Choosing guide
What to check before choosing health insurance
A practical guide to checking costs, limits and conditions before comparing your final premium.
← Back to comparisonChoosing guide
Questions to open before you choose.
Important costs, restrictions and checks, organised by category.
Information checked on 24 August 2026. Premiums, networks, models and conditions can change.Telemedicine and digital services
Costs, free services, health apps and partner pharmacies.
01Is telemedicine always free?!Attention+
No. An app or initial triage may be free, while a medical consultation, prescription or certificate can be billed and subject to the deductible and co-payment. Check the consultation price, surcharges and exclusions.
Official source: UFSP / Priminfo ↗
02Which models include free telemedicine?✓Benefit+
Several 2026 models publicly confirm free consultations, including selected plans from Assura, EGK, Helsana, KPT, Sanitas, SWICA, Sympany and others. The benefit is model-specific and may exclude psychology, certificates or third-party services, so verify the current conditions.
Official source: Medgate · health insurers (IT) ↗
03What does “free initial advice” mean?ⓘInfo+
It usually means the first orientation or symptom assessment is not billed. A subsequent doctor consultation, prescription or certificate may still generate a charge; do not read it as unlimited free telemedicine.
Official source: UFSP / Priminfo ↗
04Is an app symptom check free?!Attention+
It can be, but the doctor may not be. Compare the symptom-check fee, the consultation fee, whether the app’s instructions are binding, data handling and access to an in-person doctor.
Official source: UFSP / Priminfo ↗
05Can the model require a specific pharmacy?!Attention+
Yes. Some plans restrict you to partner pharmacies, mail order or specified purchase channels, and off-network medicines may not be reimbursed. Check emergency exceptions and delivery times.
Official source: UFSP / Priminfo ↗
Access to care and model rules
First point of contact, exceptions and provider networks.
06Who must I contact before seeing a doctor?!Attention+
It depends on the model: free choice for Standard, the nominated GP for family-doctor plans, the HMO centre for HMO, the telemedicine centre for Telmed, or an approved pharmacy/contact point for combined plans.
Official source: UFSP / Priminfo ↗
07Which appointments can I book directly?!Attention+
Exceptions vary and can include emergencies, gynaecology, maternity, ophthalmology, dental care, vaccinations, paediatrics or authorised follow-ups. Some still require later notification, so check specialties, age limits and deadlines.
Official source: UFSP / Priminfo ↗
08Can I keep my doctor?!Attention+
Only if the doctor is admitted by the selected model. Verify your GP, specialists, HMO centre and usual pharmacy, and ask what happens if a provider leaves the network.
Official source: UFSP / Priminfo ↗
09What happens if I do not follow the pathway?!Attention+
The insurer may warn you, require compliance or move you to the Standard model. Check the consequences of a first and repeated breach, reimbursement of treatment already received and emergency-notification deadlines.
Official source: UFSP / Priminfo ↗
Deductible and healthcare costs
Cost sharing and amounts that can remain payable by you.
10When do I reach the annual co-payment cap?!Attention+
For adults, the ordinary co-payment is 10% after the deductible, up to CHF 700 a year. The cap is reached after the deductible plus CHF 7,000 of eligible costs: CHF 7,300 with a CHF 300 deductible or CHF 9,500 with CHF 2,500.
Official source: UFSP / Priminfo ↗
11Which deductible should I choose?✓Benefit+
Compare total annual cost: premium plus deductible, co-payment and other charges. Ordinary maximum cost sharing is CHF 1,000 with a CHF 300 deductible and CHF 3,200 with CHF 2,500; choose the high deductible only if you can absorb that risk.
Official source: UFSP / Priminfo ↗
12Does the deductible cover all my costs?!Attention+
No. Co-payment, the inpatient contribution, non-covered benefits, some medicines, higher medicine co-payments, foreign treatment and excluded supplemental benefits can remain separate. The treatment date determines the calendar year.
Official source: UFSP / Priminfo ↗
13Why do some medicines have a 40% co-payment?!Attention+
If a product is expensive compared with equivalent generics or biosimilars, a 40% co-payment can apply instead of 10%. Ask about an equivalent lower-cost product and check the Specialities List.
Official source: UFSP / Priminfo ↗
14How much do I pay for a hospital stay?!Attention+
An inpatient stay with an overnight may add CHF 15 per day. Minors, young adults in education up to age 25 and maternity benefits are generally exempt, while deductible and co-payment may still apply.
Official source: UFSP / Priminfo ↗
15How does cost sharing work for children?ⓘInfo+
Minors have no mandatory deductible, though an optional one is possible, and their ordinary annual co-payment cap is CHF 350. Family limits apply when several children are insured with the same insurer.
Official source: UFSP / Priminfo ↗
16Are deductible and co-payment charged during maternity?ⓘInfo+
Specific maternity benefits are exempt. From week 13 of pregnancy until eight weeks after birth, broader exemptions apply to general medical benefits; ask the insurer how unrelated treatments and medicines are classified.
Official source: UFSP / Priminfo ↗
17When can a pharmacy prescription check cost more than the medicine?!Attention+
Since 1 January 2026, RBP V bills safety checks separately for reimbursable category A and B medicines: CHF 5.20/4.05 on first supply and CHF 4.25/2.05 on repeat supply, plus CHF 3.95 per prescriber per day for the patient check. With an unmet high deductible, compare the total prescription invoice with the direct pharmacy price. Category D medicines do not permit these safety-check positions under the current RBP V clarification, so ask the doctor or pharmacist which category and fees apply; do not skip a clinically necessary prescription.
Official source: pharmaSuisse · RBP V ↗ · pharmaSuisse · RBP V clarifications ↗
Premiums and insurer choice
Premiums, models and total annual cost.
18Are basic-insurance benefits the same at every insurer?✓Benefit+
The statutory catalogue is the same. Premiums, models, provider networks, first-contact rules, telemedicine, billing, customer service and digital tools differ, and every basic insurer active in your region must accept you.
Official source: UFSP / Priminfo ↗
19Is the lowest premium always the best choice?!Attention+
No. Compare annual premium, deductible, co-payment, hospital contribution, telemedicine fees, provider network, non-reimbursed costs and your ability to absorb an unexpected bill.
Official source: UFSP / Priminfo ↗
20When are new premiums published?✓Benefit+
Approved premiums are normally published near the end of September. Recheck the premium, model, deductible, accident cover, network and included services in autumn using the federal Priminfo calculator.
Official source: UFSP / Priminfo ↗
21What should I check again each year?✓Benefit+
Review the new premium, deductible, accident cover, premium subsidy, doctors and pharmacies in the network, mandatory pathway, telemedicine costs, exclusions, supplemental-insurance deadlines, foreign cover and current model conditions.
Official source: UFSP / Priminfo ↗
Switching insurer and supplemental cover
Deadlines, model changes and separating basic from supplemental insurance.
22What is the deadline for switching health insurers?!Attention+
For a basic-insurance switch on 1 January, cancellation must reach the insurer by 30 November. Send it early, apply to the new insurer at the same time and settle overdue premiums or cost-sharing amounts.
Official source: UFSP / Priminfo ↗
23When can I change deductible or model?!Attention+
A lower deductible normally requires written notice by 30 November; a higher deductible starts only at the beginning of a calendar year. Model changes must also respect the applicable deadlines, so request written confirmation.
Official source: UFSP / Priminfo ↗
24Can basic and supplemental insurance be with different companies?✓Benefit+
Yes. Changing basic insurance does not force you to cancel supplemental cover, though separate companies can mean extra administration, two billing flows or slower reimbursements.
Official source: UFSP / Priminfo ↗
25Can I cancel the old supplemental policy immediately?!Attention+
Do not cancel until the new company has accepted you finally and in writing. Supplemental insurers may refuse an application, impose reservations or exclusions and use their own cancellation periods.
Official source: UFSP / Priminfo ↗
Personal situation and savings
Accident cover and cantonal premium reductions.
26Can I exclude accident cover?✓Benefit+
If you work at least eight hours a week for the same employer, you are normally covered for non-occupational accidents and may suspend accident cover in basic insurance. Recheck this if your hours or employment change.
Official source: UFSP / Priminfo ↗
27Can I receive a premium reduction?✓Benefit+
Eligibility depends on income, household and canton. Some cantons apply it automatically and others require an application by a deadline; check the cantonal rules and report relevant changes.
Official source: UFSP / Priminfo ↗
Travel and treatment abroad
Healthcare protection outside Switzerland.
28How am I covered abroad?!Attention+
In the EU, EFTA and the UK, the European card covers medically necessary care under local rules. Elsewhere, basic insurance normally covers urgent treatment only within limits, so check travel, hospital, repatriation and rescue cover.
Official source: UFSP / Priminfo ↗