Health insurance subsidy: what is it?
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In Switzerland, health insurance is compulsory under the Federal Health Insurance Act (Loi Fédérale sur l'Assurance Maladie, or LAMal for short). But this insurance is far from free. People of modest means can benefit from reduced premiums. The cantons have introduced subsidies known as health insurance subsidies (SAM). How does the health insurance subsidy work? What is the scale applied? How do I apply for a health insurance subsidy? What supporting documents do I need to provide? Answers.
Health insurance subsidy: what is it?
The health insurance subsidy is a grant awarded to help finance compulsory health insurance. The cantons are responsible for examining applications and awarding subsidies. The latter are free to set the amount granted. In fact, the health insurance subsidy a person can benefit from depends:
- On his place of residence
- On his family situation
- On his income.
As a general rule, the health insurance subsidy is awarded automatically to people receiving:
- An AVS/AI supplementary pension
- Social assistance.
The cantons do not pay the subsidy to the beneficiary, but directly to his health insurance fund, which will deduct it from the amount owed by its insured.
The health insurance subsidy can only be applied to compulsory health insurance, not supplementary health insurance.
What is the 2024 health insurance subsidy scale?
The amount of the subsidy granted to finance part of the compulsory health insurance varies according to several factors that we cited upstream. It is therefore necessary to contact the canton in which you are domiciled to find out the amount of the subsidy and the income that must not be exceeded in order to benefit from it.
Determining your subsidy category
To give you an idea, here's the amount of the subsidy awarded by the canton of Geneva. The subsidy varies according to the group in which you will be classified based on your income.
| Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | Group 6 | Group 7 | Group 8 | Group 9 | |
|---|---|---|---|---|---|---|---|---|---|
| Adult | 300 CHF | 250 CHF | 200 CHF | 160 CHF | 130 CHF | 90 CHF | 70 CHF | 40 CHF | - |
| Adult | 300 CHF | 250 CHF | 200 CHF | 160 CHF | 130 CHF | 90 CHF | 70 CHF | 40 CHF | - |
| Young adult | 191 CHF | 191 CHF | 191 CHF | 191 CHF | 191 CHF | 191 CHF | 191 CHF | 191 CHF | 100 CHF |
| Child | 104 CHF | 104 CHF | 104 CHF | 104 CHF | 104 CHF | 104 CHF | 104 CHF | 104 CHF | 60 CHF |
The 2024 scale for single people (with or without legal dependents)
Each applicant who lives alone, with or without legal dependents, will be classified by the services of the canton of Geneva into a group according to his or her declared income.
| Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | Group 6 | Group 7 | Group 8 | Group 9 | |
|---|---|---|---|---|---|---|---|---|---|
| Person single (without legal charge) | 0 to 30,000 CHF | 30,001 to 35,000 CHF | 35,001 to 37,500 CHF | 37,501 to 40,000 CHF | 40,001 to 42,500 CHF | 42,501 to 45,000 CHF | 45,501 to 47,500 HF | 47,500 to 50,000 CHF | - |
| Single person with 1 legal charge | 0 to 51,000 CHF | 51,001 to 61,000 CHF | 61,001 to 71,000 CHF | 71,001 to 81 000 CHF | 81,001 to 91,000 CHF | 91,001 to 101,000 CHF | 101,001 to 111,000 CHF | 111,001 to 121,000 CHF | 121,001 to 151,000 CHF |
| Single person with 2 statutory charges | 0 to 57,000 CHF | 57,001 to 67,000 CHF | 67,001 to 77,000 CHF | 77,001 to 87,000 CHF | 87,001 to 97,000 CHF | 97,001 to 107,000 CHF | 107,001 to 117,000 CHF | 117,001 to 127,000 CHF | 127,001 to 157,000 CHF |
| Single person with 3 statutory charges | 0 to 63,000 CHF | 63,001 to 73,000 CHF | 73,001 to 83,000 CHF | 83,001 to 93,000 CHF | 93,001 to 103,000 CHF | 103,001 to 113,000 CHF | 113,001 to 123,000 CHF | 123,001 to 133,000 CHF | 133,001 to 163,000 CHF |
| Single person with 4 statutory charges | 0 to 69,000 CHF | 69 001 to 79 000 CHF | 79 001 to 89 000 CHF | 89 001 to 99 000 CHF | 99 001 to 109 000 CHF | 109 001 to 119 000 CHF | 119 001 to 129 000 CHF | 129,001 to 139,000 CHF | 139,001 to 169,000 CHF |
The 2024 scale for couples (with or without legal dependents)
The same applies to people living as a couple, with or without legal dependents. Please note that this is also the scale applied by the canton of Geneva. If you are not domiciled in this territory, you should not take this into account, but contact the services to which you are attached.
| Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | Group 6 | Group 7 | Group 8 | Group 9 | |
|---|---|---|---|---|---|---|---|---|---|
| Couple (without legal charge) | 0 to 45,000 CHF | 45,001 to 55,000 CHF | 55,001 to 65,500 CHF | 65,501 to 75,000 CHF | 75,001 to 85,500 CHF | 85,501 to 95,000 CHF | 95,501 to 105,500 HF | 105,500 to 115,000 CHF | - |
| Couple with 1 legal charge | 0 to 51,000 CHF | 51,001 to 61,000 CHF | 61,001 to 71,000 CHF | 71,001 to 81,000 CHF | 81,001 to 91,000 CHF | 91,001 to 101,000 CHF | 101,001 to 111,000 CHF | 111,001 to 121,000 CHF | 121,001 to 151,000 CHF |
| Couple with 2 legal charges | 0 to 57,000 CHF | 57,001 to 67,000 CHF | 67,001 to 77,000 CHF | 77,001 to 87,000 CHF | 87,001 to 97,000 CHF | 97,001 to 107,000 CHF | 107,001 to 117,000 CHF | 117,001 to 127,000 CHF | 127,001 to 157,000 CHF |
| Couple with 3 legal charges | 0 to 63,000 CHF | 63,001 to 73,000 CHF | 73,001 to 83,000 CHF | 83,001 to 93,000 CHF | 93,001 to 103,000 CHF | 103,001 to 113,000 CHF | 113,001 to 123,000 CHF | 123,001 to 133,000 CHF | 133,001 to 163,000 CHF |
| Couple with 4 legal charges | 0 to 69,000 CHF | 69,001 to 79,000 CHF | 79,001 to 89,000 CHF | 89,001 to 99,000 CHF | 99,001 to 109,000 CHF | 109,001 to 119,000 CHF | 119,001 to 129,000 CHF | 129,001 to 139,000 CHF | 139,001 to 169,000 CHF |
How do I apply for a health insurance subsidy?
To apply for a health insurance subsidy, you should contact the dedicated department within the canton in which you are domiciled. Indeed, each administration applies its own procedure. However, regardless of where they live, applicants must imperatively meet the following conditions:
- Have taken out basic health insurance in Switzerland
- Have not already received from your canton a attestation of entitlement to the subsidy
- Be of legal age (minors must submit their application with that of their parents);
- Be sure to meet the conditions for the allocation of the health insurance subsidy applied by your canton.
The steps to take
People wishing to apply for a health insurance subsidy have two options:
- Complete the online application on the website of their canton's health insurance office;
- Submit a paper application to the agency to which they are attached depending on where they live.
Whichever method is chosen, the application form must be completed. This is different for each canton.
The information to be provided
As a general rule, cantons ask you to fill in a document that brings together the following information:
- The applicant's personal details (surname, first name, date of birth, address);
- The name of the insurance company with which he or she has taken out compulsory health insurance;
- His or her family situation (cohabitation, children, etc.);
- The name of the insurance company with which he or she has taken out compulsory health insurance.)
- Data concerning the members of his household, if any;
- Whether or not the applicant and his spouse are gainfully employed;
- The amount of household income
- Etc.
Please note that if the applicant is cohabiting, his spouse must imperatively sign the health insurance subsidy application.
Documents to enclose
The health insurance subsidy application form must be accompanied by the following supporting documents:
- Proof of income for year n-1
- Proof of expenses for the same period
- A copy of bank statements
- Proof of property, if applicable.
This is not an exhaustive list. Get in touch with your canton's services to find out about all the documents you need to provide depending on your personal situation.
All you need to know about subsidies in different cantons
- Subsidies in Fribourg
- Subsidies in Geneva
- Subsidies in Neuchâtel
- Subsidies in Valais
- Subsidies in Vaud
Updated on: 01.02.2024Written by Alexis MilonHead of health insurance department at Comparea.To learn more about our team click here.