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Insurance News

City Dwellers, Romands and Ticinesi Pay More for Health Insurance

October 20, 2021 - Benjamin Manz

A analysis of Swiss mandatory health insurance premiums for 2022 shows that residents of French-speaking and Italian-speaking Switzerland pay significantly more than people in German-speaking Switzerland. Urban dwellers generally pay more than residents of rural areas.

The average health insurance premium will hardly change in 2022. According to the Federal Office of Public Health, the average premium for compulsory insurance will actually sink by 0.2 percent when the New Year rings in. A much less surprising absence of change can be seen are the stubborn premium gaps between Switzerland’s linguistic regions.

Independent online comparison service analyzed mandatory health insurance premiums across all of premium districts. It also calculated the weighted average premiums for the French-, German-, and Italian-speaking regions.

The results show that the cost of health insurance is much higher in French-speaking Switzerland and Ticino than in German-speaking Switzerland. Compared to the average 2022 premium for German-speaking Switzerland, the average premium is 18 percent higher in French-speaking Switzerland and 17 percent higher in Ticino.

“The huge contrast between the French and the German linguistic regions is primarily the result of differences in healthcare costs,” says analyst Felix Oeschger. In other words, the healthcare costs generated per capita are higher in the French- and Italian-speaking regions than in German-speaking Switzerland.

These examples shed light on how big the differences are: For Switzerland as a whole, the healthcare benefits paid out by compulsory health insurance average 3468 francs per resident. Healthcare costs are highest in the cantons of Basel-Stadt (4495 francs), Geneva (4323 francs), Ticino (4004 francs) and Neuchâtel (3986 francs). The cantons with the lowest per-capita healthcare costs are Appenzell Innerrhoden (2310 francs), Uri (2666 francs), Zug (2808 francs), and Obwalden (2825 francs).

Linguistic rift in health insurance premiums for adults

The weighted average insurance premium in German-speaking Switzerland for adult residents above the age of 26 is 365 francs per month. In French-speaking Switzerland it is 432 francs per month. “That means residents of French-speaking Switzerland pay around 800 francs per year, on average, than those in German-speaking Switzerland,” says CEO Benjamin Manz.

Premium differences between young adults

Regional differences are also noticeable in premiums for young adults between the ages of 19 and 25. Young adults in western Switzerland pay an average of 315 francs per month for compulsory health insurance, compared to 296 francs in Ticino and 257 francs in German-speaking regions.

The same pattern is visible in the youngest age group as well. Premiums for children up to the age of 18 average 102 francs in German-speaking Switzerland, 116 francs in Ticino, and 118 francs in French-speaking Switzerland.

Premiums in Ticino now nearly as high as in French-speaking Switzerland

Adults in Switzerland’s Italian-speaking canton must pay 428 francs, on average, for mandatory health insurance. “On average, residents of Ticino pay 756 francs more per year than residents of German-speaking Switzerland,” states CEO Benjamin Manz.

The difference between the average premiums of Italian- and French-speaking Switzerland is now just 4 francs per month. That is a recent development. In 2018, the average premium in French-speaking Switzerland was around 28 francs higher than that of Ticino. “Disproportionately large climbs in the cost of insurance over recent years has resulted in premiums in Ticino being nearly on par with those of French-speaking Switzerland,” says Felix Oeschger. Since 2018, premiums in Ticino have gone up faster than those in French- and German-speaking Switzerland.

Higher insurance premiums in French-speaking Valais

In 2022 also, the premiums in the French-speaking portion of Valais are higher than those in the German-speaking portion. The average monthly premium for adults in predominantly German-speaking municipalities is 330 francs, compared to 359 francs in French-speaking municipalities. That is a difference of 26 francs per month.

Lower premiums in central Switzerland

Linguistic borders are not the only place where major gaps exist. Differences between German-speaking cantons are also huge. Premiums in central Switzerland are particularly affordable. With the exception of the canton of Lucerne, premiums in the six cantons making up inner Switzerland all fall into the lowest quarter of the 41 analyzed premium regions.

The central cantons with the lowest average monthly premiums are Uri (297 francs), Nidwalden (303 francs), and Zug (304 francs). Only residents of Appenzell Innerrhoden pay less, with an average premium of 267 francs.

High premiums in urban premium districts

Residents of the cantons of Basel-Stadt (483 francs per month) and Geneva (479 francs per month) pay the most for health insurance, on average. They are followed by residents of Vaud (445 francs), the population of which largely lives in Lausanne and the towns surrounding the Lake of Geneva.  

This urban-rural divide is also visible in cantons made up of multiple premium districts. For example, the average premium in the canton of Bern’s first premium district, which includes the cities of Bern and Biel, is 437 francs. The average premiums in the canton’s second and third premium districts are 386 and 358 francs per month respectively.  

A similar pattern can be found in the canton of Zurich. The average premium in the first premium district making up the canton – which includes the city of Zurich – is 416 francs. The second premium district includes the City of Winterthur and populous municipalities surround Lake Zurich, and has an average premium of 366 francs. The third premium district has an average premium of 338 francs.

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Expert Benjamin Manz
Benjamin Manz is CEO of and an independent expert on banking and finance.