Each year, the cost of Switzerland’s obligatory health insurance goes up – more in some cantons than in others. What factors determine how much you pay in your place of residence?
In 2026, health insurance rates have increased, on average, by 4.4 percent . However, depending on your canton of residence, you are paying a higher or a lower premium.
For instance, with a hike of 6.9 percent over current premiums, residents of Ticino are saddled with the highest increase – 582 francs a month.
Next is Valais (5.8 percent – 439 francs); Appenzell-Innerrhoden (5.5 percent- 322 francs); Uri (5.3 percent – 363 francs); Zurich (5.1 percent- 451 francs); and Graubünden (5 percent – 400 francs).
These are the highest increases, according to the Federal Office of Public Health (FOPH).
As for residents of Vaud, with a 4.3 – percent increase, they are just-just below the national average, but still have a rather hefty 527 francs in monthly premiums to pay.
However, rates in a number of cantons are actually well below the average premium – even though the actual amount of premiums is high.
In Geneva, for instance, the rates went up by only 2.6 percent, but residents still have to pay 586 francs in monthly premiums.
Basel-City will also see below-average premiums (2.9 percent – 521 francs).
(While the percntages are fixed, the actual amounts may vary based on the kind of plan you have, the amount of your ‘franchise’, etc).
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Why is there such a disparity among cantons?
The general answer is that cantons have different health infrastructure and levels of government funding.
And demographics comes into play as well: health premiums in cantons with younger and healthier population will be lower than in those with higher incidence of disease, and older, chronically ill people.
However, new research carried out by the CSS Institute for Empirical Health Economics reveals that other factors also play an important role in determining how much you end up paying for health insurance where you live.
According to Caroline Chuard-Keller, the Institute’s scientific project manager, “regional differences in health care costs are among the major unresolved questions in health policy.”
The study shows that around 40 percent of the regional variation can be attributed to “differences in supply” – for instance, the number/density of regional healthcare facilities as well as general and specialist service providers, and even pharmacies.
The remaining 60 percent is driven by the demand – in other words. how often residents of a given canton seek medical help.
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You can drive the costs up or down in your region
Obviously, residents of a given canton can’t influence the ‘supply’ part – that is, the prevalence and density of hospitals, doctors, and health services in their area.
That depends largely on the local government’s budget dedicated to health services and infrastructure.
However, residents can – at least to a certain degree – shape the demand part of the equation by how often they seek medical care: do they run to see the doctor for every ache and pain – and therefore drive up the overall costs – or do they seek treatment sparingly.
So the take-away message here is this: if you live in an ‘expensive’ (in terms of healthcare) canton, you know why this is: there is a high concentration of doctors, hospitals, and high-tech equipment, and residents use these services often.
Therefore, it is the combination of both factors – supply and demand – that determines the cost of your health insurance.
Why doesn’t Switzerland have national health premiums — the same across all cantons?
The reason is the decentralised system of government, under which cantons wield a lot of power.
READ MORE: EXPLAINED: Why Switzerland’s cantons are so powerful
In terms of healthcare, responsibilities are divided between the federal and cantonal authorities.
The federal government regulates financing of the health system, ensures the quality of care, as well as safety of drugs and medical devices, and promotes research and training.
It also supervises dozens of private carriers to ensure that they comply with the federal KVG / LaMal law, which prohibits discrimination based on age or health status, withholding necessary treatments, and other provisions guaranteeing that every policyholder gets the same quality of care.
The Federal Office of Public Health (FOPH) is also responsible for approving premiums.
Cantons, on the other hand, are responsible for designing health care policies on their territories, licensing medical providers, coordinating hospital services, and setting healthcare premiums.
