Health insurance in retirement and old age

Health insurance in retirement at a glance

When you retire, basic health insurance stays as it is: the same benefits, the same premium rules, the same deadlines for switching. What changes is everything around it. Your employer no longer insures you against accidents, your income falls, supplementary insurance becomes more expensive or no longer fits, and later on questions arise about care and perhaps about living abroad.

The overview shows when each topic comes up and which article covers it in depth.

Each of the six questions below answers the essentials in its first paragraph and then leads to the in-depth article.

What changes in your health insurance when you retire?

Above all, your accident cover. As long as you are employed, your employer insures you against accidents under the Federal Act on Accident Insurance (UVG), including in your free time if you work at least 8 hours per week. This cover ends on the 31st day after the last day on which you were entitled to at least half your salary (Art. 3 para. 2 UVG). From then on, basic health insurance pays for accidents, with the deductible and retention fee as for an illness (Art. 8 para. 2 of the Federal Health Insurance Act, KVG).

Many employees have excluded their health insurer’s accident cover and saved on the premium; the reduction is at most 7 % of the premium (Art. 91a para. 4 KVV). When you retire, you must reinstate accident cover. Your employer informs you in writing; you then have one month to notify your insurer (Art. 11 para. 2 KVV). If you miss this, you are still covered, but the insurer may claim the premium share for accident cover retroactively, plus default interest (Art. 10 para. 2 KVG).

If you continue working as an employee for at least 8 hours per week after retirement, you remain insured through your employer. The details, the premium differences with and without accident cover and a sample calculation for an accident shortly after your last working day are in the article Retired: reinstating accident cover and reviewing supplementary insurance. The calculator Exclude accident cover checks whether you may exclude accident cover or must reinstate it.

Does health insurance become more expensive as you get older?

Not because of age. The KVG only provides for lower premiums for children and young adults. All other insured persons pay the same premium with the same insurer, in the same model, with the same deductible and in the same place of residence, whether they are 30 or 80 (Art. 61 paras 1 and 3 KVG). Basic health insurance becomes more expensive when your insurer raises premiums for everyone, and in retirement also because accident cover is reinstated.

Premiums 2026, municipality of Zurich (region 1), adults, with accident cover, per month; source FOPH:

Because the benefits of basic health insurance are the same at all insurers, comparing every year pays off in retirement just as it does at 30. Every insurer must accept you, without health questions and without an age limit (Art. 5 let. i KVAG). Your notice of cancellation for the end of the year must reach your current insurer by 30 November (Art. 7 para. 2 KVG). If you switch basic health insurance, your current insurer may not cancel your supplementary insurance for that reason (Art. 7 para. 8 KVG).

Whether a high or low deductible suits you depends on your healthcare costs. Adults pay everything themselves up to the deductible, then a 10 % retention fee up to CHF 700 per year (Art. 64 KVG, Art. 103 KVV). The article Health insurance for pensioners: how to compare properly shows how to compare premium, model and deductible as a pensioner, including a calculation of a CHF 300 deductible against CHF 2,500. The switching centre guides you through the switch itself.

Supplementary insurance in old age: keep, adjust or cancel?

Never cancel before you know what you will get instead. In supplementary health insurance, only the insured person may cancel with ordinary notice, not the insurer, not even after an expensive claim (Art. 35a para. 4 of the Insurance Contract Act, ICA). An existing contract is therefore very valuable in old age. For a new contract, however, an insurer may ask health questions and, based on the answers, add a reservation or reject you (Art. 4–6 ICA). At 60 or 70, you often cannot get cancelled supplementary hospital insurance back on the same terms.

Unlike in basic health insurance, supplementary insurance premiums depend on age: either on your age when you took out the policy or on age bands, with the premium rising with each new band. If the premium becomes too high, there are usually intermediate options: a higher retention fee, switching from a private to a semi-private ward, or dropping individual outpatient modules while keeping hospital insurance. The variants your insurer offers are set out in its conditions; what counts is the general terms and conditions and the information from your insurer.

If you receive supplementary benefits, they do not contribute to the supplementary insurance premium, only to basic health insurance (Art. 10 para. 3 let. d of the Federal Act on Supplementary Benefits, ELG). The article Supplementary insurance from 60: keep, adjust or cancel? goes through the modules one by one and calculates the three variants using an example. The section Supplementary insurance explains how supplementary insurance works in general.

Who helps with premiums when your income falls?

Two systems: the canton’s premium subsidy and supplementary benefits. The cantons reduce the premiums of insured persons of modest means and pay the contribution directly to the insurer (Art. 65 para. 1 KVG). Because the tax assessment is often years old, the cantons must take the most recent income situation into account on request, for example after retirement (Art. 65 para. 3 KVG). Each canton sets its own rules, income limits and deadlines for the premium subsidy.

If your old-age and survivors’ insurance (AHV) pension and your pension fund are not enough to live on, you are entitled to supplementary benefits. For health insurance, supplementary benefits recognise a flat-rate amount equal to the cantonal or regional average premium, at most the actual premium (Art. 10 para. 3 let. d ELG). In 2026, this average premium for adults in Zurich (region 1) is CHF 7,680 per year (FDHA, average premiums 2026). If your premium is higher, you bear the difference yourself. With net assets of CHF 100,000 or more, or CHF 200,000 or more for married couples, there are no supplementary benefits; a home you live in yourself does not count (Art. 9a ELG). Supplementary benefits start at the earliest in the month in which you register (Art. 12 para. 1 ELG), so it pays to register early.

The article Premium subsidies and supplementary benefits in retirement shows how the two systems interact and what happens if you receive supplementary benefits but are insured with an expensive insurer. The calculator Check your premium subsidy checks your entitlement in your canton.

What does health insurance pay in a nursing home?

Only a contribution towards care. In a nursing home, basic health insurance reimburses the same care services as for outpatient care, graded by care needs in 12 levels of 20 minutes each: from CHF 9.60 to CHF 115.20 per day (Art. 7a para. 3 KLV). Of the care costs not covered, at most 20 % of the highest contribution may be passed on to you, i.e. CHF 23.04 per day; your canton of residence regulates the rest of the care costs (Art. 25a para. 5 KVG).

Accommodation, meals and support are not health insurance benefits; you bear these costs on the nursing home invoice yourself. If your income and assets are not enough, supplementary benefits cover part of them. If you register within 6 months of moving into the home, entitlement to supplementary benefits applies from the month you moved in (Art. 12 para. 2 ELG). The three cost blocks, a fully calculated month in a care home and the supplementary benefit rules in a care home are in the article Nursing home: what health insurance pays and what you pay yourself.

Retiring abroad: where am I insured then?

That depends on your new country of residence. If you only receive a Swiss pension and move to an EU state, Iceland, Norway or the United Kingdom, you remain subject to compulsory Swiss basic health insurance (Art. 1 para. 2 let. d–ebis KVV). Your insurer then calculates your premium according to your country of residence, not your former municipality (Art. 61 para. 4 KVG). Optional deductibles, bonus insurance and GP, HMO and telemedicine models are not available to you if you live in these states (Art. 101a KVV).

In Germany, France, Italy, Austria, Spain and Portugal, you can instead take out insurance in your country of residence. For this right of option, according to the FOPH, the application for exemption must reach the Common Institution under the Federal Health Insurance Act (Gemeinsame Einrichtung KVG) within 3 months of moving, or at any time if you live in Spain. If you move to a state outside the EU, EFTA and the United Kingdom, Swiss basic health insurance ends when you leave, because the requirement to take out insurance ends (Art. 5 para. 3 KVG). You then need insurance in your new country or an international policy.

The article Retired abroad: which health insurance applies explains which option applies to which country, how treatment in your country of residence and during visits to Switzerland is billed, and what three couples with different destinations need to do. Supplementary insurance continues according to the contract or ends under the general terms and conditions; ask your insurer in writing before you move.

Common mistakes in retirement

• Forgetting to report accident cover. You are covered even without notification, but the insurer may claim the premium share for accident cover retroactively, plus default interest. The notification is a letter or a message to your insurer, nothing more.
• Cancelling supplementary insurance out of frustration. After a premium increase, the temptation is great. From 60, however, you only get a new contract after answering health questions. Ask about adjustments first.
• Applying for a premium subsidy with old tax data. Many cantons use the last tax assessment, from when you were still earning a salary. Ask the canton to take your current income situation into account (Art. 65 para. 3 KVG).
• Registering for supplementary benefits too late. Benefits start at the earliest in the month in which you register, or retroactively from the date you move into a care home if you register within 6 months. If you wait, you lose months.
• Giving up on comparing because “nobody switches in old age”. Every insurer must accept you for basic health insurance, without health questions and without an age limit.

Where to start?

1. Six months before retirement: Check your policy to see whether your accident cover is excluded, and plan to notify your insurer (Reinstating accident cover).
2. Review your supplementary insurance: List all modules with their premiums and ask your insurer which adjustments are possible without a new health assessment before you cancel anything (Supplementary insurance from 60).
3. Recalculate your income: In your first year of retirement, your income often falls significantly. Apply for a premium subsidy with the current figures and check your entitlement to supplementary benefits (Premium subsidies and supplementary benefits).
4. Compare every autumn: The FOPH publishes the following year’s premiums at the end of September. Compare them in the premium calculator and, if you switch, cancel so that your notice reaches the insurer by 30 November (Comparing for pensioners).
5. Plan ahead: If a move into a care home is foreseeable, read Nursing home costs; if you are planning to move abroad, read Retired abroad.

You will find the profiles of all insurers with the number of insured persons, reserves and contact details under Health insurers at a glance.