rising premiums?
Understand premiums, reduce
costs
Find out why premiums are rising, what Sanitas is doing about it, and how you can help save.
Health insurance premiums
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What are health insurance premiums?
The health insurance premium is the amount that insured persons pay to their health insurer for their insurance cover. The amount depends on the choice of health insurer, place of residence, age, plan and deductible.
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Why are health insurance premiums increasing?
With basic insurance, premiums are based on the healthcare costs of all insured persons. This means that premiums in a region or canton rise as the costs for doctor’s visits, hospital stays or medication increase there.
These factors drive up premiums:
- Rising life expectancy: As we’re living longer than ever, we require more and more medical services
- High proportion of people with chronic illnesses: Chronic illnesses (e.g. diabetes, cardiovascular disease) require regular treatment, resulting in high costs
- Medical progress: Access to innovative medicines, such as personalised cancer therapies or biologics, improves treatment outcomes but increases costs
- New benefits under basic insurance: Non-medical psychotherapy, care for relatives, weight-loss injections for obesity – basic insurance is covering more and more
- Overprovision: Easy access to examinations, treatments and medication leads to a certain degree of overprovision, which results in unnecessary costs
Switzerland isn’t an exception: The rise in healthcare spending has been observed for years in all OECD member countries – that is, in most affluent and industrialised nations.
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What are health insurance premiums used for?
For every CHF 100 paid in monthly health insurance premiums, CHF 95 are invested directly in medical services – just CHF 5 are used to cover administrative costs.
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What is the role of the FOPH?
The Federal Office of Public Health (FOPH) reviews and approves health insurance premiums in Switzerland. Each year, insurance companies submit proposed premiums based on detailed analyses and forecasts of the amounts needed for the following year. The FOPH assesses these proposals to ensure that they comply with legal requirements, cover healthcare costs and do not generate profits. It may require adjustments if premiums are set too high or too low. Its overarching aim is to protect and promote public health while ensuring that the healthcare system remains affordable and fair. The FOPH also provides helpful answers to frequently asked questions.
What is Sanitas doing against high premiums?
Checking invoices
In 2025, Sanitas reviewed over 11 million claims settlements and saved around CHF 420 million in unjustified costs. In addition, our invoice translator function in the Portal app makes it easier for our customers to review their own invoices.
Automating processes
Thanks to automation, administrative costs for basic insurance fell to 4.8%. Over 80% of all administrative matters can now be handled digitally, saving around CHF 14 million annually in postage and paper costs.
Negotiating fair tariffs
We work closely with healthcare providers, including hospitals, clinics, networks of physicians, mail order pharmacies and other partners. We negotiate firmly but fairly to help counter annual premium increases.
Preventive healthcare
We support your efforts to keep fit and stay healthy. Because preventing illness is always better than treating it – from a financial perspective, too.
Outpatient care
Sanitas is encouraging a shift from inpatient to outpatient treatment, as many procedures can now be performed without an overnight stay in hospital. This means greater comfort and safety for patients, as well as lower costs for the healthcare system.
Supporting customers
Our case management team supports customers through challenging health situations, ensuring an optimal treatment and recovery process.
Alternative insurance models
We are constantly improving our basic insurance plans and offering alternatives that can have a positive impact on healthcare costs (e.g. the TelMed or Family Doctor models). This way, you benefit from attractive premium discounts and the highest quality of treatment.
Political engagement
Together with our industry association prio.swiss, we advocate for a high-quality and sustainably financed healthcare system.
What can you do about rising premiums?
Take the right steps when you’re ill
Visits to A&E drive up healthcare costs. If you fall ill, contact your family doctor practice or the telemedicine hotline first, or seek advice at a pharmacy before going to hospital. These options are significantly cheaper.
Request a second opinion
If you’re faced with the prospect of a major medical procedure, it’s worth getting a second opinion – from a financial perspective, too.
Use generics
If you need medication, generics are a good and more affordable alternative to original products. You get the same active ingredient but benefit from a lower copayment.
Share scans and results
Images – whether from an X-ray, MRI or CT scan – and all other test results (such as laboratory results) belong to you. Take these with you to doctor’s appointments to avoid duplicate and therefore unnecessary examinations.
Take care of your health
If you exercise regularly, eat a balanced diet and take care of your mental health, you can prevent many diseases. We’re here to support you with great offers.
Prevention is better than cure
That’s why we support our customers with digital services to help them live healthily.
Why a single health insurance scheme would not reduce healthcare costs
What is a single health insurance scheme?
A single health insurance scheme would require everyone to take out basic insurance with the legally designated provider in their region. They would therefore lose the freedom to choose their health insurer or switch providers, as they can today. This issue is currently under political debate.
Healthy competition means better offers
The freedom to choose your health insurer, combined with healthy competition, encourages insurers to offer high-quality plans and excellent customer service – in other words, to put customers’ needs first. This benefits policyholders, who can choose the insurer that best meets their needs and switch to another if they are no longer satisfied.
Administrative costs are already low
Given the annual rise in premiums, many people see a single health insurance scheme as the solution to all their problems. However, such a scheme would not address the main reasons for these increases. Premiums are rising not because of administrative costs, but because people are living longer and treatments and medicines are becoming more frequent and expensive. Together, these factors account for 95% of total costs. A single health insurance scheme would therefore not reduce premiums.
Solutions are needed, but of a different kind
For these reasons, Sanitas remains committed to freedom of choice and competition in basic insurance – because this benefits not only every insured person, but the Swiss healthcare system as a whole. We also believe that the healthcare system must continue to evolve and that rising costs must be brought under control. We are working towards this goal through our industry association prio.swiss.
