Old-age care costs in Switzerland

Health costs over time

As we age, we often need more medical care. Many conditions can occur as we reach an older age. For instance, many people start to need hearing aids or glasses. There are also some medical conditions, like Parkinson’s or Alzheimer’s, that are often linked to old age.

Therefore, we can expect our medical costs to be higher as we reach retirement age and above.

Fortunately, health insurance premiums do not rise with age. However, old age is usually when it becomes interesting to switch to a low deductible for the health insurance. In turn, this means paying more each month for health insurance. Additionally, some people may require care not covered by the base insurance, which is either covered by supplementary health insurance or paid out of pocket.

Given our health system in Switzerland, we can expect our health costs to rise with age. However, until we need at-home care or residential old-age, these costs should be manageable by most.

At-home old-age care

In some cases, some special at-home old-age care may become necessary. This medically prescribed home care is called Spitex. In general, it is better for people to stay in their home as long as they reasonably can. But this can involve some doctors or other specialists coming to our homes to help.

All these medical services are not free. For medical services prescribed by a doctor, most of the fees are covered by the base health insurance. They have complex tables where each type of old-age care cost is considered and covered up to an hourly rate. Whatever is above this hourly rate will be charged to the customer. However, there is a rule in most cantons that a customer receiving at-home old-age care can only pay 15.35 CHF per day (as of 2025). The amount above this threshold will be covered by the canton or municipality.

In practice, many people will pay less than this maximum. But it is good to know the maximum we ought to pay, regardless of how many hours of Spitex are prescribed. This is not cheap, but it can be managed if planned well in advance. Of course, if you did not plan for it, it could represent a significant increase. Over a 50,000 CHF yearly budget, this is almost 10% extra that needs to be accounted for. For many people, this can be an issue.

Unfortunately, this may not be enough for some people. Indeed, some people require some help for cleaning and cooking or running errands such as shopping. These nonmedical home services are generally not covered by health insurance. There are a few cases where some of these services can be covered by health insurance if they are prescribed by a doctor, but they only cover a few cases.

In most cases, cooking, cleaning, and such services are not covered. As such, they need to be paid by the beneficiary. In Switzerland, these can quickly cost about 40 CHF an hour. If you need one hour a week, you will only pay about 160 CHF per month extra. But if you need an hour a day, you will pay around 800 CHF per month. And some people need even more hours, making these services expensive.

It is worth mentioning that some municipalities offer subsidized services. So, you should check with your municipality whether they can help you.

In some extreme cases, patients require 24/7 at-home care. This means that a nurse or a caregiver will live in their home to take care of them. The price for such services highly depends on the level of skill required but can easily reach 5,000 CHF per month even for nonmedical care and could go above 10,000 CHF per month. These costs will vary a lot by canton and provider. 24/7 old-age care costs can be as high as residential old-age care.

Residential old-age care

Finally, some aged people may have to spend their last few years in a residential care home. At this point, residential old-age care costs are highest.

There are three different components for these costs.

The first component is the living component. It is the same as paying rent in an apartment. This covers the room, the meals, and some services in the residence. In Switzerland, this will vary highly from one residence to another. In 2025, it is estimated to cost from 3,000 CHF to 7,000 CHF per month. This component is paid by the resident.

There are some significant differences between cantons. Some cantons, like Zurich or Geneva, are likely to cost even more than 7,000 CHF per month.

The second component is the costs for the medical care. These costs can be very high (depending on your needs). By law, the maximum contribution for the patient is 20%. Most cantons cap this contribution at around 23 CHF per day per customer (as of 2025). All costs above are covered by the canton and municipality. To know the exact limit, you should check for your canton.

The third component is the nonmedical activities. This can vary a lot based on the needs and wants of the resident. This can be participation in various group activities. But this also includes help with administrative tasks or assistance with moving things or escorting them. It is difficult to estimate this component, but generally, sources are citing anywhere from 300 CHF to 1,500 CHF per month.

Overall, residential old-age care costs can be very high.

Summary of costs

Here is a quick summary of the estimated costs as of 2025.

What if you cannot afford old-age care costs?

Some people simply cannot afford the high old-age care costs.

If a resident does not have enough income or wealth, supplementary benefits will kick in. These will cover the difference between what the patient can afford and the actual costs.

It is important to note that a person with high assets is expected to use its assets first. In 2025, the threshold is 30,000 CHF for a single person and 50,000 CHF for a couple. Above that, the person will need to use his or her assets to cover the costs before he or she can get any supplementary benefits.

Supplementary benefits will also consider the net value of the house, even though this does not generate assets. Cantons may require taking out a mortgage advance on the house to cover the old-age care costs. In the worst case, if income is really too low and the net value of the property is high, selling the home can become unavoidable. If the spouse lives in the house, they apply a large exemption to the value of the house to take this into account. Usually, this means that we do not have to sell a house where the other spouse lives.

It is also worth mentioning that cantons may reclaim supplementary benefits from the estate after death. So, if somebody was eligible for supplementary benefits but died with a large estate, the canton may claim back the supplementary benefits.

In the past, there was a law making children liable for their parents. This law was abolished in January 2022. Therefore, in Switzerland, children are not legally obligated to pay old-age care costs for their parents.

However, if parents are trying to give away their wealth as early inheritance before going into a residential care home, the children can be asked to reimburse it. This rule is to avoid people trying to get supplementary benefits while giving away large sums of money.

Some costs are tax deductible

In Switzerland, even retirees pay taxes. Therefore, it is good to know that some of these old-age care costs are tax deductible.

Generally, medical costs can be deducted from taxes if they are prescribed by a doctor. So, if you need medical care at home (Spitex), you can deduct them. Even if you have 24/7 at-home care, you can deduct the part of the services that are considered medical services.

In an old-age residential care home, you will be able to deduct the care costs again. But it is important to know that the living costs are not deductible.

At the federal level, we can only deduct medical expenses exceeding 5% of net taxable income. Cantons have their own thresholds, which may be percentage-based or fixed CHF amounts. And you will need to attach proof and details of the services if you want to deduct them.

If you still get decent income in retirement and have to pay most things out of pocket, these tax deductions can make a significant difference to your taxes.

How to delay old-age care

If you would like to delay old-age care and its costs, the only thing you can do is to try to live a healthier life. Of course, it is easier said than done. But if you live a healthy life for most of your life, you should not have much need for old-age care, or at least delay it.

Unfortunately, there are many factors at play here. Genetics plays an essential role. Some families produce much healthier and longer-living individuals than others. And sometimes, luck also plays a role.

But there are some general rules for a healthy life.

1. Sleep is critical. We live in a society where sleep is often neglected, but this can have serious health consequences in the long term. So, people should try to prioritize enough good sleep.
2. Exercising is essential. Doing some physical activity regularly is a great way to stay in shape for longer.
3. Eating well is important. It is important to eat well-diversified food. Ideally, we should cook for ourselves and especially avoid ready-to-eat foods. A cheat meal will not matter much, but going often to fast food and such is definitely bad for long-term health.

I am far from an expert on health and longevity, but if you follow basic principles, you will have done most of what you can do. Then, you can research each of these rules in detail to see how you can improve.

Conclusion

When planning a retirement, it is important to consider old-age care costs. The increase in costs may start with a chronic disease or with some general degradation like hearing or vision. But it can increase much more significantly when at home care becomes necessary or when we need to move to an old-age residential home.

It is difficult to mitigate these costs. If we start early, we can start by living a healthy life (as much as possible), but we have no guarantee that we will avoid all issues. Living healthy is good, of course, but we should still expect costs to rise.

I think it helps to plan some margin of safety into our retirement plan to account for higher old-age care costs in retirement.

What do you think about these fees? Are you planning for it?