Why do health insurance premiums rise every year? The cost drivers explained

Premiums follow costs

Basic health insurance is financed on a pay-as-you-go basis (Art. 12 of the Health Insurance Supervision Act, KVAG): what health insurers pay in one year for treatment, medicines and care must be financed by the premiums of the same year. The law requires every insurer’s premiums to cover the costs, which differ from canton to canton; what counts is where you live (Art. 16 para. 3 KVAG). When healthcare costs rise, premiums therefore also rise, with some delay.

In its press release on the 2026 premiums, the FOPH listed the reasons for the growth in costs:

The last point surprises many people. For a hospital stay, the canton of residence pays at least 55 % of the costs (Art. 49a para. 2ter of the Federal Health Insurance Act, KVG), and the health insurer pays the rest. Today, outpatient treatment is paid by the insurers alone, i.e. by premium payers. If an operation is performed on an outpatient rather than an inpatient basis, total costs fall, but the share paid by premiums rises. According to the FOPH, this will change from 2028 with uniform financing; see EFAS from 2028.

Step by step: how the new premium comes about

1. Estimating costs (spring and summer): Every health insurer estimates the costs of the current and the following year, per canton and premium region.
2. Submission to the FOPH (by the end of July): The insurer submits its premium tariffs no later than five months before they apply (Art. 27 para. 1 of the Health Insurance Supervision Ordinance, KVAV), i.e. by the end of July for 1 January.
3. Review by the FOPH (August and September): The FOPH compares the budgets with independent cost forecasts and checks solvency, cost coverage per canton and the discounts for deductibles and models. The cantons may comment (Art. 16 para. 6 KVAG).
4. Approval (end of September): The FOPH notifies all insurers of its decision at the same time and publishes the average premium. Before that, no insurer may publish new premiums (Art. 16 para. 1 KVAG).
5. Notification to you (by 31 October): Your health insurer must notify you of the approved premium at least two months in advance and point out your right to switch (Art. 7 para. 2 KVG).
6. Your decision (by 30 November): Your notice of cancellation of basic health insurance must reach the insurer by 30 November; in 2026, that is a Monday. Deadlines and a sample letter are under Deadlines for switching.

The rules of premium approval in detail

Premium approval by the FOPH is governed by the Health Insurance Supervision Act (KVAG). Under Art. 16 para. 4 KVAG, the FOPH refuses a premium tariff if it:

• does not comply with the legal requirements,
• does not cover the costs in the canton,
• exceeds those costs inappropriately, or
• leads to excessive reserves.

So the premium may be neither too low nor too high. Premiums that are too low endanger the insurer’s solvency; premiums that are too high burden insured persons. If premium income in a canton was considerably higher than costs, the insurer can make a premium adjustment in the following year (Art. 17 KVAG).

Every health insurer must also hold reserves that can absorb a very bad year. If they are too low, insurers usually rebuild them through premiums (FOPH). Surpluses from basic health insurance go into reserves, and premium income may only be used for the costs of basic health insurance (FOPH). What happens with administrative costs, reserves and salaries is explained in the article Who earns money from my premium?.

Within a canton, the insurer may grade premiums by region; the FDHA sets the regions and the maximum permitted differences (Art. 61 para. 2bis KVG). Children and young adults pay lower premiums than adults (Art. 61 para. 3 KVG).

The figures: what premiums are spent on

In 2024, basic health insurance paid benefits of CHF 42.2 billion, on average CHF 391 per insured person per month, including the co-payments of insured persons. In 2010, it was CHF 24.3 billion; according to the FOPH, this corresponds to an average increase of 4 % per year. Growth fluctuates considerably: from 2017 to 2018 +0.7 %, from 2012 to 2013 +7.8 %, from 2023 to 2024 +5.7 %.

Cost group	CHF million per year	CHF per person per month
Doctors, outpatient	9,345	86
Medicines	9,226	85
Hospital, inpatient	7,796	72
Hospital, outpatient	5,830	54
Nursing homes	2,241	21
Laboratory	2,001	19
Other benefits	1,668	15
Physiotherapy	1,630	15
Nursing care at home (Spitex)	1,503	14
Aids and appliances	985	9
Total gross benefits	42,225	391
of which co-payments of insured persons	5,662	52
Total net benefits	36,563	338

Doctors’ practices, medicines and inpatient hospital treatment together account for almost two thirds. Through the deductible, retention fee and hospital contribution, insured persons bore CHF 5.7 billion directly; premiums finance the rest.

The healthcare system as a whole is larger than basic health insurance: according to the Federal Statistical Office (FSO), it cost CHF 97 billion in 2024, over 4 % more than in 2023. Households paid 21.3 % of this directly, for example through co-payments, and 40.7 % indirectly, mainly through premiums; the public sector bore 31.3 %.

The 2026 premium. The average premium for 2026 is CHF 393.30 per month, 4.4 % or CHF 16.60 more than in 2025. By age group (FOPH, 23.09.2025):

The average premium divides all premiums paid by the number of insured persons. Because insured persons only choose their insurer, deductible and model after approval, the figure can shift afterwards: for 2025, the FOPH had announced +6 %, but according to later figures it was +5.7 %, because many insured persons had switched insurer, raised their deductible or chosen a cheaper model. The FOPH publishes next year’s premiums at the end of September.

Sample calculation: what the increase means for a household

Example with fictitious people. Mia, 41, and Luca, 40, live in Bern and each pay roughly the average adult premium. In 2026, it rises by CHF 18.50 per month compared with 2025 (FOPH).

Which deductible and which model suit your costs is something you calculate with your own figures. The benefits of basic health insurance are the same with all health insurers; the premium is the main difference.

What is being done about the increase

Cost containment has been an issue for the Federal Council and Parliament for years. As of the press release of 23.09.2025 and the law:

• Cost and quality targets: Since 01.01.2026, the Federal Council sets cost and quality targets for basic health insurance for four years at a time (Art. 54 KVG). According to the FOPH, it will set targets for the first time at the end of 2026, for 2028 to 2031; a commission monitors developments.
• Cost containment package 2: Parliament adopted it in the 2025 spring session, including volume discounts on high-turnover medicines. The FOPH puts the potential savings at up to half a billion francs per year.
• Review of benefits and prices: According to the FOPH, reviewing benefits, medicine prices and tariff structures has saved over CHF 2 billion in the last ten years.
• Uniform financing from 2028: Outpatient services will then no longer be financed by premiums alone, but jointly with the cantons.
• Premium subsidies: Since 2026, the cantons must make a minimum contribution to premium subsidies. Whether you are eligible is something you check with your canton; see Premium subsidies.

Whether and how much these measures will slow premium growth cannot be quantified today; we make no forecast.

Special cases: why your premium rises differently

• Moving to another age group: At 19 and at 26, you move into a more expensive age group. The jump comes on top of the general increase; see Premium at 19 and 26.
• Your health insurer: Every insurer calculates for itself. If an insurer has reserves that are too low or more insured persons with high costs, its premium can rise more than the average; if it had income that was too high, it can offset this. Key figures on reserves and administrative costs are shown in the health insurer profiles.
• Canton and premium region: Premiums follow the costs in your canton (Art. 61 para. 2 KVG). If you move, your premium can change, even without an increase.
• Deductible and model: Discounts for optional deductibles and cheaper models change with the premium. A model with restricted choice of service provider can partly absorb the increase; whether it suits you is clarified by the model finder.
• Supplementary insurance: Supplementary insurance premiums are not approved by the FOPH; they are governed by the Insurance Contract Act (ICA) and supervised by FINMA. They can rise differently; see Supplementary insurance premium increase.

Common mistakes

• Taking the average premium for your own. The average premium is an average across all insurers, regions, deductibles and models. Your increase is in your premium letter.
• Blaming the health insurer for the whole increase. Insurers must cover costs. They negotiate tariffs with service providers; which benefits basic health insurance pays for is determined by federal law and ordinances.
• Filing the premium letter unread. It arrives by 31 October; after that, you have until the end of November to switch.
• Comparing only the premium. With a higher deductible, you save on premiums but bear more costs yourself. Add both together.
• Choosing a cheaper model without knowing the rules. What applies to GP, HMO or telemedicine models and what happens if you do not follow the rules is set out in the insurer’s terms. Read them before switching.

More basics on basic health insurance are in the topic section Understanding basic insurance. You compare the offers for 2026 in the premium calculator, and you plan your switch under Switching health insurer. What health insurance costs without a job is explained in Health insurance when unemployed.