Settling in Switzerland means making several important decisions in your first weeks: a home, a bank account and, less obviously, your own health insurer. Switzerland’s system is universal but private. Every resident buys basic cover, known as LAMal, directly from an insurance company. Understanding how it works early on saves money and spares you an administrative scramble later.
Compulsory within three months of arrival
Basic health insurance is a legal obligation for everyone living in Switzerland, regardless of nationality or permit type. You have three months from your arrival date to take out a policy, and the same deadline applies to each family member, including newborns. Cover, and the corresponding premiums, apply retroactively from the day you arrived, so delaying does not save anything. If the deadline passes without a policy, the cantonal authorities can assign you to an insurer of their choosing, usually on terms you would not have selected yourself.
How LAMal premiums are calculated
The benefits of basic insurance are defined by federal law and identical with every insurer. The premium you pay, however, depends on three levers.
| Lever | How it works |
|---|---|
| Canton and region | Premiums vary significantly between cantons, and even between premium regions within the same canton. Geneva and Vaud are among the higher-premium cantons. |
| Deductible (franchise) | Adults choose an annual deductible between CHF 300 and CHF 2’500. The higher the deductible, the lower the monthly premium, but the more you pay out of pocket before the insurance steps in. |
| Insurance model | Alternative models, telemedicine (telmed), family doctor or HMO networks, reduce the premium in exchange for an agreed first point of contact whenever you need care. |
On top of the deductible, you pay 10 per cent of treatment costs, the co-payment, up to an annual ceiling. The right combination of deductible and model is rarely obvious: it depends on how often you consult, the stability of your budget and your family situation.
Supplementary insurance (LCA) in brief
Supplementary insurance, governed by the LCA, covers what basic insurance does not, from semi-private or private hospital wards to dental care, glasses and certain treatments abroad. Unlike LAMal, insurers may decline applicants or apply health reservations, which is why supplementary cover is best arranged early, while your medical record works in your favour.
How to choose, without losing weeks comparing
Because basic benefits are identical everywhere, the real differences lie in premium levels, the quality of claims handling, the availability of English-language service and which alternative models exist in your region. Expats often default to the cheapest headline premium or the maximum deductible, then discover that the model restricts access to a specialist they rely on, or that the deductible strains the budget the first time a family member needs care.
A sound choice starts from your situation, not from a price list: who needs to be covered, how you actually use healthcare, whether treatment across the border matters to you, and how LAMal fits with the rest of your financial planning. That assessment is precisely what a structured review provides, and it is best done person by person.
Premium subsidies in Geneva
Geneva grants income-based premium subsidies that can meaningfully reduce the monthly cost of basic insurance, for adults and children alike. Entitlement depends on your taxable income and family circumstances, and many newcomers qualify without realising it. Eligibility evolves with your situation, so it is worth reviewing your position every year, especially after a change in income, marital status or family size.
Frequently asked questions
What happens if I miss the three-month deadline?
The canton can affiliate you to an insurer of its choosing, and premiums remain due retroactively from your arrival date. Acting within the deadline keeps the choice in your hands.
Can I keep my international health insurance instead of LAMal?
In most cases, no. Exemptions exist for specific situations, such as certain students, posted workers or holders of particular permits, but they must be formally requested and approved. Without an approved exemption, LAMal applies.
Can I change my insurer, deductible or model later?
Yes. The deductible and the model can generally be adjusted for the start of each calendar year, and you may switch insurer for 1 January by giving notice in November. Reviewing your set-up annually is one of the simplest ways to keep costs aligned with your needs.
Do my spouse and children need their own policies?
Yes. LAMal is individual: each family member holds their own policy, which may even be with different insurers. Children must be insured within three months of birth or arrival, and their premiums are significantly lower than adult ones.
Talk it through with an advisor
Smart Léman is an independent financial advisory firm based in Geneva, registered with FINMA under number F01533002. We help residents and cross-border workers across the Lake Geneva region structure their health insurance, pension provision and broader financial planning as one coherent whole. To find out what the right LAMal set-up looks like for your situation, book your free financial review.