What is this LAMal, the mandatory health insurance?

Updated on January, 12th 2024.

Let’s open this topic with a small historical introduction… 

If you were in Switzerland and that time, you can probably remember these never-ending controversies about basic healthcare. Should the system remain as it is or should we opt for a single fund model? 

In this political brouhaha where lobbies were just fighting each other, we end up not even understanding what LAMal really is. Let’s have a closer look at all of this. 

What is the point of the LAMal?

The LAMal, also called basic insurance or mandatory healthcare insurance, is, just like its three names indicate, a mandatory insurance that aims to give access to care to the entire population, in case of an illness, an accident or a pregnancy. 

Entered into force on the very first day of 1996 (the same year the Macarena came out, to give you a historical fun-fact), it is the successor of the LAMA of 1912. Long time ago! 

Because the basic insurance is governed by a federal law, its service catalogue is the same for every service provider.  

However, when taking out a mandatory insurance, we do so with a private insurance, which may come as a surprise when you consider how our neighbours’ systems work abroad.

Thereby, you get to choose freely your healthcare provider. The premium amount fluctuates depending on several criterias :

• Your age,
• Where you live,
• Your deductible
• and the model or insurance you choose.

The amount you will be charged each month can greatly vary, as you can see in this other article. 

The vertiginous and continuous increase in premiums over the last few years (average premium: +6.6% between 2022 and 2023; and +8.7% between 2023 and 2024) is driving public debate, and alarming consumer associations who are calling for greater transparency regarding the costs of health insurance companies.

Yet in 2014, Swiss citizens rejected at 61.9% the popular initiative in favour of a public fund for the healthcare insurance. 

After reading this, you probably are starting to familiarise yourself with this healthcare insurance but so many questions remain unanswered: What does the mandatory healthcare cover?, How does the LAMal reimbursement system work?and What are the gaps of this healthcare insurance?