Healthcare in Zurich: how the Swiss system works for Americans, from the basic plan to the ER

Swiss healthcare is excellent, and it's not free. Think of it as Obamacare's individual mandate with stricter rules and better hospitals: everyone must buy a private plan, and you pay a real share of your bills.

The short version

• Basic health insurance is mandatory for everyone who lives in Switzerland. You have three months from the day you take up residence to sign up [1].
• Sign up on time and your cover runs back to your first day. Sign up late and it starts only when you enroll, with a possible surcharge [1].
• You pay a yearly deductible (the franchise), at least CHF 300 for adults, then 10% of costs up to CHF 700 a year [2].
• Many cheaper plans route you through a family doctor (GP), a telemedicine line or a group practice first.
• Emergency: 144 for an ambulance, 112 works too. For non-urgent medical advice in the canton, call AERZTEFON at 0800 33 66 55 [3][4].

USD conversions use the Federal Reserve H.10 rate of October 30, 2026 (USD 1 = CHF 0.8230) [8].

How Swiss health insurance works

Switzerland's system runs on the Federal Health Insurance Act (KVG, or LAMal in French). Every resident has to carry "compulsory health insurance," often called the basic plan (Grundversicherung). It's sold by private insurers, but the government sets the benefits, so the basic coverage is the same whichever company you choose [1].

A few things will surprise Americans:

• Everyone is insured individually. No family plan. Each adult and each child has a separate policy, and parents have to insure a newborn too [1].
• Your employer doesn't pick it. Unlike back home, health insurance isn't an employer benefit here. You choose an insurer and pay the premium yourself, every month.
• Insurers must take you. For the basic plan, they can't turn you down for pre-existing conditions.
• Premiums don't depend on income. They vary by insurer, canton, age group, deductible and plan model. Households on lower incomes can apply to the canton for a premium reduction.

The three-month clock starts when you take up residence. If you enroll within that window, cover starts from your arrival and the insurer reimburses costs you ran up in the meantime. You also owe premiums from that date [1]. Miss it and cover starts only when you sign up, and you may pay a surcharge unless the delay was justified [1].

Our deep dive on Swiss health insurance: the mandatory basic plan walks through choosing an insurer, deductible and plan model.

What you pay out of pocket

Source: Federal Office of Public Health [2].

You can choose a higher deductible in exchange for a lower premium [2]. The tradeoff works like a high-deductible plan back home: great if you're healthy, painful if you're not. Young adults under 25 in training are exempt from the hospital contribution, and maternity care has its own exemptions, including no coinsurance from the 13th week of pregnancy until eight weeks after birth [2].

Accident cover

If you work for a Swiss employer, accidents (on and off the job) are usually covered by your employer's accident insurance, not your health plan. If you're covered that way, you can usually drop accident cover from your health policy and save a little. Check your contract or ask HR.

Basic vs. supplementary

The basic plan covers doctor visits, hospital stays in the general ward of a listed hospital in your canton, prescriptions on the official list, maternity care and more. It doesn't cover most dental work, and it doesn't give you a private room or free choice of hospital doctor.

That's what supplementary insurance (Zusatzversicherung) is for. Unlike the basic plan, it's voluntary, and insurers can ask health questions and turn you down. Many Americans add a dental policy or a semi-private hospital plan. Buy supplements early, while you're healthy.

What about your US coverage?

Medicare generally doesn't pay for care outside the US, and most US employer plans stop when you leave the payroll. An expat or travel policy doesn't replace the Swiss basic plan if you live here. See our guide to Medicare when you live abroad before you decide whether to keep Part B.

Finding a doctor: the GP model

Most Swiss insurers offer cheaper plan models that work like an HMO:

1. Family doctor model (Hausarztmodell): you register with a GP who's your first stop for anything non-urgent and refers you to specialists.
2. Telemedicine model: you call a medical hotline before seeing anyone.
3. HMO model: you use a specific group practice.
4. Standard model: free choice of doctor, at the highest premium.

Skip the first step on a gatekeeper plan, and your insurer can refuse to pay. Emergencies, eye exams and gynecology visits are often exempt from the referral rule, but check your policy.

English-speaking doctors

Zurich has plenty of doctors who speak English, especially in the city center and around the big employers. Ask colleagues, check your insurer's doctor search, or browse a Swiss doctor-finder site that lets you filter by language. GPs in the city can be slow to accept new patients, so start looking right after you arrive, not when you get sick.

Pharmacies

Pharmacists here give real advice and can handle a lot of minor problems. Some medications that are over the counter in the US need a prescription in Switzerland, and vice versa. Bring a supply of anything you take regularly, plus a letter from your US doctor, and plan to have a Swiss doctor write new prescriptions.

Hospitals and emergencies

In a life-threatening emergency, call 144 for an ambulance [3]. The European emergency number 112 also works [4].

Emergency and help numbers

Hospitals in the city

These are the main hospitals the city tourism office lists for Zurich [4], plus the private Hirslanden clinics, which run their own emergency departments [5]:

On the basic plan, a private clinic's emergency room will treat you, but a planned stay in a private room is a supplementary-insurance perk. Check your cover before you book elective surgery.

For something urgent that isn't life-threatening, such as a sprained ankle on a Saturday, call AERZTEFON first. They can point you to an urgent care practice (Notfallpraxis) instead of a hospital ER, which is usually faster and cheaper.

The bill

Swiss doctors often bill you, and you claim from your insurer. Hospitals often bill the insurer directly. Either way, your deductible and coinsurance come out of your pocket. Keep your insurance card on you, and read every statement: it's the closest thing to an EOB from back home.

A first-month checklist

1. Register at your Kreisbüro so you're officially resident.
2. Choose an insurer and plan within three months. Compare premiums on the official federal comparison tool or a private comparison site.
3. Pick a GP if you choose a family doctor model.
4. Save the numbers: 144, 112 and 0800 33 66 55.
5. Enroll in STEP with the US Embassy in Bern, so they can reach you in an emergency [6][7]. For a US citizen emergency, the State Department's 24/7 line from abroad is +1-202-501-4444 [6].
6. Ask other Americans. Members of our community group for Americans in Switzerland swap names of English-speaking pediatricians and dentists all the time.

Sources

1. Federal Office of Public Health (FOPH): Compulsory health insurance
2. FOPH: Kostenbeteiligung für in der Schweiz wohnhafte Versicherte
3. Canton of Zurich: Notfall und Rettung (February 25, 2026)
4. Zürich Tourismus: Notfallnummern, Spitäler und Krisen
5. Hirslanden: Emergency
6. US Embassy in Switzerland and Liechtenstein
7. Smart Traveler Enrollment Program (STEP)
8. Federal Reserve: H.10 foreign exchange rates

Keep reading

• Swiss health insurance: the mandatory basic plan
• Registering in Zurich: the Kreisbüro
• Medicare when you live abroad
• Health insurance between countries