Health insurance: Recipients of a Swiss pension living abroad

Recipients of a Swiss pension resident in an EU-/EFTA country or in the United Kingdom (UK) must take out Swiss health insurance. If they live outside the EU/EFTA/UK, they must take out health insurance, not in Switzerland, but in their country of residence.

Pensioners resident in EU/EFTA/UK

Under the Swiss-EU Agreement on the free movement of persons, the EFTA Convention and the new social security Agreement with the United Kingdom (UK) recipients of a Swiss pension resident in EU/EFTA/UK, 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 with EU-citizenship 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):
Compulsory health insurance requirements applicable to persons resident in an EU-/EFTA-country or in the United Kingdom and the document (in German): “Health insurance for recipients of Swiss pensions in Spain”.

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 the respective 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 EU/EFTA/UK 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/UK 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.

Further information

Recipients of an EU/EFTA/UK pension

Pensioners resident in Switzerland who draw a pension exclusively from an EU/EFTA country or UK are not insured 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.

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.

Cross-border commuters working in Switzerland

In general, cross-border commuters are required to take out Swiss health insurance. Some exceptions apply, depending on the employee’s country of residence and nationality.

Last modification 19.04.2024

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

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