Age groups

What are age groups?

In basic health insurance, a health insurer may only vary its premiums by a few characteristics: by canton and premium region, by insurance model and deductible, by accident cover and by age group. The age groups are set by law and are the same for all insurers. There are exactly three:

Among adults, basic health insurance makes no further distinction. A 26-year-old student and an 85-year-old pensioner pay the same premium at the same insurer, in the same model, with the same deductible and in the same place of residence. This is a core principle of Swiss basic health insurance: the premium does not depend on individual risk. This distinguishes it from supplementary insurance, where insurers may vary premiums by age or age at entry.

The age groups have consequences beyond the premium. Children have their own deductible rules, a halved retention fee and no hospital contribution. For young adults in education, special rules apply to premium subsidies and the hospital contribution. And in risk equalisation between insurers, children are excluded and young adults receive relief.

How it works

Classification by year of birth

What counts is the year of birth, not the birthday. Someone born in 2008 still pays the children’s premium in 2026, even if their 18th birthday was in January. On 01.01.2027, this person automatically moves into the young adults group. The same applies to the move to adults: those born in 2001 still pay the young adult premium in 2026, while those born in 2000 already pay the adult premium.

The move happens without you having to do anything. Your insurer informs you of the new premium in the annual premium notification, at least two months before 1 January. With this notification, you can change insurer if your notice of cancellation reaches it by 30 November.

Differences between the groups

The premium for children is paid exclusively by the parents until the end of the month in which the child comes of age. The child cannot be subject to debt enforcement for it later either.

Legal basis

• Art. 61 paras. 1 and 3 of the Federal Health Insurance Act (KVG): The insurer charges its insured persons the same premiums as a matter of principle. It sets a lower premium for children and young adults; the children’s premium must be lower than the premium for young adults. Under para. 3bis, the Federal Council can set the reductions.
• Art. 16 para. 5 and Art. 16a KVG: Definition of the groups by age on 31 December: children under 19, young adults 19 to 25, adults from 26 (for the purposes of risk equalisation, adults also include young adults). In risk equalisation, insurers receive relief for young adults amounting to 50% of the cost difference compared with all adults.
• Art. 91 para. 3 of the Health Insurance Ordinance (KVV): The grading by age group is based on years of birth.
• Art. 92 para. 4 KVV: The Federal Department of Home Affairs (FDHA) publishes the average premiums each year by the categories children, young adults and adults.
• Art. 64 para. 4 KVG, Art. 93 and 103 KVV: No standard deductible for children, half the maximum retention fee; optional deductibles for each age group.
• Art. 104 para. 2 KVV: No hospital contribution for children and for young adults in education.
• Art. 65 para. 1bis KVG: Minimum subsidy of 80% for children and 50% for young adults in education with lower and middle incomes.
• Art. 7 para. 2 KVG: The insurer must notify new premiums at least two months in advance; you can switch with one month’s notice to the end of the preceding month.

Example: premium jumps in Zurich in 2026

The table shows the median monthly premium (median of all 128 offers) of basic health insurance in 2026 in the municipality of Zurich (region 1), with accident cover. For children, a CHF 0 deductible applies; for young adults and adults, a CHF 300 deductible. Source: FOPH, health insurance premiums 2026.

The jump when you move up a group is the moment when comparing is particularly worthwhile: for young adults in Zurich, the range between the cheapest and the most expensive offer is CHF 219.80 a month.

What this means for you

1. Mark the transitions in your calendar. If your child turns 19 next year, the premium rises on 1 January. If you turn 26 yourself, the adult premium applies from 1 January of that year. The new premium is stated in the premium notification in the autumn.
2. Compare when you move up a group. The cheapest insurer for a child is not automatically the cheapest for young adults. The premium calculator shows you all offers by year of birth, and the children’s premium calculator shows children’s premiums.
3. Choose your deductible again. When you move to the young adults group, the adult deductibles from CHF 300 to CHF 2,500 apply. Think about which level suits your expected costs.
4. Check for a premium subsidy. Young adults in education with lower and middle incomes are entitled to a subsidy of at least 50%. The rules are set by your canton of residence.
5. Send your notice of cancellation in time. If the switch is to take effect on 1 January, your notice of cancellation must reach your insurer by 30 November. You will find everything about the process under switching insurer.

You will find the key data on the insurers under health insurers. There is more on families with several children under family discount, and details on the children’s premium under children’s premium.

Common mistakes

• Counting from the birthday instead of the year of birth. The new age group always applies from 1 January, not from the birthday.
• Believing the premium rises with every year of age from 26. In basic health insurance, there are no further age levels after 26; only the annual premium adjustments affect everyone.
• Forgetting the children’s deductible when moving up a group. Children have no standard deductible. From 19, the deductible is at least CHF 300. Check in the premium notification which deductible the insurer has entered for the new year, and change it if necessary.
• Equating supplementary insurance with basic health insurance. In supplementary insurance, the premium can rise with age; the three age groups only apply in basic health insurance.

We explain how we build premium examples under how we calculate.