Health insurance
In general, all persons resident in Switzerland need health insurance. Eligible persons receive premium reduction. Limited groups of people are exempted from compulsory health insurance. The Department of Health decides on requests for exemption.
Table of contents
Compulsory health insurance
According to federal law, every person resident in Switzerland must be insured with a recognised Swiss health insurance company (KVG) [Swiss Federal Law on Compulsory Health Care]. The compulsory health insurance starts from birth or at taking up residence in Switzerland, whereby the enrolment must be made in within three months.
Persons resident abroad who have a short stay or residence permit valid for more than three months, who work in Switzerland (cross-border commuters) or who draw a Swiss pension are also subject to compulsory insurance.
The insurers calculate the premiums for compulsory health insurance. The Federal Office of Public Health (FOPH) approves and publishes the premiums.
Exemption from compulsory health insurance
Exemption from compulsory health insurance is possible for a small number of groups of people and only on application and is granted with restraint. The Department of Health decides on applications for exemption. You will find more detailed information below.
Instructions and documents
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Persons staying in Switzerland for education or training purposes: pupils, students, doctoral students, interns, trainees and au-pairs and their accompanying family members.
Please enclose the following documents with your application:
A. Persons with statutory or compulsary state insurance (only possible for students who are not gainfully employed):
- Confirmation of the educational institution (school or enrolment confirmation)
- Copy of the European Health Insurance Card (EHIC)
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).
B. 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 foreign insurer (not necessary for recognised student insurance companies)
- Copy of the currently valid insurance policy / the currently valid insurance certificate
Please note:
To be exempted from the health insurance obligation under the KVG [Swiss Federal Law on Compulsory Health Care], the existing / private / foreign health insurance you have taken out for treatment in Switzerland must be equivalent to the insurance under the KVG. This will be assessed on a case-by-case basis. The decisive factor is that there are no gaps or restrictions compared with the scope of benefits of an insurance policy under the KVG.
If the insurance conditions refer directly to the KVG, equivalence is given, unless restrictions have been formulated in individual cases. For insurance policies without reference to the KVG, the following points, among others, are checked:
- There must not be a general performance limit (e.g. a maximum of EUR 300,000 per year),
- Illnesses that existed before the insurance was taken out must not be excluded,
- Exclusion of benefits in the event of need for long-term care,
- Exclusions of certain types of diseases (e.g. mental illnesses) are not permitted,
- Exclusions due to personal fault or gross negligence are not permitted,
- Exclusions of illnesses or accidents resulting from the practice of certain sports (e.g. riding accidents) are not permitted.
This list is not complete. In any case, an individual case assessment will be made.
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.
Please note:
To be exempted from compulsory health insurance, the foreign health insurance policy you have taken out must at least cover the benefits according to KVG [Swiss Federal Law on Compulsory Health Care] for treatment in Switzerland. The exemption or waiver of the exemption cannot be revoked.
Please enclose the following documents with your application:
A. 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)
B. For postings from Australia, Chile, China, Ireland, Israel, Canada (including Québec), the Philippines, South Korea, Turkey, Uruguay, the United States of America, Macedonia, Bosnia and Herzegovina, Montenegro and Serbia:
- Certificate of coverage of the foreign social security authority
- Confirmation form C, signed and stamped by the employer
C. For postings from India and Japan:
- Certificate of coverage of the foreign social security authority
D. 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.
Persons who are compulsorily insured in the country of origin, with which there is no regulation on the delimitation of compulsory insurance (not for persons living in an EU/EFTA member state).
Please note:
To be exempted from compulsory health insurance, the compulsory health insurance you have taken out for treatment in Switzerland must be equivalent to insurance under the KVG [Swiss Federal Law on Compulsory Health Care].
Please enclose the following documents with your application:
- Confirmation form D, signed and stamped by the foreign insurer
- Copy of the currently valid insurance policy / the currently valid insurance certificate.
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.
Please note:
The exemption or waiver of the exemption cannot be revoked without special reason.
Please enclose the following documents with your application:
- Confirmation form H, correctly completed, signed and stamped by the foreign insurer
- Copy of the currently valid insurance policy / the currently valid insurance certificate
- If younger than 55 years: medical certificate of an existing serious health impairment or previous illness
Persons with an EU/EFTA residence permit «without gainful employment» / «not entitled to gainful employment» / «unemployed residence».
Exemption is not possible for non-employed persons with an EU/EFTA residence permit «without gainful employment» who have foreign statutory health insurance (EHIC).
Please note:
The exemption or waiver of exemption cannot be revoked without special reason.
Please enclose the following documents with your application:
- 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
Persons who are resident in Switzerland and who are exclusively employed or on parental leave in an EU/EFTA member state.
Please enclose the following documents with your application:
A. 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)
B. Private or voluntarily insured persons:
- Confirmation of employment / parental leave certificate
- Copy of the currently valid insurance policy / the currently valid insurance certificate
Persons who are employed both in Switzerland and in an EU/EFTA member state.
Please enclose the following documents with your application:
- 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
Persons who are registered in Switzerland and have moved their place of residence abroad because of their studies abroad.
Please enclose the following documents with your application:
A. 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
B. 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
Persons who are employed exclusively in Switzerland but have their centre of life in Germany, France, Italy or Austria and return there at least once a week.
Please enclose the following documents with your application:
- Copy of the residence permit (front and back)
- Copy of the currently valid insurance policy / the currently valid insurance certificate
- 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 and enclose proof of regular return abroad for a period of at least 6-8 weeks (e.g. copies of train tickets, flight tickets, fuel receipts)
Cross-border commuters from Germany, France, Italy or Austria (only with residence permit G).
Please enclose the following documents with your application:
A. Persons with statutory or compulsory state insurance:
- For France only: Form «Choix du système d'assurances-maladie applicable» completed and signed by the CPAM (form available for download below). Further information can be found on the FOPH's website.
- 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)
B. Private or voluntarily 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
Persons who receive a pension from an EU/EFTA member state.
Please enclose the following documents with your application:
A. Persons with statutory or compulsory state insurance:
- Form E 121/S1 (to be obtained from the competent authority in your home country)
B. Private or voluntarily insured persons:
- Copy of the currently valid insurance policy / the currently valid insurance certificate
- Pension statement
Persons who are not gainfully employed in Switzerland and receive unemployment insurance benefits from an EU/EFTA member state.
Please enclose the following documents with your application:
A. Persons with statutory or compulsory state insurance:
- Form E 303/U2/U3 (to be obtained from the competent authority in your country of origin
B. 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
Persons who have ceased working for an institutional beneficiary – listed by the FOPH.
Please note:
To be exempted from compulsory health insurance, the insurance you have taken out for treatment in Switzerland must be equivalent to insurance under the KVG. The exemption or waiver of the exemption cannot be revoked.
Please enclose the following documents with your application:
- 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
Persons who are included in the health insurance of a person with privileges under international law or of a person who has ceased working for an institutional beneficiary – listed by the FOPH – and who do not themselves enjoy privileges or immunities.
Please note:
To be exempted from compulsory health insurance, the insurance you have taken out for treatment in Switzerland must be equivalent to insurance under the KVG. The exemption or waiver of the exemption cannot be revoked.
Please enclose the following documents with your application:
- 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
Persons in the registration procedure / with a 90-day or 120-day permit.
Please note:
To be exempted from compulsory health insurance, the insurance you have taken out for treatment in Switzerland must be equivalent to insurance under the KVG. The exemption or waiver of the exemption cannot be revoked.
Please enclose the following documents with your application:
A. 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
Comment:
An exemption from compulsory health insurance with a European Health Insurance Card is not possible for persons working in Switzerland because the person is subject to Swiss legislation due to their employment in Switzerland (an exception applies to countries with a right to opt: Germany, France, Italy or Austria).
B. 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
Application forms for applications by post
Premium reduction
Entitlement to premium reduction
Health insurance companies charge premiums regardless of income and assets. Insured persons in modest economic circumstances are supported with a contribution to the premiums for compulsory health insurance. This is called the individual premium reduction (»individuelle Prämienverbilligung”, IPV). For persons with a low to middle income, the cantons must reduce the premiums for children by at least 80 % and the premiums for young adults in education by at least 50 %. The premium reduction is financed by the Confederation and the canton.
The IPV in the canton of Zurich is implemented by the SVA Zurich (Social Insurance Office). IPV is granted on application only and is paid directly to your health insurance. The SVA identifies those eligible to premium reduction based on the tax data. Every year, in early summer, application forms are sent out for the following year. Information regarding implementation of the IPV, namely entitlement, amount, calculation, or payment is the exclusive responsibility of the SVA.
New system as of premium reduction year 2021
On 1 April 2020, the Government Council enacted the new Introductory Act to the Health Insurance Act (EG KVG). This means that starting from premium reductions for the year 2021, the former tiered model will be replaced by a system proportional to income:
In addition to a basic contribution (around 40 % of the premium), insured persons will pay a percentage of their income for health insurance premiums, to be determined by the Government Council (so-called »Eigenanteil”, i. e. personal contribution). The difference between the personal contribution and the individually owed health insurance premium constitutes the premium reduction and is paid for by the canton.
The IPV amount will also in future depend on the income: The lower the income, the higher the IPV amount. From now on, the IPV amount will however be determined provisionally based on the last available tax assessment. This tax data usually relates to a tax period dating several years back.
In a second step, the final IPV amount is calculated based on the final tax assessment for the respective year of entitlement. Any difference between the provisional and final IPV amount is settled via health insurers. To keep such differences between the provisional and the final IPV amount as small as possible, at the beginning, only 80 % percent of the provisionally determined IPV will be paid out.
The new system is very differentiated and takes into account the increasing demands of the population for a case-by-case fairness of their IPV. For as long as the number of entitled persons remains stable, the new regulations shall improve the equity in terms of needs and therefore lead to some redistribution of the available funds: To determine young adults’ IPV amount, the income and assets of the parents liable for maintenance are from now on also considered. With their overall financial situation taken into account, some young adults in education might no longer receive IPV. In the case of cohabiting couples, the amount of the premium reduction for minor children in the joint household is determined based on the income of the parent with the higher income.
Social welfare recipients
From the application year 2021 on, all social welfare recipients must apply for IPV themselves or through the responsible municipality. Under the new law, social welfare recipients are furthermore required to take out affordable health insurance, insofar as this is possible and acceptable. If they refuse to switch to an insurance company offering lower premiums or to an insurance model with a lower premium, even though this would be acceptable and possible, the social welfare benefits will be reduced in accordance with the social welfare legislation.
An overview of the low-cost insurance models per insurance (so-called enforcement assistance, »Vollzugshilfe”) can be found in the Social Assistance Authorities Handbook (»Sozialhilfe-Behördenhandbuch”).
Persons who would be entitled to social welfare benefits can continue to apply for payment of the remaining premium without having to apply for social welfare at the same time.
Further information
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- Download General Information in English PDF | 6 Pages | Englisch | 250 KB
- Download Information Générale en Français PDF | 6 Pages | Französisch | 255 KB
- Download Information for Family Members Abroad PDF | 1 Pages | Englisch | 28 KB
- Download Information pour Membres de Famille en Étranger PDF | 1 Pages | Französisch | 36 KB
- Download Informazioni per Componenti non Attivi della Famiglia con Residenza all Estero PDF | 1 Pages | Italienisch | 36 KB
- Download Info Sheet on Exemption with Student Insurance PDF | 1 Pages | Englisch | 35 KB
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