BERN. The annual ritual has its date. In late September, the Federal Office of Public Health publishes the definitive health insurance premiums for 2027, and within days every household in the country receives the letter that sets its health budget for the year ahead. The forecast, from the comparison service Comparis, is a rise of 3.7 per cent, taking the average monthly premium to about CHF 408.
By the standards of this decade, that counts as mercy. The average rose 4.4 per cent into 2026, and the years before brought increases that politicians learned to call premium shocks. A 3.7 per cent rise would be the smallest in several years. It would also be the fifth consecutive increase, and at CHF 407.85 a month, the average premium would cost a typical household close to CHF 10,000 a year for two adults.
The interesting question is what is driving it. The answer, uncomfortable for every party that voted for it, is the basic insurance catalogue itself. Broader coverage of psychological psychotherapy, the inclusion of weight loss medication and the compensation of family carers, a reform the Federal Council approved back in 2019, now cost real money, and real money is what premiums collect.
The fastest growing line item is care at home. Spitex services now cost CHF 173 per insured person a year, a rise of 13 per cent, as hospitals push patients out earlier and an older population chooses to be treated in its own living room. Psychotherapy costs are up almost 10 per cent, to CHF 86 per person. Both are policy successes with premium consequences.
The insurers’ own arithmetic adds pressure from the other side. The federal health office told the cantons in June that insurers expect costs to rise just over 5 per cent this year, with the sector’s combined ratio near 101 per cent, meaning payouts and expenses slightly exceed premiums collected. The office describes the 2027 round as carrying a small catch-up need. Small, multiplied by eight and a half million policyholders, is not nothing.
Geography will decide who feels it. The national average conceals the usual spread: in 2026 a standard adult premium cost about CHF 264 in Zug and more than CHF 500 in Ticino, and 2027 will widen or narrow that gap canton by canton. The definitive figures, published on the official priminfo.admin.ch portal, are the only numbers that matter. The portal itself warns against signing anything on the basis of unapproved offers.
The deadlines are fixed by law. Insurers must notify every policyholder of their new premium in writing by 31 October. Anyone who wants to change provider or model for 2027 must cancel their basic insurance by 30 November, in writing, with the letter received by that date, and the new coverage takes effect on 1 January. Supplementary insurance, governed by contract rather than statute, usually demanded notice by the end of September.
Consumer advisers repeat the same three levers every autumn, because they remain the only three. Raise the deductible, switch to a restricted model such as an HMO or family doctor gate, and compare the approved premiums the day they publish. A household that has never switched is, statistically, paying for those who have.
In Bern, the politics are already warm. The Federal Council this summer endorsed a cap on health insurance executives’ pay, at the salary of a federal councillor, while conceding openly that it will not move premiums. Parliament’s cost containment package aims at 2028. The letter in the hallway aims at January.
The official figure lands in the last week of September. Forecasts have been wrong in both directions before, and the health office has its own arithmetic, but the direction is not in doubt. The letter is coming. Open it in September, not in November.