Logo of the Canton of Zurich

Application for exemption from compulsory health insurance

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  1. Before you fill in the form

    Advantages:

    • Schedule 20 minutes to complete the form
    • The data cannot be stored temporarily for further processing at a later date
    • Please fill out the form as completely as possible 
    • Keep all necessary documents ready

  2. Application form

    Applicant

    This is a required field.

    This is a required field.

    This is a required field.

    Address in Switzerland ; for cross-border commuters the address abroad

    This is a required field.

    This is a required field.

    This is a required field.

    TT.MM.JJJJ

    This is a required field.

    Please enter a correct date.

    This is a required field.

    The input does not correspond to the specifications for a telephone number.

    This is a required field.

    Please enter a valid email address.

    This is a required field.

    If no e-mail address is given, correspondence will be sent by post.

    Sex

    This is a required field.

    This is a required field.

    Children

    This is a required field.

    If available: Name of the employer (company)

    756.____.____.__ Input conforms to the specifications. Input does not conform to the specifications.

    Please enter the AHV number in the format 756.XXXX.XXXX.XX.

    Type of insurance

    This is a required field.

    statutory = foreign state health insurance within the EU/EFTA (European Health Insurance Card) ; private = foreign private and/or international health insurance ; other = e.g. student insurance according to VVG or Swiss Health Insurance

    Residence permit

    This is a required field.

    This is a required field.

    Spouse or civil partner

    This is a required field.

    This is a required field.

    This is a required field.

    Address in Switzerland ; for cross-border commuters the address abroad

    This is a required field.

    This is a required field.

    This is a required field.

    TT.MM.JJJJ

    This is a required field.

    Please enter a correct date.

    This is a required field.

    employed

    This is a required field.

    This is a required field.

    Also apply for spouse or civil partner

    This is a required field.

    Children

    This is a required field.

    This is a required field.

    This is a required field.

    This is a required field.

    This is a required field.

    TT.MM.JJJJ

    This is a required field.

    Please enter a correct date.

    employed

    This is a required field.

    Also apply for the child

    This is a required field.

    Information on education, trainings and employment

    This is a required field.

    Gainful employment is defined as any work for remuneration, even if it is low.

    Type of education

    This is a required field.

    Specified education

    This is a required field.

    This is a required field.