Health insurance for foreign nationals

Health insurance for foreign nationals

"Is membership of a Swiss health insurer compulsory if you live or work in Switzerland? Where do cross-border commuters who work in Switzerland and unemployed persons who live in the European Union have to register?

Malorie, Geneva

According to art. 3 of the LAMal, anyone domiciled in Switzerland must take out health insurance within three months of taking up residence or being born in Switzerland. Under domestic law, the criterion for joining the health insurance scheme is therefore residence in Switzerland. Affiliation is compulsory but not automatic, so it is up to the insured to choose an insurer and to join it.

However, the Agreement on the Free Movement of Persons between the European Community and Switzerland (ALCP) may derogate from the KVG scheme. Regulation 883/2004 on the coordination of social security systems, which came into force for Switzerland in 2012, is based on the principle of workplace coverage. This means that people who work in Switzerland but reside in an EU Member State are, in principle, compulsorily insured under the KVG/LAMal scheme. Conversely, people who work in the European Union and live in Switzerland are insured in the country where they are gainfully employed.

Cross-border commuters who work in Switzerland but reside in Austria, Germany, France or Italy have the right to choose whether they wish to be affiliated to the KVG/LAMal scheme or to the scheme of their country of residence. However, if cross-border commuters working in Switzerland have not exercised their right of option, they are subject to the Swiss health insurance scheme, in accordance with the place of work criterion.

In principle, persons receiving Swiss unemployment benefits who reside abroad are compulsorily insured under the LAMal scheme (art. 11 of Regulation 833/2004). However, people living in Austria, Germany, Finland, Italy and Portugal, for example, also have the right to choose whether to be insured in their country of residence or in Switzerland. On the other hand, unemployed people living in Belgium, Denmark, France and the United Kingdom are compulsorily insured under the LAMal scheme.