and, if you’re ready to request options, Get a Quote.

Further reading (strategy mindset): The A to Z Premium Guide to CFE and US Citizens Moving to Italy.

Points to verify

• Who is subject to mandatory LAMal/KVG in your specific situation and the enrolment deadline you must follow (status and canton can matter).^[1][13]
• Whether any exemption/alternative coverage options apply (if any) and how to document them (students, posted workers, certain cross-border cases).^[15][14][13]
• How franchise/deductible and cost-sharing will apply to your expected care pattern (including retention fee caps and hospital contribution rules).^[5][6]
• How supplementary underwriting, waiting periods, exclusions, and acceptance work for your household (varies by insurer and product).^[2][7]
• Cross-border living/commuting rules and what they mean for where you can receive care and how it’s reimbursed (especially EU/EFTA/UK vs non-EU/EFTA/UK).^[13][12]
• Employer coordination: whether your employer provides accident insurance (>8 hours/week) and how that coordinates with health insurance cover for accidents.^[3][4]
• Whether IPMI would be accepted/appropriate alongside Swiss requirements (depends on purpose, status, and equivalence/exemption pathways; do not assume substitution).^[1][15]