Health Insurance and Doctors in Switzerland – A Guide for Poles (2026/2027)

Are you moving to Switzerland for work or visiting? This guide will help you understand how the mandatory health insurance (Krankenkasse) works, how much you actually pay for treatment, what to do about dental care and psychotherapy, what happens with NFZ, and when EKUZ is sufficient.

Last updated: October 21, 2026. Informational material – not legal or medical advice. Amounts and rules may change; please confirm with an official source (BAG, priminfo.admin.ch, your health insurance, NFZ).

In Brief

Who Must Get Insured in Switzerland

The Swiss system is based on the Health Insurance Act (KVG, in French LAMal). Basic insurance (Grundversicherung, officially OKP – mandatory health insurance) is compulsory. According to the Federal Office of Public Health (BAG), you are required to have it if:

• you live in Switzerland, regardless of your citizenship,
• you have a residence permit for at least 3 months,
• you work in Switzerland for less than 3 months, and your insurance does not provide equivalent coverage to Swiss insurance,
• as an EU citizen, you work in Switzerland while living in an EU country (this is the case for cross-border workers, Grenzgänger – more below).

There is no family insurance like in NFZ. Each person, including newborns, must have their own policy. You do not need to get insured in Switzerland if, for example, your Polish employer sends you there for up to 24 months (BAG). In that case, you remain under NFZ, and your employer must obtain an A1 certificate from ZUS (NFZ).

The 3-Month Deadline and Consequences of Delay

You have 3 months from the start of the obligation to purchase insurance, for example, from the date of moving to Switzerland or from the birth of a child. The policy is then retroactive from the first day. The insurance provider will reimburse treatment costs from that period, but you must also pay any overdue premiums. If you are late, coverage will only start from the day you enroll. If you are late without justification, an additional premium will be added. If you do not get insured at all, the cantonal office will assign you to an insurance provider, and you will have no choice (BAG, questions 2, 8, and 9).

How to Choose an Insurance Provider and Get Insured – Step by Step

1. Compare premiums using the official calculator

   Visit priminfo.admin.ch, the government premium calculator. Enter your postal code, year of birth, deductible, and whether you need accident insurance. The premium depends on the canton and region where you live (BAG). The calculator already shows premiums for 2027.

2. Choose a deductible and model

   A higher deductible means a lower premium, but you pay more out-of-pocket when you get sick. Cheaper models limit your choice of the first point of contact. Details can be found below.

3. Check accident insurance

   If you work at least 8 hours a week for one employer, you have accident insurance (UVG) through your employer (BAG, Guide). You can then ask your insurance provider to suspend accident coverage in basic insurance and lower your premium (BAG, question 14).

4. Submit your application on time

   The insurance provider must accept you for basic insurance without reservations and without a waiting period. They cannot require a health questionnaire. If the provider does not respond, BAG advises sending your application by registered mail. Include your chosen deductible and the start date of your insurance (BAG, questions 11–13).

5. Check new rates every autumn

   Insurance providers announce premiums in the autumn. You can change your basic insurance every year until November 30 (priminfo.admin.ch). All providers offer the same range of benefits in basic insurance, differing only in price (priminfo).

How Much You Pay: Premium, Deductible, Out-of-Pocket Costs

Premium (Prämie) – you pay this monthly in advance, even when you are not sick. It does not depend on income, only on your place of residence, age, insurance provider, deductible, and model.

Deductible (Franchise) – the annual amount up to which you pay your own medical bills. For adults, it is typically 300 CHF. You can choose a higher amount: 500, 1000, 1500, 2000, or 2500 CHF. The provider does not have to offer all options. Children under 18 do not have a mandatory deductible, but you can choose 100–600 CHF for them (BAG, FAQ).

Out-of-Pocket Costs (Selbstbehalt) – 10% of costs above the deductible, but no more than 700 CHF per year. For children, the limit is 350 CHF. For certain medications, where a cheaper alternative exists, the out-of-pocket cost is 40%. This rule does not apply if the doctor prescribes the original for medical reasons (BAG).

Hospital Fee – 15 CHF per day of hospitalization. This fee is not charged to children, individuals under 25 who are in education, or women receiving maternity benefits.

The deductible and out-of-pocket costs are calculated based on the date of treatment in the given calendar year. If you change providers during the year, you do not pay them again, but you need confirmation from the previous provider of how much you have already paid. During pregnancy from the 13th week until 8 weeks after childbirth, you do not pay out-of-pocket costs (BAG).

Calculations are based on the rules from BAG. They do not include premiums, hospital fees, or increased out-of-pocket costs for certain medications. A high deductible is beneficial when the savings on premiums exceed the risk of higher expenses.

Insurance Models: Standard, Family Doctor, Telemedicine, Pharmacy

In the standard model, you choose your doctor freely. In cheaper models, you agree to first contact a point designated by the insurance provider. The range of treatment is the same; only the first contact and price differ (BAG). For premiums in 2027, the priminfo calculator uses new categories. The former “Hausarzt” (family doctor) and “HMO” (medical center) have been combined into the PRAXIS category. “Weitere Modelle,” mainly telephone models (Telmed), are now TEL_DIG. Categories PHARM and FLEX have also been added.

Insurance providers have different names and regulations for these models. BAG advises reading the insurance conditions carefully before choosing. You commit to first report to the designated point, and the consequences of bypassing this route are defined by your provider's regulations.

Premium Subsidy (Prämienverbilligung)

Individuals with low incomes may receive a premium subsidy from the canton. Each canton determines the rules and amount separately, and the funds go directly to the insurance provider. The KVG law requires cantons to reduce premiums for children from low-income families by at least 80% and for young adults in education by at least 50% (priminfo.admin.ch). The same page has a list of cantonal offices with addresses. Priminfo also advises asking about subsidies in your municipality.

Supplementary Insurance (Zusatzversicherung, VVG)

Supplementary insurance is voluntary and operates under a different law, the Insurance Contract Act (VVG). It may cover, among other things, dental treatment, single or double rooms, free choice of doctor in the hospital, glasses, alternative methods, psychotherapy with non-medical therapists, and travel insurance. Each provider determines the scope independently (priminfo). An important difference: for supplementary insurance, the provider can ask about your health status, impose exclusions, or refuse coverage (BAG, question 12). If you cancel supplementary insurance, re-enrollment may be impossible, especially after the age of 55–65 or if you have health issues (priminfo).

What Basic Insurance Covers and What It Does Not

Dentist

Dental treatment is generally not covered by basic insurance. The provider pays only if the treatment results from a serious dental disease that could not be avoided, or from a serious general illness, or if it is necessary to conduct such treatment. In the case of an accident, the provider pays only if the costs are not covered by other insurance. Routine fillings and orthodontic appliances for children are not covered (BAG). A complete list of exceptions is in Articles 17–19a of the KLV regulation. In practice, you finance dental treatment out of pocket or through supplementary insurance.

Prescriptions and Pharmacies

The provider covers medications prescribed by a doctor that are on the reimbursement list (Spezialitätenliste). According to BAG, this currently includes about 3000 medications. The pharmacist can dispense a cheaper generic, unless the doctor explicitly prescribes the original (BAG, Guide). For selected medications that have cheaper alternatives, your out-of-pocket cost is 40% instead of 10%. Ask your doctor or pharmacist if this applies to your medication.

Mental Health: Psychotherapy with a Referral

Since July 1, 2022, psychologists can bill therapy to basic insurance if you have a doctor's referral (BAG). The rules are as follows:

• one referral covers a maximum of 15 sessions, and after information exchange between the doctor and therapist, you can receive another 15,
• only doctors with specific specializations can issue a standard referral: general medicine (Allgemeine Innere Medizin), pediatrics, psychiatry and psychotherapy (including children and adolescents), and doctors specialized in psychosomatic medicine (SAPPM),
• for crisis intervention or short therapy, e.g., after a recent diagnosis of a serious illness or in life-threatening situations, any specialist doctor can refer you for a maximum of 10 sessions once,
• to continue therapy after 30 sessions, the provider must previously agree to cover the costs (Kostengutsprache).

The usual deductible and out-of-pocket costs apply. Therapy without a referral or with a therapist not authorized to bill the provider is paid privately or through supplementary insurance, if you have it.

Emergency Situations

According to ch.ch:

• 144 – emergency ambulance (Ambulanz),
• 112 – general emergency number. It also works with a foreign SIM card and a prepaid card without funds,
• 145 – poison information,
• 143 – the “Dargebotene Hand” helpline.

Remember that the ambulance is not free. Basic insurance covers half of the transport costs, up to 500 CHF per year. Life-saving actions, e.g., after an accident in the mountains or a heart attack, are covered halfway, up to 5000 CHF per year, and only in Switzerland (BAG, Guide). You pay the rest out of pocket or through supplementary insurance.

Cross-Border Worker (Grenzgänger) and Right of Choice

If you live in an EU country and work in Switzerland, you generally must get insured in Switzerland (BAG). The EU-Switzerland agreement on the free movement of persons gives some individuals the right of choice (Optionsrecht), meaning the option to remain in the insurance system of their country of residence. According to Gemeinsame Einrichtung KVG, this right applies to cross-border workers living in Germany, France, Italy, and Austria. Cross-border workers from other EU/EFTA countries, including Poland, do not have this choice and must get insured in Switzerland. The application for exemption must be submitted within 3 months of the insurance obligation arising.

In practice: if you live in Poland and work in Switzerland, you cannot remain under NFZ based on Optionsrecht. The exception is delegation with an A1 certificate. If you live in Germany, the right of choice may apply to you. Be mindful of the 3-month deadline.

What Happens with NFZ

In the EU and EFTA, you pay health insurance contributions in only one country. If you do not have insurance in Poland or were in it as a family member, retiree, pensioner, or unemployed person, the regulations of the country of employment apply from the moment you start working abroad, and Polish insurance no longer covers you. If you work simultaneously in Poland and Switzerland, ZUS decides in which country you pay contributions (NFZ). The Swiss insurance provider may request confirmation of your insurance periods in Poland. They will apply for this from NFZ; you only need to provide the regional office.

Short Stay: EKUZ

Switzerland is part of EFTA, so the European Health Insurance Card (EKUZ) is valid there. The card entitles you to necessary and unplanned treatment in the public healthcare system. The extent of treatment is determined by the doctor. You must show the physical card and an ID or passport; just the card number is not sufficient (NFZ). EKUZ does not cover planned treatment. If you lose your right to benefits from NFZ, e.g., after finishing work, the card becomes invalid, even if the date on it has not yet expired. According to NFZ, individuals without EU citizenship cannot receive free treatment under EKUZ in Switzerland, among other places.

How to Find a Polish-Speaking Doctor

We do not provide names as they could not be verified. You can search as follows:

• FMH Doctor Search (Swiss Medical Association) at doctorfmh.ch. Check if you can filter by the language spoken by the doctor.
• Your health insurance. In the PRAXIS model, the insurance provider indicates practices you can visit. Ask the hotline for doctors who speak Polish.
• Polish Embassy in Bern (gov.pl/web/szwajcaria). Ask the consular department if they have information about Polish-speaking doctors.
• Telemedicine in the TEL_DIG model. Ask in which languages the insurance provider conducts consultations.

Remember: if you have a cheaper model, check the insurance conditions before visiting a doctor outside the designated path to see if costs will be reimbursed.

Common Mistakes

• Missing the 3-month deadline. This risks an additional premium and lack of coverage for the period before enrollment.
• Believing that a child or spouse is “added” to your policy. In Switzerland, everyone has separate insurance.
• Choosing a 2500 CHF deductible solely because the premium is low, without saving money for potential illness.
• Bypassing the family doctor, telemedicine, or pharmacy in a cheaper model without checking the regulations.
• Assuming that basic insurance covers dental care.
• Cancelling supplementary insurance without checking if you can be accepted again.
• Using EKUZ after losing the right to benefits from NFZ. NFZ may then demand reimbursement of costs.

Frequently Asked Questions

Can the insurance provider refuse me because I am sick or older?

Not in basic insurance. The provider must accept every person subject to the obligation, without reservations and waiting periods. They can refuse in supplementary insurance (BAG).

I arrived in the middle of the month. Do I pay the premium for the whole month?

No. Upon arrival and departure, the provider calculates the premium by the day (BAG, question 6).

I am leaving Switzerland permanently. What happens to my insurance?

The obligation to insure generally ends with your departure. Exceptions apply to certain individuals moving to the EU, e.g., retirees with a Swiss pension and cross-border workers who still fall under the Swiss system. Leaving for travel or studies without changing your residence does not end the obligation (BAG, questions 16–17).

Does the Swiss insurance card work in Poland?

The provider issues you a European Health Insurance Card. In EU/EFTA countries, it entitles you to medically necessary treatment under the same conditions as locals. Depending on the country, costs are settled by the local institution or you pay out of pocket and apply for reimbursement (BAG, Guide).

Fact-Check Summary

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