Health insurance: Premium reduction

The Health Insurance Act HInsA stipulates that the insurance premiums for people of modest economic circumstances shall be reduced by federal and cantonal contributions.

Any person residing in Switzerland must be insured for medical care (compulsory). The insurance premiums are uniformly established, irrespective of a person’s income, by the health insurers, according to the residential region and the chosen insurance model. As a social correction to the uniform premium the Health Insurance Act HInsA stipulates that the insurance premiums for people of modest economic circumstances shall be reduced by federal and cantonal contributions. Moreover, for families with lower and middle incomes, the cantons have to reduce the premiums of children and young adults in training by at least 50 per cent.

  • The cantons have wideranging powers to set the premium reduction for their insured population. Consequently, the conditions for obtaining the premium reduction (income limits and fortune), the amount and nature of disbursement of the premium reduction (automatically or on request, deadline), vary according to the Canton.
  • Furthermore, they must ensure that the premium reduction at the health insurer occurs in such a way that the insured person does not have to advance the entire amount of their premium. 

On 17 March 2017, Parliament amended the Health Insurance Act (HIA) (https://www.admin.ch/opc/de/federal-gazette/2017/2389.pdf) in response to parliamentary initiatives 10.407 "Premium exemptions for children" (https://www.parlament.ch/de/ratsbetrieb/suche-curia-vista/geschaeft?AffairId=20100407) and 13.477 "HIA. Amendment of premium categories for children, adolescents and young adults" (https://www.parlament.ch/de/ratsbetrieb/suche-curia-vista/geschaeft?AffairId=20130477#/AffairSummary).
Under the new law, the cantons will be required to reduce the premiums of children in low and middle-income families by at least 80 per cent. They must continue to reduce the premiums of young adults in full-time education or training by at least 50 per cent. The cantons have been given two years to introduce the new system. On 11 April 2018, the Federal Council decided to bring the amendment to the HIA into force on 1 January 2019. Because of the transitional period, the cantons must therefore reduce premiums for children in low and middle-income families by at least 80 per cent by 1 January 2021 at the latest.

Last modification 03.07.2018

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