LaMal, enacted in 1994 and effective from 1996, revolutionized Swiss healthcare by mandating basic health insurance for all residents, regardless of employment status. It's not a government-run system but a private one: you choose from over 50 approved insurers, paying premiums based on age, residence, and coverage model (e.g., standard deductible of CHF 300–2,500). Average premiums in 2025 are around CHF 400–500/month for adults, varying by canton—lower in Appenzell, higher in Basel-Stadt.
For freelancers, LaMal is non-negotiable. You must enroll within three months of residency or starting self-employment, or face penalties. Unlike AVS, premiums aren't income-based; they're flat rates, making them a fixed cost that can strain variable freelance earnings.
Are LaMal premiums business expenses? No, they are not. While business-related insurances (like professional liability or accident coverage tied to your work) can be deducted as operational costs under DBG Article 27, LaMal is considered a personal obligation. It's mandatory for all residents, not specifically linked to your freelance activity. Instead, LaMal premiums qualify as personal deductions in your tax return.
Under federal and cantonal tax laws, you can deduct health insurance premiums from your taxable income as a standard or actual expense deduction. Most cantons offer a lump-sum deduction for insurance premiums, capped based on family status—e.g., CHF 2,700 for singles in some cantons, plus unreimbursed medical costs exceeding 5% of net income. This is claimed on your personal tax form, not as part of business accounting.
For example, if your annual LaMal premium is CHF 5,000, you deduct it personally, reducing your overall taxable income after business profits are calculated. This distinction matters: business expenses reduce your net profit (affecting AVS calculations too), while personal deductions apply afterward.
Insights:
Freelancers often bundle LaMal with supplementary insurances (Zusatzversicherungen) for dental or alternative medicine, but only the basic LaMal portion is fully deductible personally. If your work involves health risks (e.g., a freelance trainer), consider accident insurance (UVG), which can be partly business-deductible if employer-mandated equivalents apply. Cost-saving tip: choose higher deductibles to lower premiums, but ensure you have reserves for out-of-pocket costs. Subsidies are available if your income is low (under CHF 50,000–60,000 depending on canton and family size)—check with your cantonal health authority.
Historical context:
LaMal was born from debates on universal coverage, balancing private choice with solidarity. It ensures no one is denied care, but premiums have risen 4–5% annually, prompting calls for reform. For freelancers, this means budgeting carefully, as unlike employees, you don't get employer subsidies.