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Compulsory health insurance: Who is entitled?
Compulsory Health Insurance: Who can be exempted?
Compulsory Health Insurance
Depending on their residence status in Switzerland, people can be exempted from compulsory health insurance.
Who is entitled?
Briefly expained
According to the Health Insurance Act (KVG), anyone who lives or works in Switzerland must take out health insurance. People who live abroad but have a residence permit for at least three months are also obliged to take out insurance – as are cross-border commuters. In exceptional cases, exemption from compulsory insurance is possible.
Who can be exempted?
This overview shows the most common cases:
- Persons staying in Switzerland for education or training (students, pupils, trainees, etc.) and their accompanying family members.
- Workers posted to Switzerland and their accompanying family members
- Cross-border commuters
- Short-term residents with a permit for a maximum of three months
- Flat-rate taxpayers with a residence permit without gainful employment
Requirements
The prerequisite for an exemption is proof of foreign insurance cover that covers the costs of treatment in Switzerland at least in accordance with the KVG. The decisive factor is that there are no gaps or restrictions in the scope of benefits.
European Health Insurance Card (EHIC)
Anyone who is gainfully employed in Switzerland and has a foreign statutory health insurance (EHIC) cannot be exempted from compulsory insurance in Switzerland. In exceptional cases, an exemption is possible for persons who have their place of residence in a country with an option. The exception applies to Germany, France, Italy or Austria.
Exemption with the EHIC is only possible for non-employed persons in education and training. Gainful employment is considered to be any work for remuneration, even if it is small (e.g. part-time job, internship, au pair, doctorate).
Who can be exempted from compulsory insurance?
Exemption from compulsory health insurance is only possible for a few groups of people. The table shows who can submit an application and which documents must be enclosed. The prerequisite is that proof is provided that the health insurance taken out covers treatment in Switzerland in accordance with the KVG.
Persons staying in Switzerland for education or training purposes: – pupils – students – doctoral students – interns – trainees – au-pairs – accompanying family members
Persons in education and training with gainful employment may be exempted if they have equivalent private insurance. |
Persons with statutory or compulsary state insurance
– Confirmation of the educational institution (school or enrolment confirmation)
– Copy of the European Health Insurance Card (EHIC) front and back
An exemption with the EHIC is only possible for students who are not gainfully employed. Gainful employment is defined as any work for remuneration, even if it is minimal (e.g. part-time job, internship, au-pairs, doctorate).
Privately or voluntarily insured persons: – Confirmation of the educational institution (confirmation of school, matriculation, doctorate, internship, au-pair contract etc.)
– Confirmation form A, signed and stamped by the insurer (not necessary for recognised student insurance companies)
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
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Persons who are posted to Switzerland as employees, provided they are exempt from the obligation to contribute to the AHV/IV [Old Age and Survivors Insurance (OASI) and Invalidity Insurance (IV)] scheme, and the members of their families accompanying them. |
For postings from an EU/EFTA member state: – Form A1/E101 (obtainable from your employer or from the competent authority in your country of origin) Postings from Australia, Brazil, Canada, Chile, China, Ireland, Israel, Canada (including Quebec), the Philippines, South Korea, Turkey, Uruguay, the United States of America, Macedonia, Bosnia and Herzegovina, Montenegro and Serbia: (obtainable from your employer or from the competent authority in your country of origin): – Certificate of coverage of the foreign social security authority
– Confirmation form C, signed and stamped by the employer
For postings from India and Japan: – Certificate of coverage of the foreign social security authority
In the case of postings from other countries, it is not possible to be exempted from compulsory insurance on the basis of the posting status. |
Confirmation form C |
| Cross-border commuters from GER, FRA, IT, AUT – without permit G |
– Copy of the residence permit (front and back)
– Copy of the currently valid insurance policy / the currently valid insurance certificate front and back
– Current confirmation of your place of residence abroad (if you have spouses and/or children, also for them)
– Describe how you live abroad and in Switzerland (own apartment/house, rented apartment, rented room) and attach supporting documents
– Explain the periods of time (within one month, within one week) during which you are abroad and in Switzerland proof of regular return abroad for a period of at least 6-8 weeks (e.g. copies of train tickets, flight tickets, fuel receipts) |
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| Cross-border commuters from GER, FRA, IT, AUT – with permit G |
Persons with statutory or compulsory state insurance: – Copy of cross-border commuter permit (front and back)
– Copy of the European Health Insurance Card
– Copy of the European Health Insurance Card of the non-employed family members (resident in GER, FRA, IT or AUT)
Private insured persons: – Copy of the currently valid insurance policy / the currently valid insurance certificate of the non-employed family members (resident in GER, IT or AUT)
– Copy of cross-border commuter permit (front and back)
– Copy of the currently valid insurance policy / the currently valid insurance certificate / Certificate of Entitlement |
For France only: Form: «Choix du système d'assurances-maladie applicable», completed and signed by the CPAM |
Persons with compulsory health insurance in the country of origin (not for persons living in an EU/EFTA member state) |
– Confirmation form D, signed and stamped by the foreign insurer
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
Confirmation form D |
Persons who are elderly and/or have impaired health Persons who are privately insured abroad and who, due to their age (over 55 years) and/or state of health, cannot take out supplementary insurance in Switzerland, or can only do so on barely acceptable terms and conditions, to the extent that they were previously insured. |
– Confirmation form H, correctly completed, signed and stamped by the foreign insurer
– Copy of the currently valid insurance policy / the currently valid insurance certificate – Medical certificate of an existing serious health impairment or previous illness |
Confirmation form H |
| Persons with EU/EFTA authorisation without gainful employment |
– Copy of the residence permit (front and back)
– Confirmation form N, signed and stamped by the foreign insurer
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
Confirmation form N |
| Persons who are resident in Switzerland and who are exclusively employed or on parental leave in an EU/EFTA member state. |
Persons with statutory or compulsory state insurance: – Form E 106/S1 (to be obtained from your statutory insurer or the competent authority in the country of employment)
– Parental leave certificate
Private or voluntarily insured persons: – Confirmation of employment / parental leave certificate
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
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| Persons who are employed both in Switzerland and in an EU/EFTA member state. |
– Form A1/E101 (obtainable from your insurer or the competent authority of the foreign country) if you are employed in Switzerland and in one or more EU/EFTA member states
– Confirmations of employment (from all employers abroad and in Switzerland) and/or proof of income in the case of self-employment
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
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Study and residence abroad Persons who are registered in Switzerland and have moved their place of residence abroad because of their studies abroad. |
If studying in an EU/EFTA member state (for students up to the age of 25): – Explain how you live abroad (own apartment/house, rented apartment, rented room) and enclose supporting documents (e.g. copy of the rental contract etc.)
– Study confirmation
– Copy of the currently valid insurance policy / the currently valid insurance certificate
– Information on any employment abroad by means of a copy of the employment contract
– Details of place of employment, place of residence and existence of Swiss basic insurance of parents (not required if you live and study in one of the following countries: Denmark, Spain, Hungary, Portugal, Sweden, United Kingdom)
– Confirmation of your place of residence abroad
If studying in an EU/EFTA member state (for students aged 26 and over) or studying in a non-EU/EFTA member state: – Describe how you live abroad (own apartment/house, rented apartment, rented room) and attach supporting documents (e.g. copy of the rental contract etc.)
– Study confirmation
– Copy of the currently valid insurance policy / the currently valid insurance certificate
– Information on any employment abroad by means of a copy of the employment contract
– Confirmation of your place of residence abroad |
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| Persons with a pension from EU/EFTA |
Persons with statutory or compulsory state insurance: – Form E 121/S1 (to be obtained from the competent authority in your home country)
Private or voluntarily insured persons: – Copy of the currently valid insurance policy / the currently valid insurance certificate
– Pension statement |
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Persons receiving unemployment benefits from the EU/EFTA Persons who are not gainfully employed in Switzerland and receive unemployment insurance benefits from an EU/EFTA member state. |
Persons with statutory or compulsory state insurance: – Form E 303/U2/U3 (to be obtained from the competent authority in your country of origin)
Private or voluntarily insured persons: – Certificate from the unemployment office confirming receipt of benefits
– Copy of the currently valid insurance policy / the currently valid insurance certificate |
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Persons with privileges after leaving their posts Persons who have ceased working for an institutional beneficiary – listed by the FOPH. |
– Copy of the currently valid insurance policy / the currently valid insurance certificate
– Confirmation from your former institutional beneficiary that you have ceased your activities
– Confirmation form W, signed and stamped by the competent authority of your former institutional beneficiary / foreign/private health insurer |
Confirmation form W |
| Persons co-insured with a person with privileges |
– Copy of the currently valid insurance policy / the currently valid insurance certificate
– Confirmation of inclusion in the health insurance scheme of the institutional beneficiary
– Confirmation form V, signed and stamped by the competent authority of the institutional beneficiary / foreign / private health insurer |
Confirmation form V |
| Persons in the registration procedure / with 90- or 120-day permit | Persons resident in Germany, France, Italy or Austria (neighbouring countries) – Copy of the confirmation of the registration procedure
– Copy of the currently valid insurance policy / insurance certificate of the private health insurance or a copy of the European Health Insurance Card
Persons resident in other EU/EFTA countries (not neighbouring countries; not possible with a 120-day permit) – Copy of the confirmation of the notification procedure
– Copy of the currently valid insurance policy / the currently valid insurance certificate of the private health insurance
– Confirmation form M, signed and stamped by the foreign / private insurer |
Confirmation form M |