Obligation to accept

What is the obligation to accept?

The obligation to accept (Aufnahmepflicht) is the duty of every health insurer to accept into basic health insurance every person who is required to take out insurance and lives within its area of operation. The insurer may not refuse anyone because they are old, have been ill or are likely to incur high costs. It may not make acceptance dependent on health questions, may not add reservations for certain illnesses and may not impose a waiting period.

The obligation to accept is the counterpart to the requirement to take out insurance. Anyone who lives in Switzerland must take out insurance within three months. For this requirement to be achievable, there must also be a right to be accepted. Together with the free choice of insurer, this means: you may choose your health insurer, but the health insurer may not choose you.

The obligation to accept only applies to basic health insurance under the KVG and to voluntary daily allowance insurance under the KVG. Supplementary insurance under the Insurance Contract Act (VVG) consists of contracts under private law. There, the insurer may use a health questionnaire, add reservations or reject your application.

How it works

You apply to the new insurer. The insurer checks whether you are required to take out insurance and whether your place of residence is within its area of operation. If both conditions are met, it must accept you. If you are switching from another insurer, the new insurer informs the old one that you are insured without interruption. Only then does your old insurance relationship end.

The obligation to accept is closely linked to the premium rule. An insurer charges all its insured persons the same premiums. Differences are only permitted by canton and premium region, by age group (children, young adults, adults), by deductible, by model and by accident cover. A 62-year-old man who has had several operations pays exactly the same with the same insurer, in the same place of residence, with the same model and the same deductible as a healthy 34-year-old woman.

To ensure that insurers still have no incentive to attract only healthy people, there is risk equalisation. Insurers with many insured persons with a high risk of illness receive money from insurers with many insured persons with a low risk.

There are two important limits:

• Area of operation: not every insurer operates throughout Switzerland. The obligation to accept only applies where the insurer offers basic health insurance.
• Payment arrears: if you owe premiums, co-payments, default interest or debt enforcement costs, you cannot switch insurer until everything has been paid. In that case, the new insurer is not the obstacle, but your old insurance does not end.

Legal basis

The obligation to accept is laid down in the supervision act: under Art. 5 let. i of the Health Insurance Supervision Act (KVAG), insurers must accept, within their local area of operation, every person required to take out insurance and every person entitled to take out daily allowance insurance under the KVG. Art. 5 let. f KVAG requires equal treatment of insured persons. The obligation to accept is a condition for authorisation: an insurer that does not meet it may not offer basic health insurance.

In the Federal Health Insurance Act (KVG), further provisions complement the obligation to accept:

• Art. 3 KVG: requirement to take out insurance within three months of taking up residence or of birth.
• Art. 4 KVG: free choice among all authorised insurers.
• Art. 7 para. 5 KVG: the old insurance relationship only ends once the new insurer has confirmed that cover continues without interruption.
• Art. 61 KVG: the same premiums for all insured persons of an insurer, graded by canton, region and age group.
• Art. 64a para. 6 KVG: no switch while premiums, co-payments, default interest and debt enforcement costs are outstanding.

Example: the same premium despite different health

Heidi is 62 years old and has had two operations in recent years. Nina is 34 and has not seen a doctor for years. Both live in Zurich and want to switch insurer. The table shows the monthly premiums for 2026 of all 128 offers in the municipality of Zurich (region 1), adults with accident cover. Source: FOPH, health insurance premiums 2026.

Deductible	cheapest offer	median	most expensive offer
CHF 300	CHF 517.70	CHF 580.00	CHF 724.00
CHF 2,500	CHF 389.40	CHF 453.90	CHF 595.70

The premium calculator shows which insurers are cheap where you live, with all the offers for your municipality.

What this means for you

The obligation to accept takes the risk out of switching basic health insurance. You can compare and switch freely every year, even if you have a chronic illness or are of advanced age. Just keep an eye on the deadlines: after you receive the premium notification, your notice of cancellation must reach your old insurer by 30 November. All dates are listed under Deadlines, and a template for the cancellation under Cancellation letter.

Be careful with supplementary insurance. If you have supplementary insurance with your current insurer, it cannot force you to cancel it when you switch basic health insurance, and it may not cancel it solely because you switched. So keep it if taking out new supplementary insurance would be difficult because of your health. Basic and supplementary insurance can be with different insurers.

An overview and key figures for the insurers are available under Health insurers.

Common mistakes

• Not switching for fear of being refused. In basic health insurance, every insurer in your area must accept you.
• Cancelling supplementary insurance together with basic health insurance. There is no obligation to accept for supplementary insurance. A new insurer can refuse you.
• Trying to switch with unpaid bills. As long as premiums or co-payments are outstanding, your old insurance does not end.
• Choosing an insurer that does not operate where you live. Check in the premium calculator which insurers offer premiums for your municipality.

We explain how we analyse premiums under How we calculate.