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How long do I have to join LAMal after arriving in Switzerland?
You have 3 months from the day you take up residence in Switzerland. The deadline is federal: it is the same in all 26 cantons.
Inside the deadline, your cover goes back to the day you arrived. Outside it, cover only starts on the day you sign — and a surcharge of 30 to 50% is added to your premium.
To get yourself insured
From the day you take up residence, or from your first day of work as a cross-border worker.
Surcharge if you are late
Charged for twice as long as you were late.
On time or late: the difference
| You sign within 3 months | You sign later | |
|---|---|---|
| Cover starts | The day you arrived in Switzerland | The day you sign, not before |
| Care received in the meantime | Reimbursed | Entirely at your own cost |
| Premiums for the months gone by | Due, but you were covered | Not due — you were not insured |
| Surcharge | None | 30 to 50% of the premium, if being late is judged inexcusable |
| Choice of health insurer | Free | The canton can assign you one |
It is the gap in your cover. Joining late does not make up for the past: break a leg in your second month and sign in your fourth, and the hospital bill is yours. In Switzerland that runs into thousands of francs very quickly.
The surcharge itself is charged for twice as long as you were late. Three months late means six months of a higher premium.
What to do, and in what order
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Compare the premiums in your commune
Basic benefits are set by law: they are the same at every health insurer. Only the price changes, and the gap is often more than 100 francs a month inside the same canton. The official premiums are published by the federal government on priminfo.ch.
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Choose your deductible and your insurance model
The deductible is what you pay before your health insurer reimburses anything. The higher it is, the lower your premium. The alternative insurance models (family doctor, telemedicine) bring the premium down further, in exchange for a compulsory first call.
Possible deductibles Adults Children The lowest 300 CHF 0 CHF The highest 2,500 CHF 600 CHF On top of the deductible 10% of the remaining costs, capped at 700 CHF a year for an adult -
Sign, then send the certificate to the canton
The cantonal health insurance office writes to you shortly after you register with your commune. Send back the certificate from your health insurer as soon as you have it: that document closes the file and stops the canton assigning you an insurer itself.
The cases where you are not obliged
An exemption does exist, but it is narrow, and you have to ask for it during the three months. After that, the choice is final.
| Situation | What applies |
|---|---|
| Cross-border worker | Right of option between Swiss basic health insurance (LAMal) and the insurance of their country of residence, to be used once only |
| Posted worker | Stays insured in their home country for as long as the posting lasts |
| Student studying in Switzerland | Exemption possible with equivalent cover |
| Double insurance | Exemption possible if a foreign policy offers comparable cover |
| Drawing a Swiss pension (EU/EFTA) | Subject to the obligation, with no exemption |
The cross-border worker's right of option and the exemption cannot be taken back. Turning LAMal down in your second month commits you for as long as you work in Switzerland, unless your situation changes in one of the ways the law provides for.
The three most common mistakes
- Waiting for your residence permit. The two procedures are independent. You can, and you must, get insured without waiting for the permit.
- Thinking your employer deals with it. They register you with AVS, with the pension fund and with the accident insurer. Never with LAMal: that one is down to you, and you pay for it yourself.
- Keeping your home-country insurance "just in case". It does not replace LAMal, unless you have been formally granted an exemption. Without a written decision, you are breaking the law.
Sign early, even if you switch later. You can only change health insurer once a year, by cancelling before the end of November — but you are covered from day one, and you avoid the surcharge. The other way round cannot be put right.
Which health insurer, which deductible, and are you entitled to a premium subsidy?
Heidi works out your situation, canton by canton.
Read next
- Retirement as a cross-border worker: AVS, the second pillar and the second right to choose
- Family allowances for cross-border workers: Switzerland or France?
- What happens to my second pillar when I leave my Swiss job?
- Unemployment as a cross-border worker: where to register, who pays and how much?
- G permit: conditions, going home and changing employer
- Quasi-resident status: who can apply, and by when?
- Who gets my taxes as a cross-border worker: France or Switzerland?
- How much do you take home in Switzerland as a cross-border worker?
- How many days of remote work can I do without losing my cross-border worker status?
- Do I have to file a tax return in my first year in Switzerland?
- Am I entitled to a premium subsidy for my health insurance?
- How does the Swiss three-pillar pension system work?
- Can I keep my French health insurance when I move to Switzerland?
- What does a month of living in Switzerland really cost?
- What documents does a letting agency ask for to rent a flat in Switzerland?
- B, L or C permit: which one applies to me and how do I get it?
- What does LAMal cover, and what does it not cover?
- Which deductible should I choose for my Swiss health insurance?
- What do I need to do in my first 14 days in Switzerland?
Sources
- Institution commune LAMal — The duty to insure
- ATF 129 V 267 — art. 5 para. 2 LAMal and art. 8 OAMal, premium surcharge for joining late
- République et canton de Genève — Compulsory affiliation to a health insurance fund
- République et canton de Neuchâtel — Joining a health insurer (LAMal)
Written by the Heidi team and updated on 7 November 2026. The deductible amounts and the co-payment cap are those in force on that date. This page is for information: it does not replace a decision by your insurer or by the cantonal authority.