LAMal and taxation: what you need to know
In Switzerland, basic health insurance is mandatory for all persons domiciled in the country. The LAMal (Federal Health Insurance Act) guarantees access to essential medical care, but premiums — which are not income-dependent — represent a significant expense for households, with costs that can exceed CHF 400 per month per adult.
The good news is that the Swiss tax system provides several deduction possibilities: insurance premiums are deductible (within federal and cantonal limits), unreimbursed medical expenses can be subtracted from taxable income, and low-income families are entitled to individual premium reductions (IPR).
This guide explains in detail how these benefits work, what the cantonal limits are, and how to optimise your tax position in relation to health insurance.
How the LAMal system works
The Swiss health insurance system has unique characteristics that distinguish it from most European countries. Here are the key points:
Insurance obligation
Every person domiciled in Switzerland must take out basic health insurance (LAMal) within 3 months of arrival. Insurance is individual: every family member — including newborns — must have their own policy.
Income-independent premiums
Unlike many European countries, LAMal premiums are calculated per person (not as a percentage of salary). They vary according to the canton of domicile, the chosen insurer, the insurance model (GP, HMO, telmed) and the selected deductible.
Deductible and cost sharing
The insured person chooses an annual deductible (from CHF 300 to CHF 2,500 for adults). Beyond the deductible, they pay a 10% co-payment up to a maximum of CHF 700/year (CHF 350 for minors). The choice of deductible directly affects the monthly premium.
Covered services
LAMal covers a uniform catalogue of services defined by the Confederation: medical consultations, hospitalisations in general ward, medications from the specialities list, prescribed physiotherapy, laboratory tests and maternity care (without deductible).
Supplementary insurance
Supplementary insurance (private/semi-private room, alternative medicine, dental care) is not part of LAMal and is optional. Their premiums are also tax-deductible, within the overall limits provided.
Cantonal deductions for insurance premiums
Each canton sets its own deduction limits, which can be significantly more generous than the federal flat rate. Here are the main cantons:
| Canton | Single | Married | Per child |
|---|---|---|---|
| Zurich | CHF 2,600 | CHF 5,200 | CHF 1,300 |
| Bern | CHF 2,400 | CHF 4,800 | CHF 1,200 |
| Ticino | CHF 3,000 | CHF 6,000 | CHF 1,500 |
| Vaud | CHF 3,100 | CHF 6,200 | CHF 1,550 |
| Geneva | CHF 3,366 | CHF 6,732 | CHF 1,683 |
| Lucerne | CHF 2,300 | CHF 4,600 | CHF 1,150 |
| St. Gallen | CHF 2,400 | CHF 4,800 | CHF 1,200 |
| Aargau | CHF 2,800 | CHF 5,600 | CHF 1,400 |
Amounts are indicative and may vary depending on personal circumstances (2nd pillar affiliation, marital status). Always check current values with your cantonal tax authority.
Medical expenses deduction
In addition to premiums, you can deduct medical and dental expenses actually incurred and not reimbursed by insurance. At federal level, expenses exceeding 5% of net income are deductible.
Deductible expenses
- Medical and specialist consultations not covered by LAMal (or only partially covered)
- Dental and orthodontic treatments (not covered by LAMal)
- Prescription glasses, contact lenses and hearing aids
- LAMal cost-sharing (deductible + 10% co-payment)
- Prescribed medications not reimbursed and excess physiotherapy sessions
Non-deductible expenses
- Cosmetic surgery without medical indication
- Wellness products, non-prescribed dietary supplements
- Spa stays without medical prescription
Calculation example
Net income: CHF 80,000. 5% threshold: CHF 4,000. Total unreimbursed medical expenses: CHF 6,500. Deductible amount: CHF 6,500 – CHF 4,000 = CHF 2,500. This CHF 2,500 is added to the flat-rate deduction for insurance premiums.
Individual premium reduction (IPR)
The premium reduction subsidy (IPR, in German IPV — Individuelle Prämienverbilligung) is financial assistance for individuals and families with modest income. It is managed by the cantons, which define the eligibility criteria.
Who is eligible
Individuals and families whose income and assets are below certain thresholds set by the canton of domicile. The limits vary enormously: in some cantons, families with incomes up to CHF 80,000–100,000 also benefit.
How to apply
In many cantons, the allocation is automatic, based on data from the last tax return. In others (e.g. Geneva, Vaud), a specific application must be submitted within the established deadlines.
Reduction amount
The subsidy partially or fully covers LAMal premiums. For minors and young adults in education, several cantons guarantee a reduction of 50% or more of the reference premium.
Impact on the tax return
The reduction obtained decreases the deductible amount for insurance premiums in the tax return. In other words, only the premiums actually paid (net of the subsidy) are deducted.
If you believe you are entitled to IPR but have never applied, check the website of your cantonal health insurance office. In some cantons, the subsidy can be requested retroactively for the current year.
Special situations
Some profiles require specific attention regarding LAMal and taxation:
Cross-border workers
Cross-border workers (domiciled in an EU/EFTA country and employed in Switzerland) can in many cases choose between LAMal insurance and the health system of their country of domicile (right of option). Those who choose LAMal are entitled to the same tax deductions as residents. Those who opt for the foreign system can deduct foreign system premiums under the same conditions. The choice is generally irrevocable.
Families with children
Each child requires a separate LAMal policy. Premiums for minors are significantly lower (CHF 100–120/month on average), but the supplementary deduction per child allows recovering a significant portion. Large families with average incomes are often eligible for IPR for children even if they are not for adults.
Young adults (19–25 years)
Young adults in education benefit from reduced premiums with most insurers. If they are still dependents of their parents, the premiums can be deducted in the parents's tax return. Many cantons grant IPR with more favourable thresholds for this age group.
Retirees
For retirees, LAMal premiums are often the most significant expense after rent. The cantonal deduction and any IPR are particularly relevant. Retirees with modest pensions (AHV + any BVG) are almost always entitled to premium reductions.
Tax optimisation strategies
- Choose a high deductible (CHF 2,500) if you are in good health with few medical expenses: the premium savings often outweigh the risk, and the lower premium still falls within the deductible flat rate
- Compare LAMal premiums every year on the FOPH website (priminfo.admin.ch): switching insurers is free and can save hundreds of francs with no difference in basic coverage
- If you have significant medical expenses, concentrate them in the same tax year to more easily exceed the 5% of net income threshold and maximise the deduction
- Check your IPR entitlement every year: thresholds change and a change in income (short-time work, birth of a child, retirement) can make you eligible
- If you pay LAMal premiums for adult children in education, make sure the deduction appears in your return and not in your child's (if they have no significant income of their own)
- Keep all unreimbursed medical and dental invoices, even small amounts: added together they can exceed the 5% threshold
- Use AccountEX to track insurance premiums and medical expenses throughout the year: at tax return time you will have a ready and organised summary
Related guide
LAMal premiums are among the main tax deductions. Discover all allowable deductions in our complete guide.
Tax Deductions: What You Can Deduct in Switzerland →Simplify your Swiss accounting
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