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Health insurance within the EU/EFTA

The Agreement on the free movement of persons (AFMP) within the EU/EFTA area and Switzerland is the basis for coordination in the area of health insurance and the so-called “Koordinationsrecht” (rules on the coordination of social security systems).

With the coordination in the area of health insurance on the basis of Annexes I and II of the AFMP, compulsory health insurance is assigned according to the country in which a person is working. You therefore have to be insured in the country where you are working or receiving your pension.

Specific rules exist for different categories of persons:

Employment within the EU/EFTA

In principle, all Swiss citizens have the right to live and work in an EU or EFTA Member State. The relevant EU or EFTA Member State grants a residence permit for this purpose.

For health insurance, the place of employment is always decisive. If you are working in an EU Member State, you and members of your family who are not in active employment must have health insurance in that country, even if you reside in Switzerland.

Frontier workers

Frontier workers and members of their families who are not in active employment must have health insurance in the country in which the frontier worker pursues gainful employment. In some countries, however, frontier workers and members of their families who are not in active employment may choose the state in which they wish to have insurance. For more information, please see the table on the assignment of health insurance (in German or French).

Please also note our information for frontier workers.

Pensioners

Pensioners benefiting from OASI/DI, accident insurance and occupational benefit pensions must in principle be insured in Switzerland (see insurance right of option below).

Exception: if the pensioner receives a pension from their country of residence, they must be insured in that country. This applies even if the pension received is significantly lower than the Swiss pension.

If the pensioner is domiciled in a country from which they do not receive a pension, but they do receive a Swiss pension as well as a pension from another EU/EFTA state, they must be insured in the country in which they have held insurance for the longest period for retirement pension purposes.

Insurance right of option:

Pensioners living in Germany, France, Italy, Austria or Spain and their non-employed family members can be exempted from the insurance obligation in Switzerland. This is the case when they join the health insurance system of their country of residence. For more information, please see the table on the assignment of health insurance (in German or French).

Important information:

The insured person can make use of their option right within three months of receiving the first pension payment or upon taking up residency in an EU/EFTA Member State. This means that they must choose between the Swiss health insurance system and the health insurance system of their country of residence.

On its website, the European Commission offers an overview of the various social security systems in the EU/EFTA, which can be consulted to help with the decision.

In Switzerland, the Common Institution under the Fed. Health Insurance Act (Gemeinsame Einrichtung KVG) scheme is responsible for verifying the affiliation of Swiss pensioners to a Swiss health insurance scheme.

For health insurance in Switzerland:

Right to choose healthcare treatment Persons insured in Switzerland have the right to choose between healthcare treatment in their country of residence and in Switzerland.

Additional information:

Persons drawing unemployment insurance in Switzerland

Persons drawing unemployment insurance in Switzerland also have health insurance in Switzerland. Depending on their country of residence, they can be exempted from the insurance obligation in Switzerland if they are affiliated to the health insurance system of their country of residence. For more information, please see the table on the assignment of health insurance (in German or French).

For health insurance in Switzerland:

Right to choose healthcare treatment Persons insured in Switzerland have the right to choose between healthcare treatment in their country of residence and in Switzerland.

Additional information:

For further information, please see our factsheet “Health Insurance” in German or French.

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