Commuters who cross Switzerland's borders with Germany, Austria, Italy or France can choose their own cover and be exempt from mandatory insurance in Switzerland in order to maintain their cover in their country of residence.
By way of an exception, cross-border commuters from Germany, Italy or Austria can be exempted from mandatory insurance in Switzerland when new members join the family, for example through marriage or birth. The exemption must be requested from the competent cantonal authority (BAG) within three months of the event date.
However, the following does not constitute a change in personal circumstances:
- a change in the economic situation
- a change in the amount of the health insurance premium
- a change of employers
- a change of canton in which the person is gainfully employed
For persons who take out insurance late (after three months from when they started to work), cover starts at the earliest from the date of the insurance application, and by law this person may face a penalty on his or her premium due to late enrolment in a plan. It is therefore impossible to backdate the start of the insurance once the three-month period has expired, and the person concerned must therefore close the insurance gap with an insurer in Germany in such cases. As a rule, persons who previously were covered under a statutory plan can have their insurance converted into a "voluntary membership" plan and pay contributions that are linked to their income in Germany until their cover in Switzerland starts.
Based on the principle that applies to the place of work, gainfully employed family members must also take out insurance in the country where they work. Not gainfully employed family members are subject to mandatory insurance in Switzerland together with the cross-border commuter, provided their family status falls within the definition of the applicable national law (this generally applies to underage children or children in school up to the age of 25, as well as dependants who are of age and are entitled to support).
If you change your insurer, the following notice periods apply to mandatory basic insurance under the KVG:
- You can terminate the insurance effective 31 December, whereby written notice must reach the previous insurer no later than on the last working day in November.
- If you have ordinary basic insurance with an excess of CHF 300, you can terminate your health insurance effective from 30 June, whereby written notice must reach the current insurer no later than on the last working day in March. You won't be able to change your insurer in the middle of the year if you have basic insurance with a higher excess or with a limited choice of service providers (health network, HMO, family doctor model).
Please note that you must give notice in writing.
If you previously had statutory basic KVG insurance as a cross-border commuter, you can either adjust the premium with your current health insurer based on your new place of residence or you can switch to another health insurer. Please note that you must change your health insurer within 3 months of becoming a resident to prevent any interruptions in cover.
FAQ Cross-border commuter who are German residents
Here it is important to note that the affected persons themselves must undertake such a switch and contact the cantonal authority of their own accord. For the cantons Basel-Stadt and Aargau you will find further information about the requirements and procedures under "Important information for cross-border commuters with gainful employment in the cantons Basel-Stadt and Aargau" on the website of Gemeinsame Einrichtung KVG.
Please note that you can exercise the separate option right of your family members only as a unit (you on the one hand, and all family members jointly on the other).
In principle, however, your children must be insured in Germany if the other parent is gainfully employed in Germany, even if this activity is not subject to mandatory insurance (e.g. a small job).
Since there is a two-tier insurance system in Germany (statutory and private), you must, in principle, insure yourself in Germany; however, this does not constitute the right to enrol in a statutory health insurance plan.
If you receive unemployment benefits in Germany, you generally must have cover that complies with the statutory health and long-term care insurance provision, but from the age of 55 you remain exempt from the insurance obligation unless you were insured with a statutory health insurer (or under the KVG in Switzerland) in the last five years before any benefits came into effect.
If you have any further questions, please contact the Federal Employment Agency in Germany in good time.
If you move to Switzerland, you must adjust your insurance cover to the requirements of your new place of residence since all Swiss residents must at least have mandatory basic insurance in accordance with the KVG. Depending on your current insurance plan, you may also be able to keep your previous supplementary insurance, for example to continue consulting your current doctors in Germany.
If your usual place of residence is Germany and you had mandatory KVG health insurance (STANDARD EU) as a cross-border commuter before receiving your pension from Germany in addition to your pension from Switzerland (the amount of the pension is irrelevant here), you must also take out health insurance in your country of residence from the time you receive your pension. If you would like to keep your current insurance plan in Switzerland, you will need to forgo this pension before the pension decision is made in Germany (e.g. in the case of low pension entitlements).