Which vaccinations does Swiss health insurance pay for?

What basic health insurance pays

In basic health insurance, vaccinations are part of medical prevention. The law obliges insurers to pay for preventive measures carried out or ordered by a doctor (Art. 26 of the Federal Health Insurance Act, KVG). Which vaccinations these are is set out exhaustively in Art. 12a of the Health Care Benefits Ordinance (KLV): 20 items, from diphtheria and tetanus to measles, flu, hepatitis B, tick-borne encephalitis (TBE), HPV and Covid-19, through to shingles (herpes zoster), mpox, rotavirus and RSV.

However, it is not enough for a disease to be on the list. For each vaccination, the reference document on prophylactic vaccinations of the Federal Office of Public Health (FOPH), version of 01.07.2026, sets out exhaustively who is covered and according to which schedule. In addition, the vaccine must be on the List of Pharmaceutical Specialties for your age group and indication (Art. 12a para. 5 KLV, exceptions HPV and mpox). Vaccination advice is also covered: taking your vaccination history and checking your vaccination status, assessing the indication and providing information (Art. 12a para. 2 KLV).

Vaccination	Basic health insurance pays, for example, for	Not covered
Flu (influenza)	people aged 65 and over, pregnant women and up to 4 weeks after the birth, nursing home residents, people from 6 months of age with certain chronic illnesses	healthy adults under 65 without a risk factor
Diphtheria, tetanus	infants, boosters depending on age, from 65 every 10 years, tetanus for injuries	boosters outside the schedule
Whooping cough (pertussis)	infants, boosters at ages 4–7, 11–15 and 25, pregnant women in every pregnancy	vaccination to protect other people (family, work)
TBE (ticks)	people aged 3 and over who live in or stay in a risk area; the risk area is the whole of Switzerland except Ticino	occupational indication
HPV	people aged 11 to 26 at the first dose, only through cantonal vaccination programmes	vaccination outside a cantonal programme
Shingles (herpes zoster)	people aged 65 and over, from 50 with immunodeficiency	vaccines other than the adjuvanted subunit vaccine

No deductible since 01.01.2026. No deductible is charged any more on covered vaccinations and vaccination advice; the 10 % retention fee remains. The legal basis is Art. 64 para. 6 let. d KVG and Art. 12a para. 4 KLV, which exempts vaccinations within a national prevention programme from the deductible. According to the FOPH, the exemption is a measure of the National Vaccination Strategy adopted in 2017.

Excluded are vaccinations for occupational or travel medicine reasons, including the advice (Art. 12a para. 3 KLV). For travel, you pay yourself for yellow fever or typhoid, for example, and also for hepatitis A or rabies if they become necessary because of a trip.

What supplementary insurance pays

What basic health insurance does not cover can be paid by a supplementary outpatient insurance, depending on the contract. Typical cases are travel vaccinations and vaccinations outside the indications in the reference document, such as the flu vaccination for healthy adults under 65. Whether a product pays, how much and up to what annual amount is set out by each insurer in its general terms and conditions, often as part of a contribution towards prevention or health promotion.

Supplementary insurance may not cover the retention fee of basic health insurance (Art. 64 para. 8 KVG). So the 10 % on a covered vaccination stays with you. This should not be confused with travel insurance: it covers emergencies and repatriation abroad, not the vaccination before the trip. More on cover while travelling is explained in the article Ill abroad. We are building a comparison of supplementary products under Supplementary insurance. What counts are the general terms and conditions and the information from your insurer.

Conditions

• On the list and indicated: The vaccination must be in Art. 12a KLV and be indicated for you under the reference document, for example because of your age, a pregnancy or an illness. Vaccination advice clarifies whether this is the case.
• Carried out or prescribed by a doctor: Basic health insurance pays for preventive measures carried out or ordered by a doctor (Art. 26 KVG). At the pharmacy without a doctor’s prescription, you pay for the vaccine and its administration yourself. With a prescription, the insurer covers the vaccine, but you still pay for the vaccination itself at the pharmacy; it only reimburses administration in doctors’ practices and hospitals (FOPH).
• Vaccine on the List of Pharmaceutical Specialties: The vaccine must be on the SL for your age group and indication, and its limitations apply (Art. 12a para. 5 KLV).
• HPV only in the cantonal programme: Basic health insurance only pays for the HPV vaccination if it is given through a cantonal vaccination programme. Ask your doctor or the school doctor whether they take part in your canton’s programme.
• No work, no travel: Occupational and travel medicine indications are excluded. For occupational health vaccinations, the employer clarifies who covers the cost (FOPH).
• No deductible, but a retention fee: Since 01.01.2026 no deductible; a 10 % retention fee, at most CHF 700 per year for adults and CHF 350 for children, together with all other invoices of the year (Art. 103 para. 2 of the Health Insurance Ordinance, KVV).
• Other insurance first: If military or accident insurance is liable to pay, it takes precedence (FOPH reference document, chapter 2).

Sample calculation

Example with fictitious people. Ruth is 67, has a deductible of CHF 2,500 and has had hardly any health costs so far this year. In October, she has a flu vaccination at her GP practice. The costs for advice, vaccine and administration are assumed to be CHF 60. The exemption from the deductible and the retention fee are the rules that have applied since 01.01.2026.

For children, the infant and school vaccinations in the reference document apply; you can compare the basic health insurance premium for your child in the children’s premium calculator and your own in the premium calculator.

How to proceed

1. Bring your vaccination record: Without proof of missing or expired vaccinations, it is not possible to assess whether a vaccination is indicated.
2. Clarify the indication: Ask during vaccination advice whether the vaccination is covered for you under the reference document. The recommendations are in the Swiss vaccination schedule (in German, French and Italian).
3. Choose where to go: At a doctor’s practice, the insurer pays for the vaccine and its administration. At the pharmacy, you need a doctor’s prescription for cost coverage and you pay for the vaccination itself.
4. Submit the invoice: Submit even small vaccination invoices; they count towards the retention fee for the year.
5. Plan travel vaccinations separately: Check the general terms and conditions of your supplementary insurance before you book the travel vaccination.

Common mistakes

• Thinking every vaccination is covered. What counts is not just the disease, but whether the vaccination is indicated for you.
• Counting on the deductible. Since 2026, no deductible applies to covered vaccinations; from the first franc, the insurer pays 90 %.
• Submitting travel or occupational vaccinations. They are excluded, even if the disease is on the list.
• Going to the pharmacy without a prescription. Then you pay for the vaccine and its administration yourself.
• HPV outside the programme. Without a cantonal programme, basic health insurance does not pay for the HPV vaccination.

You will find further benefits, including psychotherapy or the breast pump, in the overview What does health insurance cover?, and key figures for the insurers in the health insurer profiles.