Emergency fee: what the planned fee for minor cases would mean

Emergency fee: the bill and today’s rule

Since 2017, an idea has been circulating in Parliament under the name “emergency fee”: anyone who goes to a hospital emergency department without a referral should pay a contribution themselves. It was launched by parliamentary initiative 17.480 “Fee for minor cases in hospital emergency departments”, submitted by Thomas Weibel and later taken over by Martin Bäumle. In the course of the debate, the original fee has become a surcharge on the retention fee.

Important first: as of 25.09.2026, there is no emergency fee. What applies today and what the bill would change:

There is no legal term “minor case”. The surcharge would therefore not be linked to how serious the case is, but to whether someone arrives with a referral.

What the bill provides in detail

The National Council’s Committee for Social Security and Health (SSHC-N) adopted the draft on 11.04.2025 by 13 votes to 12. The content according to Parliament:

1. Surcharge of up to CHF 50: For each visit to a hospital emergency department without a written referral, a surcharge of at most CHF 50 can be added to the retention fee.
2. Cantonal competence: The surcharge only applies in cantons that introduce it. There would be no uniform rule across Switzerland.
3. Only after the deductible: The surcharge is due as soon as the insured person has reached the annual deductible, regardless of how much retention fee they have already paid.
4. Exceptions: Children and pregnant women, as well as people who have been referred in writing by a physician, a telemedicine centre, a pharmacist or a cantonal emergency number. People brought in by a patient transport or ambulance service are also exempt.
5. Basic health insurance only: The surcharge concerns people who are subject to compulsory health insurance.

A second variant, in which only the annual maximum retention fee would have increased by CHF 50 per emergency visit, was defeated in the committee and went to the chamber as a minority proposal.

Status in Parliament (25.09.2026)

The bill has come a long way. The main steps according to Curia Vista and the Federal Council:

The matter is now back with the National Council’s committee. Under the Parliament Act (ParlA): if a chamber refuses to consider a draft bill for the second time, that decision is final (Art. 95 let. a ParlA). If the National Council maintains its decision to consider the bill and the Council of States again refuses, the bill is dead. How the chambers will decide is open; we will update this page after the next chamber decision.

The arguments in the debate

Supporters in the National Council spoke of strengthening personal responsibility and of a voluntary option for cantons that want to relieve their emergency departments. The Federal Council rejects the bill: it says the steering effect is small, because outside practice opening hours and in peripheral regions there is often no alternative, and implementation creates work for cantons, insurers and hospitals. The Council of States’ health committee unanimously proposed not considering the bill and named better triage as an alternative. According to the debate in the chamber, a large majority of participants in the consultation spoke out against the fee. We report the positions without judging them.

What the FOPH figures show

In 2023, the FOPH compiled data for the committee. Some of it helps put the effect of a fee into context:

• Who pays at all? In 2021, just under 10 % of insured persons reached their deductible and the maximum retention fee. Anyone who does not reach the deductible already pays the emergency invoice themselves today.
• Who goes to the emergency department? In 2021, there were 204 hospital emergency department consultations per 1,000 inhabitants. Children under 6 came most often (412 per 1,000), followed by 19 to 25-year-olds (266 per 1,000). Children would be exempt from the surcharge.
• When? In 2019, there were the most outpatient emergency visits on Saturdays and the fewest on Tuesdays.
• Models: In 2021, 76 % of insured persons were in a model with a restricted choice of service provider. Many of them already have a first point of contact in their GP or telemedicine service that can refer them.
• Minor cases: According to the FOPH, there are no statistics on this, because the term is not defined either in law or in medicine.

Sample calculation: today and with the surcharge

How much you pay for an emergency visit depends on how much deductible and retention fee you have already paid in the current year. Calculated with the statutory values (deductible CHF 300, retention fee 10 %, at most CHF 700) and an assumed emergency invoice of CHF 400.

Example with fictitious people. Jana (24) goes to the emergency department on a Sunday evening without a referral. In this example, her canton of residence has introduced the CHF 50 surcharge.

The calculation shows that the bill would mainly affect insured persons who have already used up their deductible, i.e. mostly people with higher healthcare costs or a low deductible. Anyone with a high deductible who is rarely ill would seldom notice the surcharge.

What applies in an emergency today

Regardless of the bill, the KVG already regulates what basic health insurance pays in an emergency:

• Any hospital: In an emergency, you may also go to a hospital outside your canton or one that is not on your canton of residence’s Hospital List; you do not need the canton’s authorisation for this (Art. 41 para. 3 and 3bis KVG).
• Co-payment: Emergency treatment counts towards the deductible and retention fee like any other benefit. If you are admitted as an inpatient, the hospital contribution of CHF 15 per day is added, except for children, young adults in education and in the case of maternity (Art. 104 of the Health Insurance Ordinance, KVV).
• Rescue and transport: Basic health insurance pays 50 % of the costs of rescues in Switzerland, at most CHF 5,000 per year, and 50 % of medically necessary transport, at most CHF 500 per year (Art. 26 and 27 of the Health Care Benefits Ordinance, KLV).
• List of insured persons in arrears: Even if you are on a cantonal list because of premium debts, emergency treatment is paid for; an emergency is defined in Art. 64a para. 7 KVG.

Emergencies in GP, HMO and telemedicine models

In the GP model, the HMO model or the telemedicine model, you have limited your choice to certain first points of contact (Art. 41 para. 4 KVG). The model conditions provide exceptions for genuine emergencies: you go directly to hospital and report the case afterwards. How and within what period is set out in your insurer’s model conditions; what counts is these conditions and the information from your insurer.

This matters for bill 17.480: a written referral from the telemedicine service or your GP would exempt you from the surcharge. However, the Federal Council pointed out in the debate that telemedicine centres cannot issue written referrals today. How the models work and what they cost is explained in the articles Telemedicine model and GP model and specialists. The model finder helps you work out which model fits your everyday life.

Special cases

• Children: They would be exempt from the surcharge. Already today, they pay no deductible and their retention fee is capped at CHF 350 per year (Art. 64 para. 4 KVG, Art. 103 para. 2 KVV).
• Pregnant women: Also exempt. From the 13th week of pregnancy until eight weeks after the birth, the insurer does not charge any co-payment for benefits in the event of illness and maternity anyway (Art. 64 para. 7 KVG).
• Accident: If you are insured against accidents through your employer under the Accident Insurance Act (UVG), the accident insurer covers medical treatment after an accident (Art. 10 UVG), not the health insurer. The bill only concerns basic health insurance.
• Emergency abroad: The bill only concerns hospital emergency departments in Switzerland. Abroad, basic health insurance pays for emergencies at most up to twice the amount the costs would be in Switzerland (Art. 36 KVV).

Common mistakes

• Believing the emergency fee already applies. As of 25.09.2026, it has not been adopted; the Council of States refused to consider it.
• Hesitating in a genuine emergency. The bill would never exclude an emergency from cover. If your life is in danger, fast help is what counts.
• Forgetting the model rules. If you are in a GP or telemedicine model and go directly to hospital without an emergency, you already risk the insurer reducing benefits today. Look up the reporting obligation in your conditions.
• Underestimating rescue costs. Basic health insurance only pays 50 % towards a rescue. You or a supplementary insurance bear the rest; what counts is its general terms and conditions.

How the co-payment works and which reforms are coming up is explained in the section Understanding basic insurance. The second bill on co-payment, the higher minimum deductible, is described in the article Minimum deductible CHF 400, and the digitalisation of health data in the article Electronic health record. You can compare premiums for the models in your municipality in the premium calculator, and key figures for insurers in the health insurer profiles.