Premium regions and cantons: why where you live sets your premium

How the premium-region system works

Basic insurance under the KVG offers the same catalogue of benefits throughout Switzerland – but the premiums for it are graded regionally. The legal basis: insurers may grade their premiums by canton and region, with the EDI defining the regions uniformly for all insurers and also capping the maximum permitted premium differences between regions. The division follows the cost differences between municipalities: a canton forms a single premium region where costs are similar everywhere, or is split into two or at most three regions where they differ markedly – typically with the large urban centres in the most expensive region.

For you, only your residence counts: the municipality you live in – in practice usually resolved via your postcode – determines which premium region you are insured in. Within the same region, an insurer charges the same tariff for the same profile of age class, deductible, model and accident cover, no matter which street you live on. Between two regions of the same canton, however, the premium can differ – if you live close to a region boundary, you may pay a different rate than the neighbouring municipality a few kilometres away. Where you work, or where your doctor or hospital is located, plays no role in the premium.

Why cantons differ so much in cost

Premiums are not a tax: they have to cover the expected healthcare costs of the insured population in each region. Where healthcare costs are higher, premiums are higher too. The main drivers are the general cost level of medical care, the density of doctors' practices, specialists and pharmacies, the hospital structure and its costs, and the age structure and usage patterns of the population. Urban regions with dense provision tend to sit above the national average, rural regions below it – where many providers are within reach, more services are used on average.

That is not a judgement, simply the mechanism of the system: the premium reflects the costs of the region, not your individual use of care. A healthy person in an expensive region therefore pays more than a comparable person in a cheap one – and switching insurer does not change that. What a switch can do is capture the difference between insurers within your region. Even inside the same region, insurers charge different premiums – each one calculates on the basis of its own insured population and costs, and the Federal Office of Public Health (FOPH) reviews and approves the premiums every year. Your savings potential therefore lies not in your address, but in your choice of insurer, model and deductible within your region.

Children, young adults, adults: the three age classes

The KVG knows three age classes with their own premiums: children up to 18, young adults from 19 to 25, and adults from 26. For children, a lower premium is prescribed by law; for young adults, insurers are permitted to set a lower one – which today practically all of them do. What counts is the calendar year, not the birthday itself: you move up an age class on 1 January of the year in which you turn 19 or 26 respectively. The child premium therefore still applies until the end of the year in which you turn 18, and the young-adult premium until the end of the year in which you turn 25. Within an age class, your exact age is irrelevant: a 30-year-old pays the same tariff as a 60-year-old with the same insurer, region and profile – basic insurance has no individual age loadings.

There is a concrete reason why young adults pay lower premiums than adults: since a legal change that took effect in 2019, insurers have been relieved in the risk equalisation scheme for their insured aged 19 to 25. They pay less into the equalisation between insurers for this group and can pass that room on as lower young-adult premiums. How large the discount is compared with the adult premium is not uniformly prescribed and differs from insurer to insurer – which is exactly why running your own comparison pays off particularly well in this age class.

Child premiums are set considerably lower again than young-adult premiums. Children also have their own deductible tiers from CHF 0 to 600 and a lower co-payment cap – our article on choosing a deductible explains how to pick among them. When you move up to the next age class, your insurer adjusts the premium automatically; the transition is nevertheless a good moment to run the comparison afresh.

Moving house: what happens to your premium

If you move within Switzerland, report your new address to your health insurer. If the new residence lies in a different premium region, the insurer adjusts your tariff – upwards or downwards, depending on whether the new region is rated more expensive or cheaper. Your insurance, model and deductible simply continue unchanged; only the tariff that belongs to your new region changes. If you stay within the same premium region, your premium stays the same.

A widespread misconception: moving within Switzerland does not create an extraordinary right of cancellation. Even if the premium rises at your new address, you can only switch basic insurance at the ordinary dates – as a rule at the end of the year, with notice reaching your insurer by 30 November. If you have the ordinary (lowest) deductible and the standard model, you can additionally cancel mid-year as of the end of June, with three months' notice. The only exception: if your insurer does not operate at your new place of residence at all (some insurers are active only regionally), you have to switch insurer at the move – even outside the ordinary dates. The sensible sequence is therefore: report the address straight away, compare the offers in your new region at leisure, and switch at the next ordinary date if a switch is worthwhile.

• Report the address to your insurer – the premium is switched to the tariff of the new region.
• No special cancellation right because of a move – the ordinary termination dates apply.
• Rerun the comparison: in the new region, a different insurer may be the cheapest.
• Moving abroad follows different rules – this article covers moves within Switzerland.

Only compare within your own region

Premium comparisons are only meaningful within your own premium region. The rate an acquaintance pays in another canton says nothing about what the same insurer charges you – the same insurer, model and deductible can cost significantly more or less in another region. Rankings of the cheapest insurers also shift from region to region: an insurer at the top in one region can sit mid-field in the next.

Our calculator handles the mapping for you: you enter your postcode, the calculator resolves it to the official premium region and then compares only tariffs that apply to exactly that region and your age class – based on the official FOPH premium data. That way you are guaranteed to compare like with like: the same region, the same age class, the same deductible and the same accident cover.