It has been 30 years since health insurance became mandatory in Switzerland. The introduction of the federal health insurance law brought numerous changes: Residents were required to have basic health insurance, insurance providers were required to insure all residents, regardless of their age or health condition, and customers had a right to change insurance providers.
In this report, moneyland.ch looks at what has changed since basic, mandatory health insurance was introduced.
Massive price hikes in some cities
According to statistics from the Federal Office of Public Health (FOPH), the average premium for mandatory health insurance was 128 francs in 1996, and 393 francs in 2026. That is an increase of just over 207 percent. It is worth noting that the Consumer Price Index went up by just under 20 percent between 1996 and 2026, meaning inflation has been more than 10 times higher for health insurance than for consumer prices as a whole.
It is important to note, though, that the average premium from the FOPH accounts for all insurance models, age groups, and regions. In order to provide a more relatable picture of how the cost has climbed since 1996, moneyland.ch compiled the adult premiums for 10 Swiss cities from major insurance providers. The premiums are for standard model offers with the lowest insurance deductible, including accident cover.
As the graphic above shows, the cost of standard insurance with the lowest deductible has gone up far more than that of premiums as a whole. Of the 10 cities included in the analysis, Aarau saw the biggest price hikes, with the average premium climbing from 134 francs in 1996 to 576 francs in 2026 – an increase of nearly 329 percent. Residents of St.Gallen also have to pay much more now, with the average premium increasing from 134 francs in 1996 to 572 francs in 2026. That translates into an increase of nearly 326 percent. The average increase across all of the offers included in the evaluation is 238 percent.
“The evaluation shows that for residents of some cities, the real cost of standard health insurance with the lowest deductible has increased far more than the average premium increase would indicate,” observes moneyland.ch editor Daniel Dreier.
Fewer health insurance providers
In 1996, the market for mandatory health insurance was served by 145 different health insurance providers. The number has radically declined since then. In 2026, there are just 34 providers of mandatory health insurance. That translates into a decline of more than 76 percent.
“In addition to market consolidation through mergers and acquisitions, changes in regulatory and administrative requirements have also contributed to the decline,” comments Daniel Dreier. “It is worth noting, though, that the number of Swiss health insurance providers was already declining before the introduction of mandatory health insurance, after peaking at over 1000 different providers in the 1950s.”
Cost-conscious residents have traded mid-range deductibles for the highest deductible
One of the major changes introduced with mandatory health insurance was the standardization of insurance deductible models.
In 1996, nearly 66 percent of residents used the lowest possible insurance deductible, without accounting for the approximately two percent of residents with managed care and bonus/malus models. By 1999, just over 55 percent of residents used the lowest deductible. Since then, the ratio has remained fairly stable. In 2024, the most recent year for which statistics are available, a total of 54.4 percent of residents used the lowest possible deductible.
The use of mid-range deductibles, on the other hand, has shown a continual decline.
Between 2013 and 2024, the use of mid-range deductibles declined from 32.9 percent of residents to just 14.1 percent of residents. Meanwhile, the use of the highest possible deductible increased from 14.4 percent in 2013, to 31.5 percent in 2024.
“The statistics show that the shift to higher deductibles primarily occurs among the portion of residents who were already willing to pay more out of their own pocket,” remarks Daniel Dreier. “The ratio of residents with the lowest deductible has remained relatively stable.”
Managed care has become the new norm
One of the most significant changes has been the shift from standard health insurance without limitations to restricted managed care models.
Statistics show that in 1996, more than 98 percent of residents used the standard model that lets you visit Swiss doctors and specialists without having to consult a gatekeeper first.
As per the most recent statistics, today around 20 percent of residents use the standard model. Around 80 percent use a managed care model that limits direct access to doctors and specialists.
“The statistics indicate that residents are increasingly willing to accept limitations in order to keep the cost of insurance affordable,” says moneyland.ch editor Daniel Dreier.
The ratio of premium reduction recipients has remained stable
Just over 1.65 million residents received subsidies towards the cost of mandatory health insurance in 1996. That translates into 23 percent of Switzerland’s insured population at the time. That number climbed to just over 2.45 million by 2023, the most recent year for which statistics are available. But while the actual number of recipients is much higher, the ratio of recipients to non-recipients is only moderately higher, at 27.5 percent of residents.
The average ratio across all years for which statistics are available is around 29 percent.
“Switzerland’s population has grown substantially since 1996. The ratio of premium reduction recipients has remained fairly stable, in spite of the rising cost of health insurance,” observes Daniel Dreier from moneyland.ch.
Methodology
For the cost evaluation, moneyland.ch used the premiums for standard health insurance with the lowest insurance deductible and accident cover.
Calculations for 1996 are based on the premiums from these 10 major insurance providers: Artisana (now part of Helsana), Concordia, CSS, Helvetia (now part of Helsana), KFW (now part of Sanitas), KPT, Sanitas, Supra (now part of Groupe Mutuel), Swica, Visana. These premiums were published on October 17, 1995, in the Neue Zürcher Zeitung.
Calculations for 2026 are based on the premiums from these 10 major insurance providers: Assura, Concordia, CSS, Groupe Mutuel, Helsana, KPT, Sanitas, Swica, Sympany, Visana. These premiums are published by the Federal Office of Public Health.
For each city, moneyland.ch calculated the arithmetic mean average of premiums from all 10 insurance providers.
Calculations for the mandatory health insurance providers, deductible models, insurance models, and premium reductions are based on data published by the Federal Office of Public Health, the Federal Social Insurance Office, and the Federal Statistical Office.
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