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Costs

Spitex or private care: what does it cost, and who pays?

Nursing care such as washing and dressing is paid by health insurance when the Spitex does it. Housework and company you pay yourself: at the Spitex, Pro Senectute, a respite service or a private Spitex, CHF 26 to 56 per hour depending on where you live. Your own employee costs about the same with all contributions, and you choose the person yourself. Supplementary benefits and the helplessness allowance can cover part of it.

23 September 20266 min read
1 hour of household help costs you
  • Spitex Chur (canton and communes cover the rest of CHF 91.50)CHF 26.00
  • Pro Senectute RheintalCHF 31.00
  • Spitex Zürich, by incomeCHF 31 - 44
  • Your own employee (Zurich, CHF 29 gross, all in)CHF 33.91
  • Pro Senectute AargauCHF 35.00 + travel
  • Respite service ZurichCHF 46.00 + travel
  • SPITEX Region KönizCHF 55.50 + travel
  • Spitex 24 AG, privateCHF 56.00 + travel

Personal care: health insurance pays the Spitex CHF 52.60 per hour. You pay at most CHF 15.35 per day.

Cost comparison

What does help at home cost per month?

Same hours, four ways, answer in francs.

Visits per week
AHV helplessness allowance

Your cost per month

  • Spitex or Pro Senectute

    CHF 806 - 1'144

    CHF 31.00 - 44.00 per hour · Spitex Zürich: depending on taxable income

  • Respite service

    CHF 1'326

    CHF 46.00 per hour + CHF 10.00 per visit · Example Entlastungsdienst Kanton Zürich

  • Private Spitex

    CHF 1'742

    CHF 56.00 per hour + CHF 22.00 per visit · Example Spitex 24 AG

  • Your own employee

    CHF 882

    CHF 33.91 per hour · Wage with holiday supplement, AHV/IV/EO, ALV, FAK and accident insurance. You are the employer.

Basic health insurance never pays for housework or company. Supplementary insurance pays a contribution depending on the policy.

What can be taken off your hands

  • With supplementary benefits (EL): your canton refunds help, nursing and care at home up to at least CHF 25'000 a year. The canton sets the hourly rates.

Next question: what exactly does your own carer cost, with payslip and all contributions?

Calculate the carer's wage →

Checklist for hiring correctly, by email

AHV, accident insurance, contract, payslip. One page, no spam.

Example tariffs of the named organisations, retrieved 23.09.2026. Tariffs differ by commune and often by income. Ask the Spitex in your commune which tariff applies to you.

Who pays what? Nursing, housework and company are three different things

Health insurance only pays for nursing care, and only when a recognised nurse or organisation such as the Spitex provides it. Basic insurance pays nothing for housework and company, whoever does it. That is where the helplessness allowance helps, paid regardless of income, and, if money is tight, the supplementary benefits (EL).

Nursing care

Washing, dressing, medication, wounds

  • pays: Health insuranceCHF 52.60 to 76.90 per hour, only to Spitex and nurses
  • pays: Supplementary benefitsPatient share, deductible, co-payment
  • pays: Helplessness allowanceCHF 252 to 1'008 per month, regardless of income and assets
  • pays in part: YouUp to CHF 15.35 per day, plus deductible and 10 %

Housework

Cleaning, cooking, laundry, shopping

  • does not pay: Health insuranceNever
  • pays in part: Supplementary benefitsYes, with a doctor's certificate. Hourly rate set by the canton, e.g. Aargau CHF 25
  • pays: Helplessness allowanceCHF 252 to 1'008 per month, regardless of income and assets
  • pays: YouThe rest

Company

Company, accompaniment, being there

  • does not pay: Health insuranceNever
  • pays in part: Supplementary benefitsYes. Your own employee, e.g. in Aargau, only with moderate or severe helplessness
  • pays: Helplessness allowanceCHF 252 to 1'008 per month, regardless of income and assets
  • pays: YouThe rest
payspays in partdoes not paySupplementary benefits only if you qualify, together at least CHF 25'000 a year. Supplementary insurance pays towards housework and care depending on the policy.

How to apply for the helplessness allowance and how much it is in your case is explained in Helplessness allowance: who gets it and how much. If relatives do the caring themselves, read Caring for a relative: pay and relief.

Hiring someone yourself: you become the employer

If you hire the help yourself, you pay no agency margin and no travel fee, and the same person always comes. In return, you carry an employer's duties. In Basel-Stadt, for example, supplementary benefits only refund a private household help if you are registered as an employer.

  1. 1.AHV from the first francRegister with your canton's compensation office, even for a few hours.
  2. 2.Accident insuranceOccupational accidents for every employee, non-occupational from 8 hours a week.
  3. 3.Employment contractWith the NAV minimum wage, holidays, notice period.
  4. 4.PayslipEvery month, and the wage certificate at year end.

What belongs in the contract is shown in the template Employment contract for a carer. Live-in and 24-hour care have special rules on standby time and board and lodging: Hiring a carer, the full guide. You can register her here: Register your carer with the AHV.

Register your own carer correctly

Clino prepares the AHV registration and guides you through it, creates the payslip every month and the wage certificate at year end. You then have the documents that supplementary benefits and the tax office want to see.

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Frequently asked questions

Does health insurance pay for household help?
Basic insurance does not. It pays nursing care under Art. 7 KLV (assessment, treatment care, basic care), and only to recognised nurses and organisations such as the Spitex. Cleaning, cooking, laundry and company are not nursing care. Supplementary insurance pays a contribution to household help depending on the policy; ask your insurer whether that also applies to someone you employ yourself.
What does the Spitex cost?
For nursing care, health insurance pays CHF 52.60 to 76.90 per hour. You pay a patient share of at most 20 % of the highest contribution, for example up to CHF 15.35 per day in Aargau and Bern, CHF 7.65 in the canton of Zurich, plus deductible and co-payment. Housework you pay in full: for example CHF 31 to 44 per hour depending on income at Spitex Zürich, CHF 55.50 at SPITEX Region Köniz, at most CHF 26 at Spitex Chur.
What does a respite service cost?
Entlastungsdienst Schweiz provides care at home by the hour so relatives get time off. In the canton of Zurich, since 2026: CHF 46 on weekdays and CHF 51 at weekends per hour, plus a CHF 10 travel fee per visit; in the canton of Bern CHF 44 per hour. People on low incomes can apply for a reduction. Volunteers are cheaper: the Red Cross of the canton of Bern charges CHF 20 for a visit of up to 2 hours and CHF 70 for a full day, each plus CHF 10 travel.
Do supplementary benefits pay for private household help?
Often yes, under cantonal rules. The cantons refund help, nursing and care at home up to at least CHF 25'000 a year for single people (Art. 14 ELG). Aargau pays at most CHF 25 per hour and CHF 4'800 a year for a private person who does not live in the same household, with a doctor's certificate. Basel-Stadt pays at most 16 hours a month at CHF 30 and requires you to be registered as an employer. Submit the bills within 15 months.
Can I pay a carer with the helplessness allowance?
The AHV helplessness allowance at home is CHF 252, 630 or 1'008 per month, depending on the degree. It does not depend on income or assets and requires the helplessness to have lasted at least six months. It is paid to the person concerned and so helps to finance help at home, including your own employee.
What do I need to know if I hire someone myself?
You are the employer: AHV from the first franc, accident insurance, a written employment contract paying at least the NAV wage, and a payslip every month. For live-in and 24-hour care the contract also sets standby time, rest time and board and lodging. Nursing care in the health-insurance sense stays with the Spitex; a private employee cannot bill it to the insurer.

Sources

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Salvador Jovells

Salvador Jovells, founder of Clino