Waiting period

What is the waiting period?

The waiting period, also called the qualifying period or waiting time, is a period after the start of an insurance contract during which certain benefits are not yet insured. The contract is running and you are paying the premium, but the insurer only pays for the benefits concerned once the period has expired.

In Swiss health insurance you will come across the term in two meanings, which you need to keep apart:

1. Waiting period in supplementary insurance: a benefit is excluded in the first months after the contract starts. The purpose: nobody should take out insurance only when an expensive, plannable treatment is already imminent.
2. Waiting period in daily allowance insurance: the number of days between the start of an inability to work and the first daily allowance paid. It applies anew to each case of illness and is a pricing component: the longer the waiting period, the lower the premium. You can read more about this under daily sickness allowance insurance.

Neither period exists in basic health insurance for doctors, hospitals and medicines. The insurer must accept every person who is required to take out insurance in its area of operation, without health questions and without a waiting time. If you take out insurance on time, i.e. within three months of birth or moving to Switzerland, you are covered retroactively from that date.

The waiting period must be distinguished from the reservation. A reservation excludes a specific, pre-existing illness from cover, often for several years. A waiting period applies equally to all insured persons in a product, regardless of their health, and concerns a type of benefit, not a diagnosis. In practice, both can occur together: the insurer asks you to fill in a health questionnaire, adds a reservation, and the product also has a waiting period.

How it works

In supplementary insurance

Supplementary insurance policies are private contracts under the Insurance Contract Act (ICA). Whether a product has a waiting period, for which benefits and for how long, is set by the insurer in its general terms and conditions of insurance. The law prescribes neither a minimum nor a maximum length. Typical areas are benefits that can be planned, such as those related to pregnancy and childbirth, dental treatment or certain therapies.

The period generally begins when the contract starts, not when you apply. What usually matters is when the treatment takes place or, for maternity benefits, when the birth or the pregnancy begins. How the event is assigned in time is again set out in the general terms and conditions.

Before the contract is concluded, the insurer must inform you clearly about the scope of the insurance cover. A waiting period is part of the scope of cover. The contract must set out exclusions in specific, unambiguous wording; otherwise the insurer is liable for all events that fall within the insured risk. You can revoke your application or your acceptance within 14 days; the period begins with the application.

In daily allowance insurance

Voluntary daily allowance insurance under the Federal Health Insurance Act (KVG) and daily sickness allowance insurance under the ICA pay part of your lost wages in the event of illness. Under the KVG, entitlement arises if you are at least half unable to work and, unless otherwise agreed, on the third day after falling ill. The start of benefits can be postponed in return for a lower premium. Employers often choose a waiting period during which they continue to pay wages themselves; under the Code of Obligations this is mandatory for at least three weeks in the first year of service, unless otherwise provided by agreement, standard employment contract or collective employment agreement.

If you shorten the waiting period of an existing KVG daily allowance insurance, the insurer may add a new reservation for this part, for at most five years.

Legal basis

There is no specific statutory rule for waiting periods in supplementary insurance. They are based on the contract, i.e. on the policy and the general terms and conditions. The ICA only sets the framework:

• Art. 3 para. 1 ICA: before the contract is concluded, the insurer must provide clear information about the insured risks and the scope of the insurance cover, in a form that allows proof by text.
• Art. 2a ICA: right of revocation within 14 days of the application or acceptance.
• Art. 33 ICA: the insurer is liable for all events of the insured risk, unless the contract excludes individual events in specific, unambiguous wording.

For basic health insurance, the opposite of a waiting period applies:

• Art. 5 let. i of the Health Insurance Supervision Act (KVAG): the insurer must accept every person required to take out insurance in its area of operation.
• Art. 5 para. 1 KVG: if you join on time, insurance begins at birth or when you take up residence in Switzerland. If you join late, it only begins when you join (para. 2).

For voluntary daily allowance insurance under the KVG:

• Art. 72 para. 2 KVG: entitlement from an inability to work of at least half, unless otherwise agreed on the third day after falling ill; postponement possible in return for a lower premium. If a waiting period with continued payment of wages by the employer is agreed, the minimum benefit period can be shortened by this period.
• Art. 69 KVG: reservations for pre-existing illnesses, for at most five years; under para. 4 also when the waiting period is shortened.
• Art. 324a CO: continued payment of salary by the employer during illness, three weeks in the first year of service, unless something equivalent has been agreed.

Example: waiting period for daily allowance and waiting period in supplementary insurance

Daily allowance: Sandra is 42, self-employed and has voluntary daily allowance insurance under the KVG. Let us assume she has agreed a waiting period of 30 days and a daily allowance of CHF 150. She is completely unable to work from 01.03.2026 to 19.04.2026, which is 50 days. The amounts have been chosen for the example; the calculation rule follows from the contract.

Supplementary insurance: let us assume that a supplementary hospital insurance provides in its general terms and conditions for a waiting period of twelve months for benefits related to pregnancy and childbirth. If the contract starts on 01.01.2026, such benefits would only be covered for events from 01.01.2027. Basic health insurance nevertheless covers the statutory maternity benefits from day one; the waiting period only affects the supplementary benefits, such as a room in the semi-private ward.

What this means for you

1. Take out cover early. If you want supplementary insurance for plannable benefits, take it out before you need it. The waiting period runs from the start of the contract.
2. Read the general terms and conditions. Look in the conditions for “waiting period”, “qualifying period” or “waiting time” and note for which benefits it applies and for how long.
3. Do not cancel first when switching. Only cancel an existing supplementary insurance once the new contract has been confirmed, and ask whether the new insurer credits waiting periods. With a new contract, your entry age can also increase the premium.
4. Plan for gaps in daily allowance cover. Match the waiting period to your employer’s continued payment of wages or to your savings.
5. Choose basic health insurance freely. You do not need to worry about a waiting period in basic health insurance. Compare premiums in the premium calculator and the insurers under health insurers. You can compare supplementary benefits in the supplementary insurance comparison.

The entry on supplementary insurance explains more about the differences between basic and supplementary insurance.

Common mistakes

• Only taking out supplementary insurance when you need it. During the waiting period, it pays nothing for the benefits concerned.
• Confusing the waiting period and a reservation. The waiting period applies to everyone and expires; a reservation concerns your health and can last for years.
• Assuming basic health insurance has waiting times. It covers you from day one, provided you take out insurance on time.
• Choosing too long a waiting period for daily allowance. A lower premium is of little use if you cannot bridge the waiting time financially.
• Cancelling existing contracts too hastily. With a new contract, waiting periods usually start again from scratch.

We explain how we record the benefits of supplementary insurance under How we calculate.