Two Laws, Two Worlds of Insurance
Swiss health insurance is governed by two entirely separate laws, and understanding the difference between them is one of the most important things you can do as a resident. The KVG (Bundesgesetz ueber die Krankenversicherung — Federal Health Insurance Act) governs mandatory basic insurance. The VVG (Bundesgesetz ueber den Versicherungsvertrag — Federal Insurance Contract Act) governs voluntary supplementary insurance.
These two laws create fundamentally different consumer protections. Under the KVG, you have strong rights: guaranteed acceptance, regulated premiums, standardised benefits. Under the VVG, insurers have more power: they can reject you, set their own prices, and define their own benefit catalogues. Treating both types of insurance the same way is a common and sometimes costly mistake.
Key Principle
KVG = social insurance. Every insurer must accept you, benefits are identical by law, and premiums are regulated. VVG = private insurance. Insurers can reject you, set their own benefits, and charge what they want. Never confuse the two — especially when switching.
Key Differences at a Glance
| Feature | KVG (Basic Insurance) | VVG (Supplementary Insurance) |
|---|---|---|
| Legal basis | Federal Health Insurance Act (KVG) | Federal Insurance Contract Act (VVG) |
| Mandatory? | Yes — every Swiss resident must have it | No — completely voluntary |
| Acceptance | Guaranteed — insurers must accept everyone | Not guaranteed — health questionnaire required |
| Health check | None | Yes — pre-existing conditions may lead to exclusions or rejection |
| Benefits | Identical across all insurers (defined by law) | Vary by insurer and product |
| Premiums | Regulated and approved by BAG | Set freely by each insurer |
| Premium factors | Canton, age group, franchise, model | Age, gender, health status, product chosen |
| Switching | Free to switch annually (Nov 30 deadline) | Varies — often 3 or 6 months’ notice, check policy |
| Cancellation by insurer | Not possible (except for non-payment) | Possible under certain conditions |
| Split between providers? | Yes — you can have KVG with one insurer and VVG with another | |
What Basic Insurance (KVG) Covers
The KVG defines a comprehensive catalogue of medical services that every insurer must cover. The key categories:
Doctor Visits and Outpatient Care
All consultations with licensed doctors, whether GPs or specialists (with appropriate referrals if you are in a Hausarzt or HMO model). This includes diagnostics, laboratory tests, and imaging (X-rays, MRIs, CT scans) when medically indicated.
Hospital Stays
Inpatient treatment in the general ward of your canton’s listed hospitals. You are covered for the hospital in your canton of residence. Out-of-canton hospitals are covered only if the treatment is medically necessary and not available in your canton, or in emergencies.
Medications
Prescription medications listed on the official Spezialitaetenliste (SL) are covered. Generic substitution may apply — pharmacists can dispense a cheaper equivalent unless your doctor specifies otherwise. Over-the-counter medications are generally not covered.
Maternity Care
Prenatal check-ups, birth (including caesarean section when medically indicated), postnatal care, and midwife services. From the 13th week of pregnancy and for eight weeks after birth, you pay no franchise or co-payment for pregnancy-related care.
Other Covered Services
- Physiotherapy (with doctor’s prescription)
- Emergency dental treatment (accidents or severe conditions — routine dental care is not covered)
- Certain preventive screenings (e.g., mammography for women 50+)
- Rehabilitation after hospitalisation
- Ambulance transport (50% covered, up to CHF 500 per year)
- Complementary medicine from certified doctors (acupuncture, traditional Chinese medicine, homeopathy, anthroposophic medicine, phytotherapy) — basic coverage since 2017
Important
The KVG does not cover routine dental care, glasses/contact lenses for adults, or private/semi-private hospital rooms. These are the most common gaps that supplementary insurance fills.
What Supplementary Insurance (VVG) Covers
Supplementary insurance fills the gaps left by basic insurance. Unlike the KVG, there is no standard benefit catalogue — each insurer designs its own products with its own terms. The most common supplementary insurance categories:
Ambulatory Supplementary Insurance (Ambulante Zusatzversicherung)
The most popular type of supplementary insurance. Typical benefits include:
- Complementary and alternative medicine: Acupuncture, osteopathy, naturopathy, traditional Chinese medicine from non-doctor practitioners (basic insurance only covers treatments by certified doctors)
- Glasses and contact lenses: Contributions of CHF 150–300 per year
- Dental check-ups and hygiene: Contributions of CHF 200–500 per year
- Fitness and prevention: Gym memberships, sports courses, health programmes (CHF 200–500 per year)
- Vaccinations: Travel vaccines and others not covered by KVG
- Transport and rescue: Full ambulance coverage, helicopter rescue (Rega), repatriation
Typical cost: CHF 20–60 per month depending on age, insurer, and scope of coverage.
Hospital Supplementary Insurance (Spitalzusatzversicherung)
Upgrades your hospital experience beyond the general ward covered by basic insurance. Two levels:
- Semi-private (Halbprivat): Two-bed room, choice of senior physician, free hospital choice across all of Switzerland
- Private (Privat): Single room, choice of chief physician, free hospital choice including private clinics
Typical cost: CHF 100–400 per month depending on age, gender, and level of coverage. Premiums increase significantly with age.
Dental Insurance (Zahnversicherung)
Covers routine dental care, hygiene appointments, fillings, crowns, bridges, and sometimes orthodontics. Coverage limits vary widely — typically CHF 1’000 to CHF 5’000 per year. Dental insurance is most cost-effective when taken out for children, as orthodontic treatment can cost CHF 5’000 to CHF 15’000.
Pro Tip
Dental insurance should ideally be taken out for children before age 3–5, when no dental history exists. For adults with existing dental issues, insurers will likely exclude those conditions or reject the application entirely.
Travel Insurance (Reiseversicherung)
Covers medical treatment abroad beyond what basic insurance provides. The KVG covers emergency treatment outside Switzerland, but only up to twice what the same treatment would cost in Switzerland. In countries with expensive healthcare (USA, Canada, Australia), this can leave significant gaps. Travel supplementary insurance covers the difference and often includes repatriation.
Daily Sickness Allowance (Krankentaggeld)
Replaces income during illness. While employers must continue paying wages for a limited period (under the OR, the obligation is relatively short in the first years of employment), daily sickness allowance insurance provides longer coverage — typically 720 days within 900 consecutive days. This is particularly relevant for self-employed individuals and employees with short tenure.
The Health Questionnaire: VVG’s Gatekeeping Mechanism
Unlike basic insurance, supplementary insurers assess your health before accepting you. The application includes a health questionnaire (Gesundheitsfragebogen) that typically asks about:
- Current and past medical conditions (usually the last 5–10 years)
- Ongoing treatments and medications
- Previous surgeries and hospitalisations
- Mental health conditions
- Planned treatments or known upcoming procedures
Based on your answers, the insurer may:
- Accept you fully: No restrictions, full benefits
- Accept with exclusions (Vorbehalte): Specific conditions are excluded from coverage, sometimes permanently, sometimes for a defined period (typically 5 years)
- Accept with a premium surcharge: Higher premium due to elevated risk
- Reject your application: Complete refusal, with no obligation to explain why
Critical Warning
Answer the health questionnaire truthfully. If an insurer later discovers you concealed a condition or provided false information, they can void the contract retroactively — even years later — and refuse to pay claims. Swiss courts consistently uphold insurers’ right to rescind contracts for dishonest applications.
Who Actually Needs Supplementary Insurance?
Not everyone needs supplementary insurance. Basic insurance covers all medically necessary treatments. Supplementary insurance is about comfort, convenience, and covering gaps that matter to you personally.
| Your Situation | Recommended Supplementary Coverage | Why |
|---|---|---|
| Healthy young adult, minimal medical needs | Basic ambulatory (glasses, dental hygiene, fitness) | Low cost, covers the most common gaps |
| Family with young children | Ambulatory + dental for children | Children’s dental and orthodontic costs can be very high |
| Regular user of alternative medicine | Ambulatory with complementary medicine | Covers non-doctor practitioners not included in KVG |
| Frequent international traveller | Travel insurance | KVG coverage abroad is limited and may leave large gaps |
| Values comfort in hospital | Semi-private or private hospital | Single/double room, doctor choice, free hospital choice |
| Self-employed | Daily sickness allowance | No employer obligation to continue wage payments |
| Budget-conscious, healthy, no specific needs | None — basic insurance may be sufficient | KVG covers all medically necessary care |
Switching Rules: KVG vs VVG
The switching rules differ dramatically between the two types:
Basic insurance (KVG): You can switch to any insurer annually with a November 30 deadline. No health check, guaranteed acceptance. See our How to Switch Health Insurance guide for details.
Supplementary insurance (VVG): Switching is more complex and risky:
- Notice periods vary by product and insurer (typically 3–6 months)
- You must pass a health questionnaire with the new insurer
- If rejected by the new insurer, you cannot simply go back to the old one
- Pre-existing conditions may be excluded or lead to higher premiums
- Some conditions that developed while you were insured may now count against you with a new insurer
The golden rule: never cancel supplementary insurance before receiving written acceptance from the new insurer.
Can You Split Basic and Supplementary Between Insurers?
Yes, absolutely. There is no legal or practical requirement to have basic and supplementary insurance with the same company. Many Swiss residents deliberately split their coverage:
- Basic insurance: Choose the cheapest insurer for your canton and situation
- Supplementary insurance: Choose the insurer with the best coverage for your specific needs
There is no penalty, no disadvantage, and no coordination problem. Each insurer handles its own claims independently. The only minor inconvenience is dealing with two companies instead of one. Some insurers offer small premium discounts (CHF 5–10 per month) if you hold both basic and supplementary with them, but these rarely outweigh the savings from choosing the cheapest basic insurer separately.
Most Popular Supplementary Insurance Products in Switzerland
| Product | Monthly Cost (approx.) | What It Covers | Worth It For |
|---|---|---|---|
| SWICA COMPLETA | CHF 30–55 | Alternative medicine, glasses, fitness, dental hygiene, worldwide emergency | Alternative medicine users, active lifestyle |
| Helsana TOP/COMPLETA | CHF 25–50 | Complementary medicine, glasses, prevention, dental | Broad ambulatory coverage |
| CSS myFlex Balance | CHF 20–45 | Modular — choose your coverage blocks | People who want customisation |
| Semi-private hospital (various) | CHF 100–250 | Two-bed room, senior physician, free hospital choice | Comfort-oriented, older adults |
| Children’s dental (various) | CHF 15–30 | Dental care, orthodontics up to CHF 5’000–15’000 | Families with young children |
*Premiums are approximate and vary by age, gender, canton, and specific product variant. Always request a personalised quote.
When to Take Out Supplementary Insurance
Timing matters more for VVG than for KVG. Because supplementary insurers assess your health at application, the best time to apply is when you are young and healthy:
- Ambulatory supplementary: Ideally before age 30, when you are least likely to have conditions that trigger exclusions
- Hospital supplementary: The younger you start, the lower the premium. Premiums increase significantly with age — a policy that costs CHF 120 per month at age 30 may cost CHF 350 at age 55
- Dental for children: Before age 3–5, ideally at birth. Once dental issues appear, coverage becomes difficult to obtain
- Daily sickness allowance: As soon as you become self-employed, or if your employment contract has short wage continuation terms
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Frequently Asked Questions
What does KVG stand for?
KVG stands for Krankenversicherungsgesetz — the Federal Health Insurance Act. It governs mandatory basic health insurance in Switzerland. Every resident must have KVG coverage, and every insurer must accept every applicant.
What does VVG stand for?
VVG stands for Versicherungsvertragsgesetz — the Federal Insurance Contract Act. It governs voluntary supplementary insurance. Unlike the KVG, the VVG allows insurers to set their own terms, conduct health assessments, and reject applicants.
Can an insurer reject me for basic insurance?
No. Under the KVG, every insurer must accept every resident for basic insurance. There is no health questionnaire, no waiting period, and no exclusions. This is a fundamental consumer protection in the Swiss system.
Can an insurer reject me for supplementary insurance?
Yes. Supplementary insurance operates under the VVG, which gives insurers the right to assess risk. They can reject your application, accept you with exclusions for pre-existing conditions, or charge a higher premium based on your health status.
Do I need supplementary insurance?
Not necessarily. Basic insurance covers all medically necessary treatments, hospital stays, and medications. Supplementary insurance covers extras like private hospital rooms, dental care, glasses, extended alternative medicine, and better international coverage. Whether you need it depends on your personal priorities and health needs.
Can I have basic insurance with one company and supplementary with another?
Yes. There is no requirement to hold both with the same insurer. Many people choose the cheapest basic insurer and the best supplementary insurer separately. There is no penalty or coordination issue.
What happens if I lie on the supplementary insurance health questionnaire?
If the insurer discovers false or incomplete information, they can void the contract retroactively — even years later. This means they can refuse all claims and potentially demand repayment of past claims. Swiss courts consistently uphold this right. Always answer truthfully.
Is dental care covered by basic insurance?
Only in limited circumstances — emergency dental treatment due to accidents, severe conditions affecting general health, or dental treatment required due to a serious systemic disease. Routine dental care, check-ups, fillings, and orthodontics are not covered by the KVG. For dental coverage, you need supplementary insurance.
Are glasses and contact lenses covered by basic insurance?
For adults, no. The KVG no longer covers glasses or contact lenses for adults (this changed in 2011). For children under 18, basic insurance covers CHF 180 per year toward glasses or contact lenses. Adult coverage requires ambulatory supplementary insurance.
Insurance Guide
Our editorial team has over 15 years of experience in the Swiss insurance market and has helped over 2,500 clients navigate the federal KVG system.
