Health insurance subsidy: How does it work?

Health insurance subsidy How it works
In Switzerland, basic health insurance (LAMal) is compulsory for everyone. To make these premiums affordable, health insurance subsidies have been introduced, enabling people of modest means to reduce the cost of their premiums. Here's a complete overview of how subsidies work.

What is a health insurance subsidy?

The health insurance subsidy is a financial assistance which applies to premiums thebasic insurance. Its allocation depends mainly on the policyholder's income and family situation. Some key points to remember :

  • In most cases, the subsidy is granted automatically on the basis of your income. However, certain categories of people are required to submit an application.
  • It currently takes around 8 weeks to process an application. In the event of a positive decision, the subsidy is retroactive to January.
  • The subsidy is not paid directly to the insured. Instead, it is passed on to your health insurance company, which deducts it from the premium you have to pay.

Find out if you have been awarded a subsidy

Although the subsidy is usually granted automatically, it is important to check whether you are eligible. Every eligible person receives a certificate of subsidy directly by mail. This certificate is essential for all administrative procedures and should be kept in a safe place.

If you can no longer find your certificate or wish to check your entitlement, log on to your espace e-démarches. This will enable you to visit and print your certificate free of charge.

Scales and award criteria

The grant is awarded on the basis of several criteria, including :

  • The determining income (RDU): This is the income used to calculate your subsidy entitlement. It can be adjusted according to whether you have a single or joint income, and according to the number of legal dependents (dependent children or young adults).
  • Family situation: Rates vary from canton to canton, depending on whether you live alone or as a couple, and on the number of legal dependents. For example, in the case of a couple with two children, the amount of the subsidy is determined according to the RDU and the group to which you belong.

Subsidies and supplementary benefits

It is also important to note that beneficiaries of supplementary benefits (PC) do not need to apply for a subsidy, as these subsidies are directly integrated into the supplementary benefits paid by the service concerned.

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Fondeca is a blog dedicated to providing information on insurance and finance for individuals and companies in Switzerland.

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