Swiss health insurance, explained for someone arriving from the NHS
Money · 7 min read · Reviewed
If you take one thing from this section, take this: Swiss healthcare is excellent, and you pay for it directly, monthly, per person, out of your net salary. There is no employer scheme, no payroll deduction and no household rate. A family of four pays four premiums.
For someone arriving from the NHS this is the single biggest adjustment to the household budget, and it is the one most often discovered late — because unlike rent or tax, nothing about a job offer flags it.
Geneva is also the most expensive canton in Switzerland for premiums, which does not help.
What it costs, and what drives the number
Basic compulsory cover — LAMal — runs to roughly CHF 460 a month for an adult in Geneva on the highest deductible, and can approach CHF 560 on a lower one. The Swiss national average is closer to CHF 380, so Geneva carries a meaningful premium on top of an already high figure.
Four things move it: your canton and premium region, your age, your insurer, and your chosen deductible. Children are cheaper but not free. The basic cover itself is identical by law whichever insurer you pick — they compete on price and service, not on what is covered — so shopping around is worth real money for no loss of cover.
The federal government runs the only official comparison tool, priminfo.ch, and it is the one to use. Verify your own number there rather than relying on any figure quoted here or by a relocation agent.
| What | Per month | Who pays, and what to know |
|---|---|---|
| Health insurance (LAMal), per adult | CHF 460 | Compulsory, private, and per person rather than per household — children are charged too, at a lower rate. You must take out a policy within three months of arriving and it is backdated to your arrival date. The figure shown is a Geneva adult on a CHF 2,500 deductible; a low deductible costs meaningfully more. Geneva is the most expensive canton in Switzerland for this. Cantonal subsidies exist for lower incomes and are worth checking. |
| Health insurance deductible, spread monthly | CHF 210 | The franchise is what you pay before the policy pays anything, up to CHF 2,500 a year on the cheapest premiums, plus a 10% co-payment above it. Budget for it as a running cost rather than a surprise, because in a year when you need healthcare you will spend it. |
| Serafe (broadcasting fee) | CHF 28 | CHF 335 a year per household, billed automatically once you register your address. It is not optional and not connected to whether you own a television. |
| Charges (service charges) | CHF 250 | Quoted separately from rent in Swiss listings and typically covering heating, hot water, building maintenance and sometimes a caretaker. A rent advertised at CHF 2,000 'plus charges' is really CHF 2,250. Reconciled annually, so expect a balancing bill or credit. |
| Rental deposit (guarantee) | Varies | Up to three months' rent, held in a blocked bank account in your name. On a CHF 2,000 flat that is CHF 6,000 you cannot touch, on top of the first month. Deposit-insurance products exist as an alternative but cost more overall. |
| Third-party liability insurance | CHF 12 | Not legally compulsory but demanded by essentially every landlord as a condition of the lease, so treat it as compulsory. Usually bundled with household contents cover. |
Total of the fixed rows above: CHF 960 (about £900) a month, on top of rent. Sources: Federal Office of Public Health (OFSP) priminfo premium calculator for canton Geneva, 2026; Serafe AG published household fee for 2026; Swiss Code of Obligations, articles 257e and 269, on rental deposits and charges.
The deductible, and the trap in it
You choose a franchise — an annual deductible — between CHF 300 and CHF 2,500. A high deductible cuts your monthly premium substantially; a low one raises it. Above the deductible you still pay a 10% co-payment up to an annual cap.
The arithmetic is straightforward: if you expect to use very little healthcare, the CHF 2,500 deductible is cheaper overall. If you have a chronic condition, are pregnant, or have young children, the low deductible usually wins. The trap is choosing the high deductible for the low premium and then not having the CHF 2,500 available in the year you need it.
You can normally only change your deductible or insurer at the end of a calendar year, with notice. Getting the first choice roughly right matters more than it would in a market you could leave next month.
You have three months from arriving to take out cover, and it is backdated to your arrival date. Missing the deadline does not save you money — it means paying several months of premiums at once, plus any medical costs you incurred meanwhile.
Subsidies, and who actually qualifies
Geneva runs a cantonal subsidy scheme — the subside d'assurance-maladie — for lower and middle incomes, and the thresholds are more generous than most arrivals assume. It is worth checking rather than dismissing, particularly for a single-income household with children.
It is not automatic. You apply through the cantonal service, and the assessment is based on your taxable income, which for a new arrival may be estimated rather than known.
What about the French side?
If you live in France and work in Switzerland on a G permit, you get a choice — the droit d'option — between the Swiss LAMal system and the French one. You generally exercise it once, within three months, and it is difficult to reverse.
The French option is usually substantially cheaper, because French social insurance is funded largely through payroll contributions rather than flat premiums. The Swiss option buys access to Swiss providers on Swiss terms. Which is better depends on where you want to be treated, whether your family is with you and how much you value continuity if you later move across the border.
This is a genuinely consequential decision with a short deadline and it is worth paying for an hour of proper cross-border advice before making it.
Common questions
Is Swiss health insurance compulsory?
Yes, for everyone resident in Switzerland, and you must arrange it within three months of arriving. Cover is backdated to your arrival date, so delaying does not avoid the cost. There is no state alternative and no opting out.
How much is health insurance in Geneva?
Roughly CHF 460 a month for an adult on a CHF 2,500 deductible, rising towards CHF 560 on lower deductibles. Geneva is the most expensive canton; the Swiss average is nearer CHF 380. Children are charged at a reduced rate but are charged. Check your own figure on the federal priminfo.ch calculator.
Does my employer pay for health insurance in Switzerland?
No. Unlike accident insurance, which employers do cover, health insurance is a private contract between you and an insurer, paid monthly from your net salary. Nothing about it appears on your payslip, which is why British arrivals so often fail to budget for it.