Key points at a glance
- The reference premium is a cantonal calculation value for premium subsidies, not the premium of a health insurer.
- Each canton sets it itself, usually annually and separately by age group, sometimes also by premium region.
- In Aargau in 2026, it corresponds to the average of the ten cheapest GP or HMO premiums in the canton: CHF 5,830 for adults, CHF 4,260 for young adults and CHF 1,380 for children a year.
- The subsidy is paid at most up to the amount of your actual premium, directly to the health insurer (Art. 65 para. 1 KVG).
What is the reference premium?
The reference premium is a fixed benchmark amount that a canton uses to calculate the premium subsidy. It represents the premium that the canton considers appropriate for one person’s basic health insurance. The cantons set it separately for adults aged 26 and over, young adults aged 19 to 25 and children up to 18. Some also differentiate by premium region.
The term does not come from federal law. The Federal Health Insurance Act (KVG) only requires the cantons to reduce the premiums of people of modest means. How they do so is up to them. Cantons with a percentage model work with a reference premium; others pay a fixed amount depending on the income bracket. In the canton of Zurich, the corresponding value is called the reference premium (Referenzprämie); the cantonal government sets it annually.
The reference premium is not the premium of a particular health insurer. Nor is it the same as the FOPH’s average premium, a statistical average across all insured persons, or the average premium taken into account for supplementary benefits.
How it works
In a percentage model, the canton calculates as follows: it adds up the reference premiums of all people in the household and deducts a percentage of the relevant income. What remains is the premium subsidy. If the result is zero or negative, there is no entitlement.
In Aargau, the formula for 2026 is: premium subsidy = sum of the reference premiums minus 17.5% of the relevant income. There, the reference premiums correspond to the average of the ten cheapest premiums in the canton for GP and HMO models, plus the forecast premium increase. Premiums without accident cover are compared, for adults and young adults with a CHF 300 deductible and for children without a deductible.
| Age group | Aargau | Appenzell Innerrhoden |
|---|---|---|
| Adults | CHF 5,830 | CHF 4,640 |
| Young adults | CHF 4,260 | CHF 3,446 |
| Children | CHF 1,380 | CHF 1,034 |
Appenzell Innerrhoden bases its figure on the premium of the cheapest provider with an office in the canton, with the GP model, a CHF 300 deductible and accident cover. The subsidy covers the part of the reference premium that exceeds 7% of the relevant income for incomes up to CHF 45,000, and the part exceeding 12% from CHF 85,000; in between, the rate rises by 0.125 percentage points per CHF 1,000.
The canton pays the subsidy directly to the health insurer; you receive a lower premium invoice. It is granted at most up to the amount of the actual premium. For people receiving social assistance, Aargau limits the entitlement to the reference premium; the municipality can claim the difference from the actual premium until a switch to a cheaper model is possible.
Legal basis
Art. 65 para. 1 KVG requires the cantons to grant premium subsidies to insured persons of modest means and stipulates that they pay the contribution directly to the insurers. Under Art. 65 para. 1bis KVG, the cantons must reduce the premiums of children by at least 80% and those of young adults in education or training by at least 50% for lower and middle incomes. A cantonal model with reference premiums must comply with these requirements.
There is no federal definition of the reference premium. It is set out in the cantonal act introducing the KVG and in the annual decisions of the cantonal government. It must not be confused with the flat-rate amount for health insurance in supplementary benefits: under Art. 10 para. 3 let. d of the Federal Act on Supplementary Benefits (ELG), this corresponds to the cantonal or regional average premium including accident cover, at most the actual premium.
Example: a family in Aarau in 2026
The Keller family lives in Aarau: two adults born in 1988 and two children born in 2016. The household’s relevant income is CHF 60,000. The figures come from the GDK overview 2026 and the FOPH’s 2026 premiums.
| Step | Amount per year |
|---|---|
| Reference premiums: 2 × CHF 5,830 + 2 × CHF 1,380 | CHF 14,420 |
| 17.5% of the relevant income of CHF 60,000 | CHF 10,500 |
| Premium subsidy according to the formula | CHF 3,920 |
What this means for you
- Look up your canton’s reference premium. You will find it at the cantonal office responsible; in Aargau and Zurich, this is the social insurance institution (SVA). How the system works in your canton is explained on the premium subsidy page, for example premium subsidy in Aargau.
- Compare your actual premium with the reference premium. If your premium is well above the reference premium, you pay the difference yourself. Switching to a cheaper insurer or to a GP or telemedicine model reduces this remainder. Compare in the premium calculator.
- Choose your insurer based on data. The profiles under Health insurers show the premiums and key figures of each insurer.
Common mistakes
- Thinking the reference premium is your own premium. It is a calculation value. Your invoice can be higher or lower.
- Choosing an expensive insurer in the expectation that the canton will pay more. In these cantons, the subsidy is based on the reference premium, not on your premium.
- Using another canton’s figures. Reference premiums, percentages and reference dates differ from canton to canton and from year to year.
- Mixing up the year. The 2026 reference premiums only apply to the 2026 entitlement. The cantons set new values for 2027.
Frequently asked questions
Is the reference premium my premium?
No. The reference premium is a calculation value set by the canton. Your actual premium depends on your insurer, deductible, model and place of residence and can be higher or lower.
How high is the reference premium in my canton?
Each canton sets it itself, usually annually. The Swiss Conference of Cantonal Health Directors (GDK) publishes an overview of all cantons every year; the information from the cantonal office responsible is binding.
Do I get a higher subsidy if I choose an expensive health insurer?
Not in cantons with a reference premium. The subsidy is based on the reference premium, not on your premium. If you choose a more expensive insurer, you pay the difference yourself.
What is the difference from the average premium?
The average premium is a statistical average that the FOPH publishes every year. The reference premium is a parameter that a canton decides on for its premium subsidy system.
Related terms
- Premium subsidyA premium subsidy (Prämienverbilligung, IPV) is a contribution from your canton of residence towards your basic health insurance premium if you live on a modest income. The canton pays the money directly to your health insurer, so your bill gets smaller. For children from families on lower and middle incomes, it must reduce the premium by at least 80%.
- Relevant incomeRelevant income is the amount your canton uses to check whether you receive a premium subsidy and how much. Each canton calculates it itself, usually from your tax assessment: taxable or net income plus part of your assets, with some deductions added back. In Aargau, for example, 20% of taxable assets are added in 2026.
- Average premiumThe average premium is the average of all basic health insurance premiums paid in Switzerland per insured person, calculated by the FOPH. In 2026, it is CHF 393.30 a month, and CHF 465.30 for adults. It shows how premiums are developing, but does not tell you what you personally pay.
- PremiumThe premium is the amount you pay your health insurer for basic health insurance, in advance and usually monthly. It depends on the insurer, where you live, your age group, your deductible and your insurance model, but not on your income or health. In 2026 the mean premium in Switzerland is CHF 393.30 a month.
- Social assistance and health insuranceIf you receive social assistance, you remain insured in basic health insurance just like everyone else. The premium is paid through the canton’s premium subsidy and, for the rest, through social assistance. As a rule, social assistance also covers the deductible and the retention fee. In the canton of Zurich, you must switch to a cheaper insurer if this is reasonable.
Sources
- Federal Health Insurance Act (KVG), Art. 65Art. 65 KVGfedlex.admin.ch
- GDK: overview of cantonal premium subsidy systems 2026 (German)gdk-cds.ch
- Federal Act on Supplementary Benefits to the AHV and IV (ELG), Art. 10Art. 10 para. 3 let. d ELGfedlex.admin.ch
- FOPH: health insurance premiums 2026 (opendata.swiss)opendata.swiss