KVG (Federal Health Insurance Act, Switzerland)

Concept

The Federal Health Insurance Act (KVG) is the Swiss federal statute governing mandatory basic health insurance, to which every person residing in Switzerland is subject. It sets out, in particular, the benefits catalog of basic insurance, premium structuring, and supervision of licensed health insurers.

Guaranteed Acceptance and Community Rating

Unlike German private health insurance, health insurers licensed under the KVG are required to accept every applicant without medical underwriting (guaranteed issue) and, for basic insurance, may not charge risk-based premiums within the same region and age group; instead, they must apply community-rated premiums differentiated only by canton, age group, and deductible.

Supplementary Insurance and Competition

While basic insurance under the KVG offers a uniform, statutorily defined scope of benefits, health insurers compete through voluntary supplementary insurance (for example, for semi-private or private hospital wards, dental treatment, or alternative medicine), which is not governed by the KVG but by general insurance contract law and may include medical underwriting.