Under the Health Insurance Act (KVG), premiums for people on low incomes are to be reduced through federal and cantonal subsidies.
Every person resident in Switzerland is required to have compulsory health insurance. The premiums set by health insurers are not dependent on income, although they do vary according to age category (child, young adult, adult), region of residence and the type of insurance chosen. As a social-policy measure compensating for standard premiums, the Health Insurance Act (KVG) provides for federal and cantonal subsidies to reduce premiums for people on low incomes. In addition, for families with low and middle incomes, the cantons are required to reduce premiums by at least 50% for children and young adults in education/training.
- The cantons have wide-ranging powers to regulate premium subsidies for their insured population. Consequently, the conditions for obtaining a premium subsidy (limits on income and assets), as well as the amount and the mode of payment (automatic or on request, deadline for applications), vary according to the canton of residence.
- When they consider premium subsidies – especially if requested to do so by policyholders – the cantons take into account the current income and family circumstances.
- In addition, they have to ensure that premium subsidies are paid to the health insurer in such a way that policyholders do not first have to pay the full amount.
On 17 March 2017, the Health Insurance Act (KVG) was amended by Parliament (https://www.admin.ch/opc/de/federal-gazette/2017/2389.pdf) in response to the parliamentary initiatives 10.407 “Exemption from premiums for children” (https://www.parlament.ch/de/ratsbetrieb/suche-curia-vista/geschaeft?AffairId=20100407) and 13.477 “KVG. Modification of premium categories for children, adolescents and young adults” (https://www.parlament.ch/de/ratsbetrieb/suche-curia-vista/geschaeft?AffairId=20130477#/AffairSummary).
The cantons will now be required to reduce premiums for children in low- and middle-income families by at least 80%. Premiums for young adults in education/training will continue to be reduced by at least 50%. The cantons have been granted a two-year period to introduce the new system. On 11 April 2018, the Federal Council decided that this amendment to the KVG would come into force on 1 January 2019. Given the transitional period, the cantons are thus required to reduce premiums by at least 80% for children in low- and middle-income families by 1 January 2021 at the latest.
Last modification 07.04.2020
Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Operational Supervision Section
Tel. +41 58 462 21 11