Do pregnant women have to pay a deductible in Switzerland? Guide on cost exemption

The Swiss healthcare system, governed by the Federal Law on Health Insurance (LAMal¹Federal Health Insurance Act regulating universal compulsory healthcare in Switzerland.), stands out for its high quality and its cost-sharing structure. For residents and the growing expatriate community, understanding cost exemptions is a fundamental strategic measure to optimize the family budget during maternity. The financial security offered by the Swiss system allows expectant mothers to focus on their well-being and that of the newborn, eliminating economic uncertainty thanks to robust and updated state protection.

Having this support guarantees access to top-level specialists without medical bills being an obstacle. Below, we present a detailed analysis of the cost-sharing rules according to the current regulations of 2025.

1Do pregnant women have to pay a deductible in Switzerland?

Protection for maternity is a central pillar of basic insurance in Switzerland. The logic behind this regulation is to reduce the economic burden on households to ensure that no woman gives up essential care for financial reasons.

According to the LAMal²Federal Health Insurance Act regulating universal compulsory healthcare in Switzerland. law and its 2025 update, women do not pay a deductible or copayment³Fixed annual amount you pay out-of-pocket for medical expenses before basic insurance acts. for maternity benefits. The total exemption now applies from the beginning of pregnancy for any treatment for general illness. This protection eliminates shared costs up to eight weeks after delivery, guaranteeing full financial security.

This legal change, consolidated in the amendment to the LAMal⁴Federal Health Insurance Act regulating universal compulsory healthcare in Switzerland. of March 2025 (FF 2025 1108), represents a significant advance. Previously, there was a distinction based on the 'week 13,' but the current regulation establishes that the exemption from the deductible and the 10% co-payment⁵Fixed annual amount you pay out-of-pocket for medical expenses before basic insurance acts. is activated from the first day of pregnancy. This 'starting point' drastically simplifies financial planning for families, as it eliminates the administrative burden of having to prove whether a medical treatment is specific to maternity or a general illness; everything is covered at no additional cost from the beginning.

Once this total protection is understood, it is vital to identify which specific medical services are part of this savings ecosystem.

2Medical services exempt from cost-sharing

The scope of coverage guaranteed by Swiss federal law is fundamental for public health. By including midwifery services and postpartum care free of charge for the insured, the system promotes constant professional follow-up that prevents long-term complications for both the mother and the child.

What medical expenses are covered at no additional cost during pregnancy? Basic insurance covers preventive check-ups, deliveries in hospitals or birth centers, and postpartum care. These services, carried out by doctors or midwives, are completely exempt from deductible and cost-sharing, ensuring comprehensive and free care throughout the entire period of legal coverage.

Following the provisions of Art. 29 of the LAMal⁶Federal Health Insurance Act regulating universal compulsory healthcare in Switzerland., services exempt from any co-payment⁷Fixed annual amount you pay out-of-pocket for medical expenses before basic insurance acts. include:

• Maternity check-ups: Preventive exams, ultrasounds, and diagnostic tests performed by doctors or professional midwives.

• Childbirth: Assistance during delivery and hospital stay, whether in public centers, clinics on the cantonal list, or birth homes.

• Postpartum care: Outpatient follow-up by a midwife to monitor maternal recovery and the health of the newborn.

• Medications: Drugs prescribed during pregnancy and up to eight weeks after childbirth, always within the limits and lists established by the Federal Council.

Beyond direct exemptions in medical services, families have additional tools to reduce their monthly fixed expenses.

3Subsidies and premium reduction for families

The 'Réduction de primes⁸Fixed monthly fee you pay to maintain your health coverage.' (RIP) system acts as a tool of social equity in the Swiss cantons. Since the arrival of a child is usually accompanied by a restructuring of family income, these subsidies are vital to maintain financial stability. In cantons such as Valais or Graubünden, the support is divided into the reduction of the insurance premium⁹Fixed monthly fee you pay to maintain your health coverage. and specific family subsidies.

How to apply for a reduction in the health insurance premium¹⁰Fixed monthly fee you pay to maintain your health coverage.? Residents with modest financial means can apply for cantonal subsidies to ease the monthly cost. The process is handled through the Compensation Fund of the canton of residence (such as in Valais or Graubünden), where the family's financial situation is evaluated to grant the benefit directly on the bills.

To manage these benefits (with projections for 2025/2026), the following steps must be followed:

1. Assess the right according to income: Check the limit in the cantonal tables. In the canton of Graubünden, for example, there are also family subsidies that, according to reference data, reach 220 CHF per month per child.

2. Official processing: Submit the application to the competent authority. In the case of Valais, it must be sent to the Caisse de Compensation of the canton of Valais, located at Avenue Pratifori 22, 1950 Sion.

3. Required documentation: Provide the most recent tax declaration, proof of address certificates, and the current health insurance policy.

It is crucial to carry out this procedure on time, especially at the beginning of the year or after the birth, to ensure the application of benefits and not lose retroactivity.

4Conclusion

Motherhood in Switzerland benefits from exceptional legal protection that guarantees full exemption from deductibles and cost-sharing from the beginning of pregnancy. With the 2025 legal update and the possibility of accessing cantonal subsidies, families can go through this stage with complete economic security.

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