Premium subsidies and supplementary benefits in retirement

Two routes to a lower premium

For many people, income falls on retirement, while the basic health insurance premium stays the same. The median premium for adults in 2026 was CHF 465.30 per month (FOPH); the median premium includes all deductibles and models, and your own may be higher or lower. Two systems help you bear these costs:

The premium subsidy is the first step if money is tight. Supplementary benefits go further: they secure your entire living needs and include the health insurance premium as a fixed item.

Step by step: checking your entitlement in retirement

1. Look up the rules of your canton of residence. Each canton decides for itself who receives a premium subsidy, how much and by when you must apply. You will find the rules of all cantons under Premium subsidies.
2. Report your current income. Cantons often calculate with an older tax assessment: in Aargau in 2026 with that of the tax year that began three years before the year of entitlement, in the canton of Bern with the tax year before last. It still shows your salary. After retirement, you can ask the canton to take your most recent circumstances into account (Art. 65 para. 3 of the Federal Health Insurance Act, KVG).
3. Meet the deadline. Some cantons check entitlement using tax data and write to people who may be eligible; others require an application by a deadline. The canton decides what applies if you register late.
4. Check supplementary benefits if your pension and savings are not enough. If your net assets are below CHF 100,000 (married couples CHF 200,000) and your AHV and pension fund pensions do not cover your living needs, rent and premium, you register with your canton’s supplementary benefits office, usually the cantonal compensation office.
5. Do not wait. Supplementary benefits start at the earliest in the month in which you register (Art. 12 para. 1 of the Federal Act on Supplementary Benefits, ELG). There is nothing retroactively.
6. Compare your premium with the flat-rate amount. If you receive supplementary benefits, it is worth looking at your insurer’s premium: if it is above the average premium, you pay the difference yourself (see below).

Premium subsidies: the rules in detail

The cantons grant premium subsidies to insured persons of modest means and pay the contribution directly to the insurer (Art. 65 para. 1 KVG). Since 01.01.2026, every canton has set the maximum share of disposable income that the premium may account for (Art. 65 para. 1ter KVG). Your insurer must inform you of the amount of the subsidy with the next invoice at the latest (Art. 65 para. 4bis KVG), and the canton must regularly inform people of their right to a premium subsidy (Art. 65 para. 4 KVG).

There is no age criterion. What matters is the relevant income, which each canton defines itself, usually from the tax assessment plus part of your assets. Two examples from the 2026 overview of the Swiss Conference of Cantonal Health Directors (GDK):

• Aargau: taxable income plus 20 % of taxable assets; deductions such as pillar 3a or purchases into the pension fund are added back.
• Bern: net income plus 5 % of net assets after a deduction of CHF 17,000 per family member.

For retirement, this means: lower pensions instead of a salary can give rise to an entitlement. Withdrawing pension fund capital as a lump sum, on the other hand, increases your assets and can reduce it. Because tax data lag behind income, it is worth applying after retirement for the calculation to be based on your current circumstances (Art. 65 para. 3 KVG).

Supplementary benefits: what they mean for health insurance

Entitlement

People who are resident and habitually live in Switzerland and receive an AHV old-age pension (Art. 4 para. 1 ELG) are entitled to supplementary benefits if their recognised expenses exceed their eligible income (Art. 9 para. 1 ELG). If you have net assets of CHF 100,000 or more, you receive no supplementary benefits; for married couples, the threshold is CHF 200,000. A property you live in yourself does not count for this purpose, but assets you have given up do (Art. 9a ELG).

For people living at home, the recognised expenses include the general living allowance of CHF 20,670 per year for single people and CHF 31,005 for married couples (Art. 10 para. 1 let. a ELG), rent up to a maximum amount and the health insurance premium.

The flat-rate amount for basic health insurance

For basic health insurance, supplementary benefits recognise an annual flat-rate amount equal to the cantonal or regional average premium, including accident cover, but at most your actual premium (Art. 10 para. 3 let. d ELG). The supplementary benefits office pays this amount directly to your insurer (Art. 21a ELG). Premiums for supplementary insurance are excluded (Art. 10 para. 3 let. c ELG).

This leads to a simple rule: if your premium is below the flat-rate amount, it is covered in full. If it is above, you pay the difference out of your living allowance.

Healthcare costs

In addition to the annual supplementary benefits, the canton reimburses documented healthcare costs, including dental treatment, help, care and support at home, and the co-payment for basic health insurance, i.e. the deductible and retention fee (Art. 14 para. 1 ELG). The cantons may set maximum amounts for this. You submit the invoices to the supplementary benefits office.

Minimum amount and repayment

Supplementary benefits amount to at least the highest premium subsidy that the canton has set for people without supplementary benefits or 60 % of the flat-rate amount, whichever is higher (Art. 9 para. 1 ELG). Supplementary benefits received lawfully are repaid from the estate after death, to the extent that the estate exceeds CHF 40,000; for married couples only from the estate of the second spouse to die (Art. 16a ELG).

Figures: flat-rate amount and premiums 2026

The Federal Department of Home Affairs (FDHA) sets the average premiums for supplementary benefits every year. For 2026, the following apply to adults in premium region 1, among others (source: FDHA, Ordinance on average premiums 2026):

Comparing these amounts with the 2026 premiums shows how much your choice of insurer matters even with supplementary benefits. 2026 premiums, adults, CHF 300 deductible, with accident cover; source FOPH:

With the lowest and the median premium, the premium in both cities is below the flat-rate amount and fully covered. With the highest premium, an own share remains. The FOPH publishes the following year’s premiums at the end of September; the FDHA sets the average premiums for supplementary benefits anew for the following year each time.

Sample calculation: supplementary benefits and an expensive insurer

Example with fictitious people. Margrit, 76, lives alone in a rented flat in the city of Bern and receives supplementary benefits. She has been with the same insurer for decades, in the standard model with a CHF 300 deductible. Her 2026 premium is the highest premium in Bern.

The example is not a recommendation for any particular insurer or model. It shows why comparing matters even with supplementary benefits as soon as your own premium is above the flat-rate amount. You can see the offers in your municipality in the premium calculator, and key figures and contact details for the insurers in the health insurer profiles. The article Comparing health insurance for pensioners explains how to go about it.

Special cases

Moving into a care home or hospital

If you move into a care home, supplementary benefits calculate with the daily rate instead of rent and living allowance, plus an amount for personal expenses (Art. 10 para. 2 ELG). If you register within six months of moving in, entitlement applies from the month you moved in (Art. 12 para. 2 ELG). The article Nursing home: what health insurance pays explains what health insurance pays towards care in a home.

Married couples

For married couples, supplementary benefits add expenses and income together, and the asset threshold is CHF 200,000. If one spouse lives in a care home, supplementary benefits calculate entitlement separately for each spouse (Art. 9 para. 3 ELG).

Supplementary insurance

Supplementary benefits do not take premiums for supplementary insurance into account. Whether you want to keep an existing supplementary insurance is a calculation of its own; the article Supplementary insurance from age 60 helps with this.

Common mistakes

• Putting off registering for supplementary benefits. Supplementary benefits start at the earliest in the month of registration; every month of delay costs money.
• Waiting for the tax assessment. After retirement, you can ask the canton to calculate the premium subsidy with your current income.
• No longer comparing premiums once you receive supplementary benefits. If your premium is above the flat-rate amount, you pay the difference yourself.
• Not submitting the deductible and retention fee. The canton reimburses them to people receiving supplementary benefits as healthcare costs, but only against receipts.
• Giving away assets to get supplementary benefits. Supplementary benefits continue to count assets you have given up (Art. 9a para. 3 ELG).

You will find all topics relating to retirement in the topic section Retirement and old age and the cantonal rules under Premium subsidies. We explain how we evaluate premiums under How we calculate.