Basic insurance & MiGeL 2026
The mandatory health insurance
(KVG/LaMal) reimburses medical aids listed on the
List of Aids and Appliances (MiGeL). As of
1 January 2026, chapters 21.05 and 21.06 were
deleted and replaced by 21.07 (standalone CGM) and
21.08 (CGM combined with an insulin pump). The prior
Kostengutsprache (prior approval) requirement for alarm CGM
is gone — qualifying patients can be prescribed CGM by any
endocrinologist/diabetologist without insurer sign-off.
The positions relevant for glucose monitoring in 2026:
| Position | Category | Reimbursement cap |
|---|---|---|
21.02.03.00.1 | BGM with integrated lancing device A basic blood glucose meter with integrated lancing, reimbursed once every 2 years. | CHF 55.55 per device |
21.02.10.00.1 | BGM with voice output For blind or severely visually impaired insulin-dependent diabetics. Once every 2 years. | CHF 102.84 per device |
21.03.01.01.1 | Blood glucose test strips Consumables for capillary blood glucose measurement. Unlimited for insulin-treated patients; capped at 200/year for non-insulin type 2 diabetes (up to 400 with medical justification). | CHF 0.62 per strip (CHF 31 / 50-pack) |
21.03.01.03.1 | Ketone test strips In specifically justified medical cases (e.g. type 1 DKA risk). | CHF 2.53 per strip |
21.07.02.00.1 | CGM sensors — standalone FreeStyle Libre 2+/3+, Dexcom G7, Accu-Chek SmartGuide, Senseonics Eversense. Eligibility: intensive insulin therapy OR insulin-treated with HbA1c ≥ 8 % before CGM start. Chapter 21.07 was created 01.01.2026 when the old 21.05/21.06 chapters were deleted. | CHF 4.85 per day (flat rate) |
21.07.01.00.1 | CGM reader — standalone For patients who cannot use a smartphone. | CHF 65.54 every 3 years |
21.08.01.00.1 | CGM sensor with integrated transmitter — pump-integrated For patients on insulin pump therapy (e.g. MiniMed 780G). Cannot combine with 21.07. | CHF 4.85 per day |
21.08.02/03 | CGM sensor w/o transmitter + separate transmitter (pump) Medtronic Guardian 4 / Simplera Sync. Flagged "In Evaluation" to 31.12.2026 — likely delisted from 2027; LCA supplementary coverage recommended. | CHF 11.74 / day + CHF 2.66 / day |
Deductible (Franchise)
Before basic insurance pays, you bear the cost up to your chosen deductible (CHF 300 to 2,500 for adults, CHF 0 to 600 for children). A higher deductible reduces your monthly premium but increases your out-of-pocket risk.
For people with regular diabetes consumables, the standard CHF 300 deductible is usually cheapest: total of premium + own share is lower once annual sensor and strip costs exceed the deductible.
Co-payment (Selbstbehalt)
Above the deductible you pay 10 % of costs as a co-payment, capped at CHF 700 per year (adults) or CHF 350 (children).
Example CGM calculation (FreeStyle Libre 3 Plus, 15-day wear): CHF 4.85/day × 365 = CHF 1,770 reimbursed annual cost; with standard deductible + 10 % co-payment your out-of-pocket share is roughly CHF 300 + 147 = CHF 447/year (plus premium share).
Calculator
Use the estimator below to model your own 2026 out-of-pocket share under the BAG-authoritative HVB rates.
2026 MiGeL reimbursement estimator
Estimate your annual out-of-pocket cost under Swiss basic insurance (KVG/LaMal) using BAG-authoritative rates from the MiGeL edition effective 01.01.2026.
Breakdown
| Deductible (Franchise) | CHF 300 |
| Co-payment (10 %, capped) | CHF 149 |
| Total out-of-pocket | CHF 449 |
Estimate only. Real billing depends on your insurer, tiers-garant vs tiers-payant flow, remaining franchise balance at time of purchase, and any LCA supplementary coverage. Not medical or legal advice.
The calculator uses the HVB rates from the BAG MiGeL edition effective 01.01.2026. It assumes retail sensors are priced to match the MiGeL ceiling (true for most CGM products in Switzerland per obsidian/perplexity_2026_findings.md); real prices vary by retailer and may add a small gap.
Children & special cases
- Children under 18: CGM sensors are reimbursed without a deductible (CHF 0–600 selectable), co-payment halved.
- Gestational diabetes: services under maternity benefits are exempt from deductible and co-payment once pregnancy is certified.
- Disability insurance (IV): for minors with type 1 diabetes, IV often covers aids under birth defect 247.
Prescription & supply
All MiGeL positions require a doctor's prescription. Many pharmacies, specialised mail-order suppliers and manufacturers (Roche, Abbott, Dexcom) offer direct billing to your health insurer, so you only have to advance the deductible and co-payment.