Premium subsidy – who is eligible?

In Switzerland, people with low incomes and assets are entitled to a premium subsidy for their health insurance. Premium subsidies vary according to the canton of residence.

What is a premium subsidy?

The premium subsidy or health insurance subsidy provides financial support for basic insurance premiums. It provides relief for people with low incomes and assets.

Who is entitled to a premium subsidy?

Individuals, couples and families whose annual income and assets fall below a specific threshold are entitled to a premium subsidy. The cantons regulate premium subsidies. Many cantons inform those entitled to a subsidy directly, while in others there is an obligation to apply. Find out more below.

For young adults, general rules apply: For initial training, they receive a premium subsidy until the end of their education. Young adults aged 18 and over are subject to their own tax factors, even if they live with their parents.

Who pays the premium subsidy?

The federal government provides the cantons with an amount for health insurance premium subsidies.

How much is the individual premium subsidy?

The individual premium subsidy for health insurance is calculated on the basis of a person’s net income, assets declared in the tax statement, marital status and number of children.

How do I receive a health insurance subsidy?

In most cantons, subsidies are granted automatically based on the tax assessment. However, in some cantons you have to submit an application to the responsible authority. In most cases, applications must be received by a specific deadline. We recommend that you get in touch with the responsible authority in your canton or municipality of residence in good time to discuss the procedure.

You will find a list of the responsible cantonal authorities here.

Canton of Zurich: change to the premium subsidy system

Since 2021, the premium subsidy in the Canton of Zurich has been calculated on the basis of an individual’s final income and assets for the current year.

The premium subsidy is calculated as follows:

  • The premium subsidy for the current year is calculated using the tax return from the previous year.
  • Based on this, the social security authority (SVA) first calculates the provisional claim. Sanitas pays 80% of this claim directly to you or the person in your family who is responsible for insurance affairs, provided the SVA has approved the provisional claim.
  • As soon as the final tax return for the current year is available and has been approved by the SVA, Sanitas pays the remaining 20% to you or the responsible person in your family.

What exactly does that mean for you?

If your financial situation improves between the time of the provisional and the final tax return, i.e. if you earn more, the premium subsidy will be reduced accordingly. That would mean repaying the premium subsidy that has already been paid out.  Sanitas does not have any influence on this decision. Our tip: include any potential repayment of the premium in your financial planning so that you do not receive any unwelcome surprises.

If you have any questions about your premium subsidy, contact the SVA in your canton of residence Zurich: