Health insurance for Swiss abroad: obligations (cross-border guide)
Learn the rules for health insurance of Swiss retirees and workers abroad: obligations, deadlines and a fixed deductible of 300 CHF.
Contesto
In brief - Anyone receiving an AVS/AI pension is required to choose a basic health insurance within 3 months. - The basic insurance can be Swiss or from the country of residence in the agreed EU/EFTA states. - Only funds with more than 500,000 insured persons may cover those who leave Switzerland for the EU. - What: insurance obligation for AVS/AI recipients abroad. - When: decision within the first 3 months of residence (except Spain). - Where: EU/EFTA countries (including the United Kingdom) and non‑EU countries. - Who: Swiss retirees, posted workers, citizens without Swiss income. - Amount: fixed deductible of 300 CHF for Swiss funds that cover abroad. - Regulation: Federal Law on Health Insurance (LAMal). - Authorities: AVS compensation funds, Organization of Swiss Abroad (OSE), Federal Department of Foreign Affairs (FDFA). On 22 April 2025 Swissinfo published an article outlining the health‑insurance rules for Swiss citizens moving abroad. The analysis starts with the fundamental distinction between retirees and non‑retirees. Anyone receiving an AVS or AI pension from Switzerland is, in principle, obliged to take out basic health insurance under LAMal. However, Switzerland has negotiated optional rights with several countries, including all neighbours and Spain. In these states the retiree can decide whether to keep Swiss coverage or join the local scheme. The decision must be made within the first three months after the change of residence, with the exception of Spain where it can be postponed. The article emphasizes that Swiss coverage is reserved for funds with more than 500,000 insured persons. Only these are authorised to guarantee coverage for people moving to an EU country. In addition, the deductible is set at 300 CHF, regardless of the country of reside...
Dettagli operativi
Implications for Swiss pensioners who emigrate The rules outlined in this article introduce a series of practical choices for pensioners. First and foremost, the requirement to decide within three months means a precise timeline for financial planning. The fixed deductible of 300 CHF is an extra expense compared to the Swiss cantonal model, where the deductible may vary. This can affect the calculation of the net cost of coverage, especially for those with frequent medical expenses. Another key factor is the difference in premiums between insurance funds. Funds with more than 500,000 insured persons, such as CSS or Visana, offer lower rates thanks to a broader risk pool. However, the case of Poland shows that premiums can vary dramatically (Visana is nearly five times more expensive than CSS). For those moving to countries with high healthcare costs, the option agreement may be more advantageous if the country offers lower premiums or a smaller deductible. From the perspective of the federal system, the possibility to choose the country of insurance strengthens pensioners' freedom of movement, but requires coordination between Swiss authorities (AVS funds, FDFA) and the health authorities of the host countries. LAMal remains the reference legal framework, but exceptions (e.g. Spain) show only limited flexibility. ### Workers without AVS/AI pension For workers who do not receive a pension, the rule is more complex. If the workplace is abroad, the host country's regulations require local insurance. This means that a Swiss citizen employed in London must register with the NHS (National Health Service) or a private British insurance, depending on UK requirements. The difference compared to LAMal is that the federal law on insurance contracts (LCA) allows Swiss funds to o...
Punti chiave
Step‑by‑step guide to choosing basic health insurance abroad 1. Check your pension: make sure you receive an AVS or AI pension from Switzerland. If yes, you are subject to the LAMal obligation. 2. Identify your country of residence: verify whether the country is on the EU/EFTA list with the right of option (including neighboring countries and Spain). The list is available on the DFAE website. 3. Three‑month deadline: mark the start date of residence on your calendar and count three months to make a decision. Only for Spain can the deadline be postponed. 4. Compare insurers: see which Swiss insurers have more than 500,000 insured persons (e.g., CSS, Visana). Check the premiums specific to the country of residence; the deductible will still be 300 CHF. 5. Request quotes: contact the selected insurers and ask for a quote that includes annual premium, deductible and geographic coverage. 6. Evaluate the local option: obtain information on premiums and deductibles of the local health‑care system. Compare them with the Swiss quote. 7. Decide and subscribe: within the three months, inform the Swiss insurer of your choice or subscribe to the local insurance. Keep the confirmation for possible tax checks. 8. Update AVS: notify AVS of the new coverage status to avoid penalties. ### Emergency scenarios - If the decision is postponed (Spain only), you can keep Swiss coverage for up to 12 months, but you should check the specific conditions with the insurer. - If you miss the deadline: the Swiss insurer may consider the coverage terminated and impose penalties or request a refund of premiums not owed. - If you move to another country again: you must repeat the procedure within three months of the new move. ### Useful tools - Health insurance calculator to compare premiums and deduc...
Punti chiave
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Frequently Asked Questions
- When do I have to choose basic insurance if I receive an AVS pension?
- Anyone receiving an AVS or AI pension must decide within the first three months of residence whether to take out basic insurance in Switzerland or in the country of residence. Only Spain allows postponing this decision.
- Which Swiss pension funds can insure people living abroad?
- Swiss pension funds that cover abroad must have more than 500,000 insured persons. The deductible is set at 300 CHF for all beneficiaries, regardless of country of residence.
- Do I have to take out British insurance if I work in London?
- If you move to London for work, you must enrol in the mandatory basic insurance in the United Kingdom. If you move without working or receiving a Swiss pension, you can keep Swiss coverage, but it depends on your fund's decision according to the LCA.