Many households in Switzerland receive a single bill, bearing the name of a single insurer, and conclude that they have “health insurance”. In reality there are almost always two contracts, and they do not follow the same rules. One is compulsory, and the insurer cannot turn you down. The other is optional, and the insurer decides whether to accept you.
This difference is not an administrative detail. It decides what you can change, when, and what you risk losing when you do.
Basic insurance (KVG/LAMal): compulsory, and open to everyone
Compulsory health care insurance is governed by the federal law on health insurance, known as the KVG in German and the LAMal in French. Its Article 3 sets the principle: everyone domiciled in Switzerland must be insured for health care in the event of illness. This is not a recommendation but a legal obligation tied to where you live.
In return for that obligation, the law places a matching duty on the insurer. Article 4 of the KVG guarantees a free choice among authorised insurers; the duty to accept, for its part, is in the federal law on the supervision of health insurance (KVAG/LSAMal), which requires the insurer to accept, within the area in which it operates, anyone who is required to be insured. In other words: for basic insurance, an insurer active where you live cannot make you fill in a health questionnaire, impose a reservation on you, or turn you down because of your age or your health.
A second consequence matters just as much. The list of benefits covered by basic insurance is set by the law and its ordinances, and it is the same at every insurer. What varies from one insurer to the next is the premium, the insurance model, the deductible you choose and the quality of service — not the list of treatments covered.
Supplementary insurance (VVG/LCA): optional, and subject to the insurer's agreement
Supplementary insurance does not fall under the KVG. It is governed by the federal law on insurance contracts, the VVG in German and the LCA in French, which is the law of private insurance contracts. The Federal Office of Public Health (FOPH) puts it plainly: supplementary insurance falls under the VVG/LCA, and there is no obligation to accept applicants.
Freedom of contract therefore works both ways. You are not obliged to take out supplementary insurance, and the insurer is not obliged to accept you. It can turn an application down, or accept it while excluding certain benefits or certain conditions — what is known as a reservation.
This is also why the VVG/LCA requires the applicant to disclose the facts that matter for assessing the risk, when they are asked about them. If an incorrect answer comes to light later, the law allows the insurer to terminate the contract within four weeks of learning of it. An omission when filling in the questionnaire can therefore cost you years later, at the worst possible moment.
Why the two are so often confused
Three reasons add up. First, the same insurer often sells both, under the same brand, with a combined bill. Second, both contracts concern health, and the line between what basic insurance pays and what supplementary insurance pays is not intuitive. Finally, marketing language talks about “cover” without always saying which one it means.
Yet the two contracts are legally independent. They can be held with different insurers, and cancelling one does not cancel the other. This is a real possibility, not just a theoretical one: nothing requires you to keep your basic and supplementary insurance in the same place.
Switching: two regimes, two calendars
For basic insurance, the KVG sets the deadlines itself. Article 7 allows a change of insurer at the end of a calendar half-year with three months' notice, and a right to switch at the end of the month before a new premium takes effect, with one month's notice. In practice, it is this second case that concerns most households in the autumn, when the following year's premiums are announced.
One safeguard is worth knowing: the KVG provides that your cover with the old insurer ends only once the new insurer has told it that it is insuring you without interruption. The risk of being left uninsured between two insurers is therefore handled by the law itself.
For supplementary insurance, the rules are those of the contract. The VVG gives an ordinary right of termination at the end of the third year or of any following year, with three months' notice, life insurance excepted. But the general terms of your contract may set other dates, and those are the ones to read. The VVG also gives a fourteen-day right of revocation after you have applied for or accepted the contract.
What to check before switching supplementary insurance
The order of the steps matters more than the choice of product. Because there is no duty to accept you, cancelling before you have been accepted elsewhere can leave you with no supplementary cover at all.
- Get the new insurer's written acceptance before you cancel the old contract.
- Read any reservations and exclusions proposed: acceptance with a reservation is not the same thing as acceptance.
- Look at the waiting periods that apply to certain benefits.
- Check how the premium changes with age, not just what it is today.
- Compare what each product actually covers, rather than the names of the plans.
And where does this comparison site fit in?
This site compares supplementary insurance, that is, VVG/LCA contracts. It does not compare basic insurance premiums: for compulsory insurance, the benefits are the same everywhere and the Confederation publishes its own premium comparison.
The amounts shown here are estimates meant to help you structure your thinking. The actual terms and prices of a policy only ever come from the insurer or an adviser, never from a comparison site.