Health insurance: Co-payment for persons insured in Switzerland

Persons insured in Switzerland and resident abroad can be treated either in Switzerland or in their country of residence. The co-payment regulations vary depending on the country where treatment is received. 

Treatment in Switzerland

Co-payment is subject to the provisions of Swiss law. Further information can be found under “Cost participation for persons insured in Switzerland”.

Treatment in the country of residence

Using the S1 form (previously E106, E109, E121) provided by the insurer, policyholders and/or family members can register to obtain benefits in kind from the healthcare institution of their country of residence, which will be reimbursed by the Swiss health insurer. Co-payment is subject to the legal provisions of the country of residence.

Treatment in another EU/EFTA country or UK

With the European Health Insurance Card (EHIC) issued by the health insurer, policyholders, in the event of illness, accident or maternity during their stay, are entitled to receive all benefits in kind considered medically necessary given the type of treatment and expected length of their stay. Co-payment is subject to the regulations of the country where treatment is received and is generally payable directly. Co-payment in Switzerland is then not applicable. Nor is co-payment in an EU/EFTA country or the United Kingdom (UK) taken into account for the Swiss deductible or retention fee. For more information, see “Stay in EU/EFTA or in UK” (available in French/German/Italian) on the website of the Common Institution under the KVG (Swiss liaison body).

Treatment in a non-EU/EFTA country or UK

During a temporary stay in a country outside the EU/EFTA or the United Kingdom (UK), the costs of emergency treatment for illness or accident (in cases where a return to Switzerland is not possible for medical reasons) will be reimbursed up to a maximum of twice the amount that the insurer would have paid if the treatment had been provided in Switzerland. In the case of inpatient treatment, however, this means that the insurer will reimburse no more than 90% of the costs that would have arisen for hospitalisation in Switzerland. Medical costs in certain countries outside the EU/EFTA or UK (e.g. the US, Canada and Japan) are very high. The benefits of the basic insurance are not sufficient to cover these costs. Co-payment is based on the Swiss regulations. Further information on this topic can be found under “Cost participation for persons insured in Switzerland”.
Other medical treatments abroad are not generally covered by compulsory health insurance.

Further information

Health insurance: Co-payment for persons resident in Switzerland

Services are generally subject to co-payment by policyholders.

Treatment abroad for policyholders resident abroad

Persons insured in Switzerland and resident abroad are entitled to be treated in the country where they are staying or residing, or in Switzerland.

EU/EFTA/UK premiums and premium subsidies

Persons insured in Switzerland pay the EU/EFTA/UK premiums applicable for their country of residence. Those on low incomes are entitled to premium subsidies.

Last modification 19.04.2024

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Contact

Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Legal Supervision of Health Insurance Section
Schwarzenburgstrasse 157
3003 Bern
Switzerland

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