Health insurance: Workers in the EU or EFTA

Since the Agreement on the free movement of persons (AFMP) came into force, health insurance obligations have been based on the place-of-work principle. 

Remunerated activity in a single EU/EFTA country

Despite being resident in Switzerland, Swiss nationals or nationals of an EU/EFTA country who exercise a remunerated activity in the territory of a single EU/EFTA member state are obliged to contribute to that country’s health insurance scheme.

The Common Institution under the Health Insurance Act (KVG) is responsible for the registration of persons resident in Switzerland who contribute to a health insurance scheme in an EU/EFTA member state. Registration requires proof of entitlement issued by the health insurer abroad. Any queries on this topic should be addressed directly to the Common Institution under the Health Insurance Act (KVG) in Olten (see the link below).

Simultaneous employed activities in the EU/EFTA or Switzerland

A Swiss national or national of an EU member state who simultaneously pursues employed activities either in the territory of more than one EU/EFTA member state, or in Switzerland and in the territory of one or more EU/EFTA member states is subject to the legislation of a single country. The legislation of the country of residence is applicable if a substantial part of the person’s activities (in general, more than 25%) are performed there. Depending on the circumstances, a person without substantial activities in his or her country of residence may be subject either to the legislation of the country where the employer is based, or to that of the country of residence. For further information, see the document “Information of 9 March 2012 on the new European legislation on the coordination of social security systems” (in French/German/Italian).

Employed and self-employed activities in the EU/EFTA or Switzerland

A person who pursues an employed activity in one country and a self-employed activity in another is subject to the legislation of the country in which the employed activity is pursued.

AHV compensation offices

In Switzerland, the AHV compensation offices are responsible for deciding on liability to social insurance, and their decision on this matter is also applicable to health insurance. If you simultaneously pursue activities in Switzerland and in the EU/EFTA, please contact your AHV compensation office directly.

Further information

Health insurance: Requirement to obtain insurance

In general, people leaving Switzerland to live abroad are no longer subject to compulsory health insurance. However, exceptions apply for certain groups of people.

Last modification 04.05.2020

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

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