Health insurance: Recipients of a Swiss pension living abroad

Recipients of a Swiss pension domiciled in an EU/EFTA state must take out Swiss health insurance. If they are domiciled outside the EU/EFTA they are no longer subject to compulsory Swiss health-insurance requirements and must take out cover in their country of domicile.

Pensioners domiciled in an EU/EFTA country

Following the harmonisation of social-security systems introduced in 2002 by the Agreement on the Free Movement of Persons with the EU (AFMP) and the EFTA Agreement, recipients of a Swiss pension who are domiciled in an EU/EFTA country are required to take out compulsory Swiss health-insurance cover as are all members of their family not in gainful employment.

Persons in receipt of a pension from their country of residence must take out health insurance in that country.
Persons in receipt of pensions from several states (but not from the state in which they reside) must take out health insurance in the country in which they have the longest contribution record.

Option right

Switzerland has however also concluded agreements with the neighbouring countries (Germany, Austria, France and Italy) and some others (e.g. Spain) granting recipients of a Swiss pension who are resident there the option of taking out health insurance in their country of residence. In the case of Portugal, the right of option is restricted to pensioners themselves. Any family members not in gainful employment must take out health insurance in Portugal. For further information, see the table “Requirements governing compulsory Swiss health insurance for EU/EFTA residents” and the document "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 an EU country (no such deadline applies for Spain).

To exercise their right of option, such 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 is required to enrol him or her in a health insurance fund in Switzerland.

In March 2015 the Swiss Federal Supreme Court issued a ruling on the exercising of option rights in health insurance. According to this ruling, the "tacit exercising" of the option right does not have legal force.
Pension recipients who have hitherto been insured abroad rather than in Switzerland without having submitted a formal request for exemption from the insurance obligation in Switzerland may take out insurance cover in accordance with the Health Insurance Act (HIA). They must obtain confirmation from the Common Institution under the KVG that they have not yet exercised their option right with legal force. By presenting this confirmation, they will then be accepted by the Swiss health insurer (see factsheet dated 10 April 2015 below).

Exercise of option right with France

Pensioners who are insured in France and have a right of option must, within 3 months, complete the form below “Choice of health-insurance system” and return it, signed by the French Caisse -primaire d'assurance-maladie (CPAM), to the Common Institution. Persons insured in Switzerland who move to France and decide to take out health insurance there must, without delay, send a copy of this form, signed by the CPAM, to their Swiss health insurer in order to terminate their cover in Switzerland.

The modalities for exercising the option right are set out in the agreement dated 7 July 2016 between Switzerland and France (see wording of the agreement below and the related factsheet dated 11 July 2016 plus FAQ.

Common Institution under the KVG

In Switzerland, the Common Institution under the KVG is the health-insurance liaison organisation for recipients of a Swiss pension domiciled in an EU/EFTA country and insured in Switzerland.

You will find all the information you require on the Institution’s website (see link below). Please direct any questions directly to them.

Further information

Recipients of an EU/EFTA pension

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

EU/EFTA premiums and premium reductions

Persons insured in Switzerland pay the EU/EFTA premiums applicable to their country of domicile. Those of limited means are entitled to a premium reduction.

Cross-border commuters working in Switzerland

In principle, cross-border commuters must take out Swiss health insurance. Some exceptions may apply depending on the employee’s country of domicile and nationality.

Last modification 10.02.2020

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Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Section Legal Supervision of Health Insurance
Schwarzenburgstrasse 157
3003 Berne
Tel. +41 58 462 21 11

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