Registered too late with a health insurer: surcharge and back payment

Registered too late: two consequences you need to keep apart

The requirement to take out insurance starts when you move to Switzerland or at birth. You have 3 months to register (Art. 3 para. 1 of the Federal Health Insurance Act, KVG). If you miss this three-month deadline to take out insurance, you join late. This has two consequences that occur independently of each other:

There is no third consequence: the insurer may not reject you because of the delay. Every insurer must accept you for basic health insurance, without health questions and without reservations (Art. 5 let. i of the Health Insurance Supervision Act, KVAG). You choose your insurer, deductible and model freely like everyone else.

The concept only applies to basic health insurance. There is no obligation to take out supplementary insurance, so there is no such thing as joining it late.

Step by step: what to do now

1. Register immediately. Every further month of delay extends the period without cover and the surcharge by 2 months. Compare premiums in the premium calculator and register directly with the insurer. Your start of insurance is the day you join.
2. Record the reasons for the delay. Write down why you did not register in time and collect evidence: a hospital stay, incorrect information from an authority, a pending application for exemption. They may become important when the insurer decides whether the delay is excusable.
3. Disclose your financial situation. The insurer sets the rate according to your financial circumstances (Art. 8 para. 1 KVV). If your means are limited, it can be below 30 %.
4. Sort out unpaid bills from the gap. Basic health insurance does not cover bills from the period before you joined. If you were employed, your employer’s accident insurance pays for work-related accidents, and for non-work-related accidents too if you work at least 8 hours a week for one employer (Art. 13 para. 1 UVV).
5. Request a written decision if you disagree. If the insurer sets a surcharge you consider wrong, request a written decision (Art. 49 para. 1 ATSG). You can lodge an objection against it within 30 days.
6. Check premium subsidies. If your income is low, the canton reduces your premium (Art. 65 para. 1 KVG). The rules are under Premium subsidies.

How the premium surcharge is calculated

The rules for joining late are set out in Art. 5 para. 2 KVG and Art. 8 of the Health Insurance Ordinance (KVV):

• Amount: 30 to 50 % of the premium (Art. 8 para. 1 KVV). The insurer sets the rate within this range according to your financial situation.
• Duration: twice as long as the delay, at most 5 years. The ordinance does not say explicitly from which day the delay counts; the insurer sets the duration in its decision.
• Financial hardship: If the surcharge would cause financial hardship, the insurer sets a surcharge below 30 % and takes the circumstances of the delay into account (Art. 5 para. 2 KVG, Art. 8 para. 1 KVV).
• Social assistance: If a social assistance authority pays your premiums, no surcharge is charged (Art. 8 para. 2 KVV).
• Changing health insurer: Your previous insurer notifies the new one of the surcharge. A surcharge once set remains binding on later insurers (Art. 8 para. 3 KVV).
• Excusable: The law does not list any reasons. It only distinguishes between excusable and inexcusable delay. If the delay is excusable, there is no surcharge; cover nevertheless only starts when you join.

Delay	Surcharge for
1 month	2 months
4 months	8 months
12 months	24 months
30 months or more	5 years (upper limit)

Example calculation: four months late in Geneva

Example with fictitious people. Luca, 38, moves from Italy to Geneva and registers with the municipality on 01.02.2026. His deadline runs until 01.05.2026. He only registers with an insurer on 01.09.2026, 4 months after the deadline. The table uses these 4 months as the delay; if the insurer counts differently, the duration changes. He chooses a CHF 2,500 deductible with accident cover. In the municipality of Geneva, this costs between CHF 476.00 and CHF 785.50 per month in 2026 for someone born in 1988, with a median of CHF 541.10 (premiums 2026, adults, with accident cover; source: FOPH).

Surcharge rate	Surcharge per month	Duration	Total surcharge
30 %	CHF 162.33	8 months	CHF 1,298.64
50 %	CHF 270.55	8 months	CHF 2,164.40

The premium calculator and the health insurer profiles show which premiums apply in your municipality and which insurers offer them.

Special cases

Children. Newborns must also be insured within 3 months of birth. If a child joins late, the parents owe the surcharge to the extent that they are responsible for the delay (Art. 5 para. 2bis KVG).

Allocation by the canton. If you do not register at all, the cantonal authority allocates you to an insurer (Art. 6 KVG). You then do not choose the insurer yourself. The obligation to pay premiums applies nevertheless.

Short work assignments from the EU and EFTA. If you work in Switzerland for no more than 3 months under the notification procedure without a permit and have no equivalent cover, you must be insured from the start of work. In this case, insurance starts on the first working day even if you join late (Art. 7 para. 2bis KVV). You then pay the premiums retroactively from that day. More on this in the article Short-term residents.

Rejected application for exemption. If you applied for exemption within the deadline and the canton rejects it, register immediately. Keep the application and the decision to hand: they explain the delay. The article Exemption from compulsory health insurance explains who can be exempted.

Supplementary insurance. There is no surcharge for supplementary insurance. However, the insurer may ask health questions there and reject you. What counts are the general terms and conditions and the information from the insurer.

How to challenge a surcharge

If you consider the surcharge or the rate to be wrong, the procedure of social insurance law applies:

1. Request a written decision. For claims you disagree with, the insurer must issue a written decision, with reasons and information on legal remedies (Art. 49 para. 1 and 3 of the Federal Act on the General Part of Social Insurance Law, ATSG).
2. Lodge an objection. Within 30 days of receiving the decision, with the insurer, free of charge (Art. 52 para. 1 and 3 ATSG). Enclose your reasons and evidence.
3. Appeal to the court. You can appeal against the response to the objection to the Cantonal Insurance Court within 30 days (Art. 56, 57 and 60 ATSG).

Before taking formal steps, the Office of the health insurance ombudsperson can mediate. Its advice is not binding and does not replace an objection; the 30-day deadline keeps running.

Common mistakes

• Believing you save on premiums. The surcharge eats up part of the premiums you did not pay, and you pay for any treatment during the gap yourself.
• Waiting even longer to register. Every additional month extends the surcharge by 2 months.
• Accepting the surcharge without explaining your situation. The rate depends on your financial circumstances, and in financial hardship it is below 30 %.
• Missing the deadline for objections. After 30 days, the decision becomes final.
• Hoping that changing insurer will help. The surcharge is transferred to the new insurer.

The article The Swiss health insurance system explains how the system works as a whole. The article Health insurance within three months shows how not to miss the deadline in the first place. You will find all topics relating to moving here in the New to Switzerland section.