The short answer: Switzerland’s compulsory basic health insurance does not cover ordinary non-medical household help such as cleaning, cooking, shopping or companionship. It contributes to legally defined nursing care when the conditions are met. Other support may be available through a supplementary policy, current supplementary benefits or an AHV helplessness allowance—but none is automatic.
The confusion is understandable. The same Spitex organisation may provide insured nursing care and separately billed household support. What matters is the specific service, not whether the invoice says “Spitex.”
This guide reflects the official rules available on 25 August 2026. It separates what applies now from the supplementary-benefits reform expected in 2028.
Two-minute coverage check
Start with the type of help—not the provider name
A Spitex organisation can offer both insured nursing care and separately billed household support. Choose the work you need to see which rules usually apply.
Usually not covered by basic insurance
Plan a separate funding route
Ordinary household help and support are generally self-funded. A supplementary policy, supplementary benefits or a helplessness allowance may help in an individual case.
What to check next
- 1Ask the supplementary insurer for written confirmation before booking.
- 2If the person receives or may qualify for supplementary benefits, ask the cantonal EL office what it reimburses now.
- 3For a lasting need for help with everyday activities, check AHV helplessness allowance eligibility.
What about 2028?
The planned change concerns supplementary benefits (EL), not basic health insurance. According to the federal authority, specified home-support benefits are expected from 1 January 2028 for eligible EL recipients; it is not a universal entitlement.
Orientation only. The insurer, EL office and care provider decide the individual case.
Compare non-medical senior home helpersAt a glance: who usually pays?
| Help at home | Basic insurance | What to check instead |
|---|---|---|
| Cleaning, laundry and household organisation | Generally no | Supplementary policy, cantonal EL rules or self-funding |
| Cooking, shopping and errands | Generally no | Supplementary benefits, local support or self-funding |
| Companionship, walks and appointment accompaniment | Generally no | Supplementary benefits, helplessness allowance or self-funding |
| Nursing assessment and coordination | Contribution possible when legal conditions are met | Approved provider and assessed care need |
| Treatment care such as wound care or injections | Contribution possible | Nurse assessment, doctor’s prescription and approved provider |
| Qualified basic care linked to a health need | Contribution possible | Nurse assessment and approved provider |
“Contribution possible” does not mean that the insurer pays the entire bill. The insured person may still owe the franchise, co-payment and a patient contribution set under cantonal rules.
What basic insurance actually covers in 2026
The Federal Office of Public Health (FOPH) lists three categories of qualifying care under compulsory insurance:
- Assessment, advice and coordination.
- Examination and treatment measures.
- Basic care measures.
The person’s care needs must be assessed by a nurse and an approved provider must deliver the service. Examination and treatment measures also require a doctor’s prescription. A prescription is not universally required for assessment, coordination or basic care, but the other conditions still apply.
For home care, the official 2026 contributions are CHF 76.90 per hour for assessment, advice and coordination, CHF 63 for treatment and CHF 52.60 for basic care. These are insurance contributions toward qualifying care—not hourly wages, retail prices or cash paid directly to a family. The patient contribution can be up to CHF 15.35 per day, often lower under cantonal rules, in addition to normal cost sharing. Cantons and/or municipalities regulate and finance the remaining recognised care costs.
Spitex Switzerland explains the same dividing line: compulsory insurance does not finance household work or general support that is not listed in the care ordinance. A doctor’s note does not make cleaning an insured service.
Why “Spitex” does not automatically mean “covered”
Spitex describes help and care delivered at home; it is not one single insurance category. A provider can place two different items on the same plan:
- A nurse assesses a wound and changes the dressing: potentially qualifying nursing care.
- A home-support worker cleans the kitchen and shops for groceries: ordinarily non-covered household help.
Ask for the care and household-support items to be separated in the quote and invoice. Before care starts, confirm that the provider is approved to bill compulsory insurance and ask who obtains the assessment and any necessary prescription.
Four possible funding routes
1. Compulsory basic insurance for qualifying nursing care
Use this route for assessed nursing needs, not ordinary household tasks. Start with a professional care-needs assessment. The provider and insurer can then clarify which services qualify and what share remains with the patient.
2. Voluntary supplementary insurance
A supplementary policy may contribute to household help, but there is no general Swiss entitlement. Coverage depends on the individual contract, benefit limits, waiting periods, approved providers and documentation. The FOPH confirms that supplementary insurance is voluntary and contract-based.
Ask the insurer in writing:
- Is household help covered for this situation?
- Is a medical certificate required and is it sufficient?
- Must the provider be on an approved list?
- What amount, duration and waiting period apply?
Do not book on the strength of a telephone “probably.” Request a written decision.
3. Supplementary benefits and AHV helplessness allowance
People eligible for supplementary benefits (EL) can already ask for reimbursement of certain uncovered illness and disability costs, including help, care and support at home. The canton defines the detailed reimbursable costs and evaluates each case. The official AHV/IV information on illness and disability costs is the starting point; the application goes to the competent cantonal office.
AHV helplessness allowance is different. It is a cash benefit for a sustained, assessed need for third-party help with everyday activities—not reimbursement of one helper invoice, and not a general cleaning subsidy. For people receiving an AHV pension, the official 2026 monthly amounts are CHF 252, CHF 630 or CHF 1,008 according to the assessed degree. The need generally must have continued for at least six months. Income and assets do not determine entitlement. The claimant must live in Switzerland; the slight degree is paid only to people living at home, and a competing entitlement under compulsory accident or military insurance excludes the AHV allowance. Check the AHV/IV Information Centre’s current rules.
4. Privately funded non-medical home help
Where no benefit applies, families can arrange practical support directly: cleaning, meals, laundry, errands and companionship. Define the tasks clearly so nobody mistakes non-medical support for nursing care. You can compare real senior home-help profiles and availability on Helpore or first read what non-medical senior home help includes.
What is expected to change in 2028
Parliament adopted new provisions in June 2025 to strengthen help and support at home through supplementary benefits. The Federal Social Insurance Office (FSIO) lists emergency-call systems, household help, meals at home, accompaniment and transport among the intended categories. It says the change is expected to enter into force on 1 January 2028.
Three limits matter:
- This is an EL reform, not an expansion of compulsory health insurance.
- It applies to eligible supplementary-benefit recipients, not every senior.
- The implementing ordinance was consulted on until 9 March 2026. That consultation has closed, but check the final ordinance and confirmed commencement before relying on any operational detail.
Current cantonal EL reimbursement does not disappear from the conversation: some eligible people can receive help with qualifying costs today. Ask the cantonal EL office about the rules that apply now, then revisit the decision when the reform enters into force.
A five-step decision checklist
- Write down the actual tasks. Separate nursing care from cleaning, meals, shopping and companionship.
- Arrange a nursing assessment if health-related care is needed. Do not try to turn ordinary household work into nursing care.
- Get written insurance confirmation. Ask both basic and supplementary insurers which exact service, provider and period they accept.
- Check public benefits. Contact the cantonal EL office and, for sustained daily assistance needs, check AHV helplessness allowance eligibility.
- Arrange the remaining help legally. Paid home help and elder support are domestic employment when the household directly employs the worker. The 2026 AHV domestic-work leaflet explains registration and contributions. Our legal household-employment checklist covers the practical steps.
For a realistic self-funded budget, use our separate guide to senior home-help costs in Switzerland. Keeping costs and insurance in separate guides prevents two very different questions from being mixed together.
Where Helpore fits—and where it does not
Helpore is a marketplace for non-medical household help and companionship. It is not a health insurer, medical provider or benefits authority. Profiles show services, experience, languages, rates and availability so a family can choose the right practical support. Insurance and public-benefit decisions remain with the responsible institutions.
When a household directly employs a helper, the arrangement creates the employer duties that apply under Swiss social-insurance rules. The required declaration, insurance and documentation steps depend on factors such as the helper’s age, pay and working pattern. Helpore makes those costs and duties visible instead of presenting household help as if a doctor’s certificate made it free.
Frequently asked questions
Does basic insurance pay if a doctor prescribes household help?
Not by itself. A prescription does not turn cleaning or shopping into nursing care. Qualifying care must fall within the statutory categories, be professionally assessed and be delivered by an approved provider.
Can supplementary insurance reimburse a Helpore helper?
Only the insurer can confirm that. Ask whether the specific policy accepts non-medical home help, which providers qualify, which documents are needed and what limits apply. Get the answer in writing before booking.
Can Spitex and a private home helper work together?
Yes. Spitex can handle assessed nursing care while a non-medical helper handles the household and companionship. Keep responsibilities, schedules and invoices separate.
Is AHV helplessness allowance means-tested?
No. It is based on the assessed degree and duration of helplessness, not income or assets. It is also not automatic and does not reimburse a particular cleaning invoice.
Will basic insurance cover household help from 2028?
No announced reform says that. The expected 2028 change concerns supplementary benefits for eligible recipients, not compulsory health insurance for everyone.
Who should I contact first?
For nursing needs, contact a doctor or approved care provider for an assessment. For policy coverage, contact the insurer. For EL or helplessness allowance, contact the competent cantonal AHV/EL office. For self-funded non-medical support, compare senior home helpers on Helpore.
Editorial review: Helpore AG checked this guide against FOPH, FSIO, AHV/IV and Spitex Switzerland sources on 25 August 2026. It provides general orientation, not an individual insurance or benefits decision.