Recipients of a Swiss pension resident in an EU/EFTA country must take out Swiss health insurance. If they live outside the EU/EFTA, they must take out health insurance, not in Switzerland, but in their country of residence.
Pensioners resident in an EU/EFTA country
In 2002 the Agreement on the Free Movement of Persons between Switzerland and the EU (AFMP) and the EFTA Convention led to the harmonisation of social security systems. For this reason, recipients of a Swiss pension resident in an EU/EFTA country, as well as non-working family members, are subject to compulsory health insurance in Switzerland.
Persons drawing a pension from their country of residence must take out health insurance in that country.
Persons drawing pensions from several countries (but not from their country of residence) must take out health insurance in the country in which they paid contributions for the longest period.
Option of obtaining insurance in country of residence
Switzerland has, however, concluded agreements with its neighbouring countries (Germany, Austria, France and Italy) and some others (e.g. Spain) so that recipients of a Swiss pension living in these countries have the option of taking out health insurance in their country of residence. In the case of Portugal, this option is restricted to pensioners themselves; non-working family members must take out health insurance in Portugal. For further information, see the table below (in German).
Persons who do not wish to take out Swiss health insurance must submit an application for exemption to the Common Institution under the KVG in Olten within three months of receiving their first pension payment or moving to an EU country (no such deadline applies for Spain).
To exercise this option, these persons must provide evidence that they are covered for treatment in their country of residence, as well as during stays in other EU/EFTA countries and in Switzerland (e.g. European Health Insurance Card).
If a pensioner does not submit an application for exemption, the Common Institution under the KVG is required to assign him or her to a health insurer in Switzerland.
In March 2015, the Federal Supreme Court issued a ruling on the exercise of this option in the area of health insurance. According to the ruling, the so-called tacit exercise of this option does not have legal force. Pensioners who have previously been insured abroad rather than in Switzerland and who have not submitted a formal application for exemption from compulsory insurance may take out insurance in Switzerland under the KVG. They must obtain confirmation from the Common Institution under the KVG that they have not yet exercised this option with legal force. On presenting this confirmation, they will be enrolled by the Swiss health insurer (see information letter dated 20 April 2015 below).
Procedure for exercising the option for France
Pensioners who are insured in France and have this option available must, within 3 months, complete the “Choice of health insurance system” form (see below) and return it, signed by the French Caisse primaire d'assurance-maladie (CPAM), to the Common Institution under the KVG. Persons who are insured in Switzerland but who move to France and wish to obtain health insurance there must, without delay, send a copy of this form, signed by the CPAM, to the Swiss health insurer, so that their insurance in Switzerland can be terminated.
The procedure for exercising this option for France is governed by the agreement of 7 July 2016 between Switzerland and France (see the agreement below, together with the information letter of 11 July 2016 and the FAQ).
Common Institution under the KVG
In Switzerland, the Common Institution under the KVG in Olten is the health insurance liaison body for recipients of a Swiss pension resident in an EU/EFTA country and insured in Switzerland.
Useful information can be found on the Institution’s website (see link below). If you have any queries, please contact the Institution directly.
Compulsory health-insurance requirement applicable to persons residing in an EU/EFTA member state (in German) (PDF, 210 kB, 13.08.2018)
Choice of health-insurance system - Form for exercising option right for France (in French) (PDF, 141 kB, 10.07.2019)
Information letter dated 20 April 2015 : health-insurance option rights – Federal Supreme Court decision ruling of 10.03.2015 (9C_801/2014) (in French) (PDF, 43 kB, 08.03.2022)
Information letter dated 11 July 2016 for cantons and LAMal health insurers : Agreement on health insurance between the Swiss Confederation and the Republic of France (in French) (PDF, 522 kB, 08.03.2022)
Agreement between the Swiss Confederation and the French Republic on Health Insurance of 7 July 2016 (in French) (PDF, 4 MB, 07.07.2016)
FAQ for frontier workers and Swiss pensioners residing in France on the Franco-Swiss agreement of 7 July 2016 concerning the possibility of exemption from Swiss health insurance (in French) (PDF, 163 kB, 01.07.2017)
Last modification 21.04.2021
Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Section Legal Supervision of Health Insurance
Tel. +41 58 462 21 11