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Foundations of compulsory health insurance

Persons who work or live in Switzerland are subect to compulsory health insurance in accordance with KVG (Federal Act on Health Insurance). An exemption from the compulsory health insurance is possible in specific situations.

Insurance obligation in case of residence in Switzerland (residence principle)

Every person with residence in Switzerland or their legal guardian is reqiuired within three month from taking up residence or of birth in Switzerland to take out basic compulsory health insurance (art. 3 KVG). If the insurance is joined on time (within three months) the cover will begin at the time of birth or from taking up residence in Switzerland (art. 5 para. 1 KVG). If the insurance is joined with delay the cover will start at the time of participation and in case of an unexcusable delay will lead to surcharge being added to the premium. Information concerning the insurance premiums can be found under www.priminfo.ch.

The residence is located wherever a person intents to remain (art. 23 ZGB). The registration at the municipal administration is not the only criteria to determine one’s residence. The residence remains unchanged until a new one will be established.

 

Insurance obligation in case of employment in Switzerland (place of employment principle)

Since 1st June 2002, with the entry into force of the Agreement on the Free Movement of Persons between the European Union and Switzerland (AFMP) persons with residence in the EU/EFTA and employment in Switzerland (border workers) are also subject to compulsory Swiss health insurance.

The obligation of insurance extends to unemployed family members unless they are subject to compulsory health insurance in their country of residence. Family members include the spouse and children until the completed age of 18 and full-aged children entitled to aliments.

The insurance begins with the taking up of an economic activity in Switzerland.

Insurance obligation in Switzerland in other cases

Persons with residence in the EU/EFTA are subject to compulsory health insurance if they receive a Swiss pension from the federal old-age and survivors's insurance (AHV), disability insurance (IV), military insurance (MV), accident insurance (UV) or occupational benefit plan (BV). Within the scope of BV this is also valid for lumpsum payments if the official retirement age is reached.

Detailed information concerning the insurance obligation and exceptions can be found to the right.

Cantonal regulation

The examination of the insurance obligation is regulated by the cantons. Every canton is responsible for the examination of the insurance obligation of its own inhabitants and border workers.

On the basis of art. 18 para. 2sexies KVG the Gemeinsame Einrichtung KVG is in charge of this task for the cantons of Aargau, Appenzell Ausserrhoden, Basel-Landschaft, Basel-Stadt, Glarus, Uri the muncipalities of Cham, Risch Rotkreuz und the city of Zug.

Additionally the Gemeinsame Einrichtung KVG decides on requests of exemption from compulsory health insurance of pensioners an their family members with residence in the EU, Iceland or Norway (art. 18 para. 2bis KVG). You can find detailed information under pensioners.

Learn more about health insurance in Switzerland in the Federal Office of Public Healths’ brochure: The compulsory health insurance in a nutshell

 

The Gemeinsame Einrichtung KVG, as federal body, is subject to the provisions of the Federal Data Protection Act (DSG).