Switzerland Spitex vs Pflegeheim 2027 Cost Comparison
Compare costs of Spitex (home care) vs Pflegeheim (nursing home) in Switzerland 2026-27 — patient share, KVG basic insurance coverage, cantonal funding, EL Ergänzungsleistungen for low-income elderly, and potential family financial contribution liability.
Three Funding Sources for Pflegeheim
Swiss nursing home (Pflegeheim) costs are split across three payers: (1) KVG basic health insurance covers a capped portion of "Pflegekosten" — currently up to CHF 108/day at maximum care level. (2) The canton or community covers approximately 40% of total care cost (cantons vary). (3) The patient covers Hotellerie (room + board) plus a CHF 23/day maximum personal Pflegekostenbeitrag. Total patient share commonly CHF 5,500-9,000/month.
Spitex: Home Care Math
Spitex (home care) is paid hourly at ~CHF 95/hour. KVG covers most "Pflege" hours up to a hourly cap (CHF 65/hour for nurses, less for housekeeping). The patient covers the difference plus a small co-pay. For Level 3 care (~10 hrs/week Spitex), patient cost is typically CHF 600-900/month plus existing housing costs. For Level 6+ care needing 20+ hrs/week, Spitex begins to exceed Pflegeheim economically.
EL Ergänzungsleistungen Safety Net
Federal Ergänzungsleistungen (EL) cover the gap between income/assets and minimum living standard for low-income pensioners. 2026 single-person EL threshold: assets ≤ CHF 28,725, income gap calculated against standardized expenses. EL covers Pflegeheim patient share fully for those eligible. Applied through cantonal SVA (Sozialversicherungsanstalt). Without EL, patient assets are depleted to threshold then EL kicks in — typical scenario for long-term Pflegeheim stays.
Verwandtenunterstützung — Family Liability
Swiss law (ZGB Art. 328) requires adult children to contribute to indigent parents' care IF the children have "günstigen Verhältnissen" — typically taxable income over CHF 120k single / CHF 180k couple. Contribution is calculated case-by-case based on net income beyond a generous personal allowance. Many cantons (particularly Zurich, Bern) actively pursue children for repayment of EL/social-assistance funds advanced to parents. Wealthy adult children often pre-empt by structuring transfers.
Sources: bag.admin.ch Pflege 2026, ahv-iv.ch EL 2026, bsv.admin.ch Spitex. Last updated: May 2026.