Switzerland’s health insurance premiums are projected to rise by an average of 4.5% to 5% in 2027, according to a recent assessment by comparison platform bonus.ch. Despite insurers having bolstered their reserves, the persistent increase in healthcare costs is anticipated to exert further pressure on premiums. In 2026, premiums already saw a 4.4% hike, and another substantial adjustment is expected next year. In a more optimistic scenario, the increase could be contained between 3.5% and 4%; however, a surge in healthcare spending or costs associated with new outpatient tariffs could push the rise beyond 5%. Variations are likely across individual policyholders based on factors such as insurer, canton, premium region, age, deductible, and insurance model, with potential increases reaching over 10% or even 20% in certain cases.
The ongoing escalation in healthcare costs remains a significant driver of the expected premium rises. In the second quarter of 2026, the costs within Switzerland’s mandatory health insurance system climbed by 0.4% from the previous year, following a 2.9% increase in the first quarter. The average annual cost per insured person reached CHF 4,834, marking a CHF 21 increase from the previous year. However, these figures might not accurately capture actual expenditures due to delays in outpatient billing linked to a new flat-rate tariff system, which temporarily reduced recorded costs in the sector. As outstanding invoices are processed, recorded cost figures could rise, complicating interpretations of the recent slowdown as a lasting reduction in healthcare spending.
Significant variations in healthcare spending are also evident across Switzerland’s cantons. During the second quarter of 2026, increases ranged from 9.6% in Schaffhausen to an 8.7% decrease in Zug. Cantons such as Glarus, Graubünden, Jura, and Zurich experienced above-average increases, while Solothurn, Basel-Stadt, Bern, Thurgau, and Geneva reported lower costs than the previous year. Despite these differences, annual forecasts suggest continued overall growth, with projections from the KOF Swiss Economic Institute at ETH Zurich indicating a 4.5% increase in healthcare costs per insured person in 2026 and a further 4% in 2027.
Health insurers face additional financial pressures, as estimates submitted to the Federal Office of Public Health suggest that healthcare costs could rise by slightly more than 5% in 2026. The FOPH has also highlighted a possible catch-up effect for 2027 premium calculations, with the estimated combined ratio for 2026 nearing 101%, potentially leading to premium adjustments that exceed the underlying increase in healthcare costs. Swiss health insurers have strengthened their financial position, recording a combined surplus of nearly CHF 569 million in 2025, with the amount allocated to reserves, bringing total reserves to about CHF 8.6 billion.
This financial buffer is crucial for insurers to absorb unexpected cost increases without abrupt premium adjustments, yet differences in reserve levels among insurers remain significant. For instance, reserve rates in 2024 ranged from 53% for Visana to just 5% for Philos. The debate over reserves is tied to premium policy, as lower reserves can temporarily reduce premiums but maintaining a substantial financial buffer is essential for stability. Reserve ratios have declined for several insurers since 2020, illustrating the ongoing challenges they face in balancing financial health with consumer costs.
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