Healthcare professionals and LaMal: Canton Ticino's decisions (cross-border guide)

Context

In brief

• The Canton of Ticino decides on access to LaMal for healthcare professionals.
• New rules for cross-border workers in the healthcare sector.
• Practical implications for those residing in Italy and working in Ticino.

Key facts

• What: Decisions on access to LaMal for healthcare professions.
• When: By June 30, 2024.
• Where: Canton of Ticino.
• Who: Cantonal authorities of Ticino.
• Amount: Up to CHF 300 for registration procedures.

The Canton of Ticino has recently made important decisions regarding access to mandatory health insurance (LaMal) for healthcare professionals working in the territory. This decision has a significant impact on cross-border workers who reside in Italy and work in the healthcare sector in Switzerland. The new rules aim to clarify the requirements and procedures for accessing LaMal, thus ensuring greater clarity and security for transborder workers.

Implications for Cross-Border Workers

The new provisions of the Canton of Ticino mainly concern healthcare professionals working in Ticino but residing in Italy. These workers will now have to follow specific procedures to access LaMal, which may include the submission of additional documents or proof of a real link with the Swiss territory. The cantonal authorities have emphasized the importance of these measures to ensure a fair and sustainable healthcare system.

Operational Checklist

1. Required Documents:

• Valid passport or identity card.
• Work contract in Ticino.
• Proof of residence in Italy.
• Previous work certificate (if applicable).

2. Procedures:

• Submission of the application to the competent office of the municipality of residence in Ticino (e.g., Lugano, Bellinzona, Locarno).
• Payment of an administrative fee of CHF 100-300.
• Waiting for confirmation of registration, within 30 working days.

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Operational details

Procedures and Requirements

The new rules for cross-border healthcare professionals' access to LaMal, which came into effect on January 1, 2023, include a series of specific requirements. Among these, demonstrating a genuine link to Swiss territory, which can be proven through tax residence, withholding tax payments, or participation in Swiss social assistance programs. Additionally, workers will need to present additional documents attesting to their professional activity in Ticino, such as employment contracts, certificates of employment, and income tax returns.

📊 Operational Checklist:

• Tax residence in Switzerland (e.g., certificate of domicile)
• Withholding tax payments (e.g., certificate from the AFC)
• Participation in Swiss social assistance programs (e.g., accident insurance)
• Employment contract in Ticino
• Certificate of employment
• Swiss income tax return

Comparison with the Previous Situation

Before these new provisions, cross-border healthcare professionals could access LaMal through less stringent procedures. For example, a simple declaration of residence in a border municipality such as Mendrisio or Chiasso was sufficient. The new rules represent a significant change, especially for those who do not have a direct link to Swiss territory. However, the cantonal authorities have assured that these measures are necessary to ensure a fair and sustainable healthcare system.

"These measures are essential to prevent abuse and ensure the sustainability of the Ticino healthcare system," declared the Ticino State Council.

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Key points

What to Do Now

Healthcare professionals who are cross-border workers in Ticino must act urgently to ensure the continuity of their health insurance coverage. The new regulations of the Canton of Ticino, which came into effect on January 1, 2024, require proof of a genuine link to Swiss territory. This link can be demonstrated through various documents, including tax residence, payment of withholding taxes, or participation in social assistance programs. For example, a nurse residing in Chiasso and working in Lugano must submit the Swiss tax return for 2023, which certifies a taxable income of at least CHF 12,908, corresponding to the LaMal coverage minimum.

Step-by-Step Procedures

1. Gather Documents: Start gathering all necessary documents to prove your link to Swiss territory. This may include:

• Tax residence: Rental contract or property ownership in Ticino.
• Withholding taxes: Certificate of payment of withholding taxes for 2023.
• Social assistance: Documents certifying participation in social assistance programs, such as childcare subsidies (CHF 200-300 per month per child).
• Economic activity: Work contracts or documents certifying stable economic activity in Switzerland.

2. Contact Cantonal Authorities: Contact the cantonal authorities of Ticino for further information on the new procedures and specific requirements for access to LaMal. You can contact the Social Insurance Institute (IAS) in Bellinzona or consult the official website of the Canton of Ticino.

3. Submit the Application: Once you have gathered all the necessary documents, submit your application for access to LaMal following the new procedures established by the cantonal authorities. The application can be submitted online through the official portal or in person at the IAS offices.

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