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What does LAMal cover, and what does it not cover?
Swiss basic health insurance (LAMal) covers illness, accident and maternity: consultations, hospital treatment in a general ward in your canton, medicines on the official list, and part of your transport costs.
It does not cover everyday dental work, glasses for adults, a private room, or a hospital outside your canton chosen for convenience. Those are entirely at your own cost, or come under optional supplementary insurance.
One thing surprises every new arrival: the benefits are set by law. They are therefore exactly the same at every health insurer. A more expensive insurer does not reimburse better — it simply costs more.
Of outpatient care in Switzerland
After your deductible and your 10% co-payment.
For everyday dental work
A scale and polish, a filling, a crown: nothing is reimbursed.
Covered or not: the table
| Benefit | LAMal | Within what limits |
|---|---|---|
| Seeing a doctor | Yes | In Switzerland, with no limit on the number of visits |
| Hospital | Yes | General ward, a hospital on the cantonal list, at your canton's tariff |
| Medicines | Yes | If they are prescribed and on the official list |
| Maternity | Yes | 7 check-ups, 2 scans, the birth, a postnatal check-up, 150 CHF towards classes |
| Psychotherapy | Yes | On a doctor's prescription, with a recognised psychologist |
| Physiotherapy | Yes | On a doctor's prescription |
| Complementary medicine | Yes | Acupuncture, homeopathy, herbal medicine, Chinese and anthroposophic medicine — given by a recognised doctor |
| Prevention and vaccinations | Yes | Screening and vaccinations recommended by the federal government |
| Ambulance | Half | 50% of the cost, up to 500 CHF a year |
| Rescue (helicopter) | Half | 50%, up to 5,000 CHF a year, in Switzerland only |
| Glasses, children | In part | 180 CHF a year up to age 18, lenses or contact lenses, frames not included |
| Spa treatment | In part | 10 CHF a day, 21 days a year, in Switzerland, on prescription |
| Glasses, adults | No | Unless there is a recognised condition, such as diabetes or eye surgery |
| Everyday dental care | No | Unless there is serious disease of the jaw, or an accident |
| Orthodontics | No | Unless there is a recognised serious malformation |
| Private or semi-private room | No | Comes under supplementary insurance |
| Hospital outside your canton by choice | No | Covered only in an emergency or for medical reasons |
| Cosmetic surgery | No | Unless it follows an accident or an illness |
| Laser eye surgery | No | Never, even with a prescription |
| Medicines not on the list | No | Even when prescribed by your own doctor |
Abroad: three different sets of rules
| Where | What is covered |
|---|---|
| EU, EFTA, United Kingdom | Emergencies, on presentation of your insurance card, at the local rates of that country |
| Rest of the world, outpatient | Emergencies, up to twice what the same care would cost in Switzerland |
| Rest of the world, hospital | Up to 90% of the cost of equivalent treatment in your canton |
A hospital stay in the United States routinely costs more than LAMal reimburses, and the rest is yours to pay. It is the one gap in cover that can run to tens of thousands of francs. Travel insurance costs a few tens of francs.
And repatriation is never covered by LAMal, anywhere.
Accidents: watch out for paying twice
LAMal covers accidents, but only if nobody else does. As soon as you work 8 hours a week or more for the same employer, their accident insurance takes over, including for accidents in your free time.
In that case you can ask your health insurer to suspend the accident cover on your LAMal. Your premium drops by around 7%, and you lose nothing: you are already covered through your employer. Plenty of employees pay for this double cover for years without knowing.
Remember to switch it back on the day you leave your job.
What supplementary insurance does
Supplementary insurance is optional and follows different rules: each insurer sets its own prices and its own benefits, and can turn you down depending on your health or your age. It typically covers:
- dental care and orthodontics;
- a private or semi-private room, and free choice of hospital in Switzerland;
- glasses for adults and part of the cost of contact lenses;
- alternative medicine with therapists who are not doctors;
- gym membership, travel vaccinations, repatriation.
Take out your LAMal first: it is compulsory and cannot turn you down. Supplementary insurance comes afterwards, and only if a specific item justifies it. It never replaces the basic cover.
The three most common mistakes
- Choosing an insurer "that reimburses better". There is no such thing for the basic cover: the law sets the same benefits everywhere. Only the price changes.
- Assuming dental work is covered. It is the first thing new arrivals find out about, often with a four-figure bill.
- Paying twice for accident cover. If you are employed for 8 hours a week or more, it duplicates your employer's cover.
Is your treatment on the list? Is your hospital on your canton's list?
Heidi checks it for your exact situation.
Read next
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- 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?
- Which deductible should I choose for my Swiss health insurance?
- How long do I have to join LAMal after arriving in Switzerland?
- What do I need to do in my first 14 days in Switzerland?
Sources
- Compulsory health care insurance — a detailed list of benefits and caps
- Office fédéral de la santé publique — Premiums and costs, frequently asked questions
- Reimbursement of glasses and contact lenses by LAMal
- Institution commune LAMal — The duty to insure
Written by the Heidi team and updated on 7 November 2026. The amounts and the lists of benefits are those in force on that date and change every year. To find out whether a particular treatment is reimbursed, the decision rests with your insurer.