bonus.ch sees 2027 Swiss health premiums rise 4.5% to 5% on average

bonus.ch expects Swiss health insurance premiums to rise about 4.5% to 5% in 2027, with some policyholders facing increases of up to 20%. The forecast comes even as insurer reserves improve, underscoring continued pressure from medical costs and uneven regional trends.

Why it matters: - Swiss households should brace for another increase in mandatory health insurance premiums in 2027. - bonus.ch expects an average rise of 4.5% to 5%, after a 4.4% increase in 2026. - Some policyholders could face premium jumps above 10%, and in the worst cases up to 20%. - The forecast suggests cost pressure in the health system remains strong despite healthier insurer reserves.

What happened: - bonus.ch published its 2027 outlook for Swiss health insurance premiums on Sept. 8, 2026. - The Lausanne-based comparison site said the most likely scenario is an average premium increase of 4.5% to 5%. - The same outlook says the gap between regions, insurers, franchises and insurance models will remain wide. - bonus.ch also said some exceptional tariff repositionings could theoretically push increases to 50%, though those cases are not considered representative.

The details: - The key driver is the rise in costs covered by mandatory health insurance. - Health insurance costs rose 0.4% over the 12 months ending in the second quarter of 2026, after a 2.9% rise in the first quarter. - Average costs per insured person reached CHF 4,834, up CHF 21 from a year earlier. - bonus.ch warned that the second-quarter figure is distorted by billing delays tied to the rollout of a new global tariff system for outpatient medical care. - Those delays temporarily lowered reported hospital outpatient costs by 4% in the first quarter and 16% in the second quarter of 2026. - The timing of the catch-up effect remains unclear. - The 0.4% quarterly increase should not be read as proof of a lasting slowdown in health spending. - SPITEX home care recorded the sharpest rises among major care categories, up 14% in the first quarter and 15% in the second quarter of 2026. - Psychologist and psychotherapist costs rose 10% and 11%. - Physiotherapy costs rose 7% in both quarters. - Outpatient doctors excluding laboratory work rose 6% and 7%. - Laboratory costs rose 6% in both quarters. - Pharmacy costs rose 5% in both quarters. - Nursing homes rose 3% and 4%. - Hospital stays rose 3% and 2%. - Medicines dispensed by doctors rose 1% in the first quarter and fell 1% in the second. - Laboratory costs in doctors’ offices stayed nearly flat. - Canton-level cost growth ranged from +9.6% in Schaffhausen to -8.7% in Zug in the second quarter of 2026. - Schaffhausen followed a 7.2% increase in the first quarter with another 9.6% rise in the second quarter. - Glarus rose 4.4%, the Grisons 3.7%, Jura 3.6% and Zurich 3.3%. - Solothurn posted -2.3%, Basel-Stadt -1.6%, Bern -1.3%, Thurgau -1.0%, Geneva -0.9% and Zug -8.7%. - KOF at ETH Zurich, in forecasts prepared for the Federal Office of Public Health, expects per-person costs to rise 4.5% in 2026 and 4.0% in 2027. - That would lift costs from CHF 4,968 per insured person in 2025 to CHF 5,191 in 2026 and nearly CHF 5,400 in 2027. - KOF said total costs would climb by almost CHF 900 per person between 2023 and 2027. - Insurers’ estimates point to a little more than 5% cost growth in 2026. - The Federal Office of Public Health said the estimated combined ratio for 2026 is close to 101%, meaning premiums would not fully cover expenses. - The office expects a slight catch-up effect in the 2027 premium calculation. - Swiss health insurers ended 2025 with a combined surplus of nearly CHF 569 million. - That surplus was added to reserves, bringing total reserves to CHF 8.6 billion. - bonus.ch said the stronger reserve position may soften pressure on premiums but cannot offset annual spending growth of 4% to 5% over time. - The release said reserves are meant to protect solvency and absorb shocks, not permanently hold down premiums. - Federal rules eased in 2021 to allow insurers to reduce excess reserves and pass some of that benefit to policyholders through lower premiums. - bonus.ch said that policy helped briefly but also left some insurers with less room to absorb cost surges later. - Reserve levels still vary sharply across insurers. - In 2024, Visana reported a reserve ratio of 53%, Agrisano 39%, CONCORDIA 31%, Assura 9%, Mutuel Assurance 9% and Philos 5%. - Several major insurers have seen reserve ratios fall sharply since 2020. - CSS fell from 31% to 11%, Helsana from 32% to 13%, CONCORDIA from 50% to 31% and Vivao Sympany from 32% to 13%. - Visana’s reserve ratio declined from 66% in 2020 to 53% in 2024. - Agrisano’s reserve ratio declined from 47% to 39% over the same period. - The study and premium comparison tool are available here and here.

Between the lines: - The premium forecast points to a system still catching up with spending trends rather than one that has regained balance. - Temporary improvements in reported quarterly costs may understate the eventual increase if delayed bills flow through later. - Reserve rebuilding is now part of the premium story, not just medical inflation. - That makes the 2027 hike less about a one-off shock and more about insurers restoring financial cushions after years of depletion.

What's next: - The Federal Office of Public Health will use insurer cost estimates and catch-up effects to set 2027 premiums. - The final increase could end up closer to 3.5% to 4% if cost growth slows more than expected. - A stronger-than-expected rise in 2026 spending or extra costs from the new ambulatory tariff system could push the average increase above 5%. - Individual premium notices will likely diverge sharply by canton, insurer, age, franchise and model.