FAQs for cross-border commuters

The scope of cover in Switzerland is defined by the Federal Health Insurance Act (KVG). You can find an extract from the catalogue of benefits below:

Overview of benefits for cross-border commuters

If you receive treatment in Switzerland, you should send all your bills to SWICA for settlement. You will need to pay the bill yourself. Depending on the canton, some providers may also settle their invoices directly with us via your SWICA insurance card.

Important: When dealing with a service provider in Switzerland (doctor, pharmacist, hospital, etc.), you must present our SWICA card only.

If services are used in Switzerland, all KVG benefits will be reimbursed to you less the annual excess of CHF 300.– and a statutory deductible of 10% of the invoice amount up to a maximum of CHF 700.–. However, it is also possible that the benefit amount may be paid directly to the service provider and that you will be asked for the co-payment.

Example calculation: excess and deductible

• Medical bill: CHF 1000.–
• Less excess: CHF 300.–
• Subtotal: CHF 700.–
• Less 10% deductible of CHF 70.-
• Reimbursement: CHF 630.–

After registering with your statutory health insurer in your country of residence (known as the «assisting carrier»), you will be eligible for all non-cash benefits under the official catalogue of benefits for your country of residence. You will receive an insurance card that your service provider (doctor, therapist, pharmacist, hospital, etc.) can use to claim payment directly from your assisting carrier for the services provided. You should contact your statutory health insurer in your country of residence regarding any more detailed questions.

Important: When using services in your country of residence, you must present only the insurance card provided by your assisting carrier.

If you temporarily travel to another country, you are also covered for medically necessary treatment in EU/EFTA countries and the UK, and for emergencies worldwide. In the EU/EFTA or UK, you should if required present your SWICA insurance card; your European insurance card is on the reverse. In the event of an emergency outside the EU/EFTA or UK, we will reimburse your costs up to twice the maximum amount that we would pay in Switzerland.

Unfortunately, SWICA is not able to provide any form of supplementary insurance to anyone living outside Switzerland. If you have any questions about supplementary forms of insurance, you should speak to an insurance company in your country of residence.

Insurance normally starts when you begin working in Switzerland (or start drawing a pension in Switzerland), provided that we receive your insurance application within three months of this date. If received later, your insurance will «only» begin from the date that SWICA receives your application, and a premium surcharge may be applied.

Cross-border commuters living in Austria, France, Germany or Italy have the right to opt out of the insurance obligation in Switzerland within three months of it starting to apply. To do so, a written application must be made to the relevant cantonal authority. This right of opt-out also applies to pensioners subject to an insurance obligation in Switzerland who are resident in Portugal or Spain (Swiss and Spanish nationals only).

The extent to which your family members who are not in gainful employment have the option to opt out also depends on your country of residence. See the question «What about my family members who are not in gainful employment?»

Cantonal authorities: opt-out from insurance obligation

• A fully completed insurance application (including signed offer)
• A copy of the employment contract/cross-border commuter permit
• A signed power of attorney for each adult family member not in gainful employment
• A signed supplementary sheet for cross-border commuters for each adult

When switching insurer within Switzerland, we do not require an employment contract or cross-border commuter permit. SWICA can also terminate your existing insurance for you. To do so, we also require the signed termination form.

Family members not in gainful employment must normally be insured with you in Switzerland, provided that (in the case of children) the other parent is not in gainful employment. If the other parent is in gainful employment in the country of residence (whatever their level of income), your children will not be insured with SWICA. The health insurer in your country of residence will verify and determine who is classed as a family member not in gainful employment.

If you live in Denmark, Hungary, Liechtenstein, Portugal, Sweden, Spain or the UK, your family members not in gainful employment must be insured in your country of residence. If you live in Finland, your family have free choice in this matter.

If you live in Austria, France or Italy, your family members not in gainful employment have the right to opt out of the insurance obligation in Switzerland, but only in conjunction with you. This means that everyone must be insured either in Switzerland or in your country of residence.

If you live in Germany, your family members not in gainful employment have their own right to opt out, separately from you. As such, your family members can apply to the relevant cantonal authority for an opt-out within three months, even if you yourself take out insurance with SWICA.

Cross-border commuters are normally subject to the social security system of just one country. Where cross-border commuters work in more than one country, a competent authority must establish which country's social security system applies. The question of who should carry out this examination depends on your country of residence. Please contact us if you have any questions in this regard.

You can work from home for up to 24.9% of your activity on behalf of your Swiss employer without your insurance obligation in Switzerland being affected. If you work from home 25% or more of the time, this normally gives rise to a social security obligation in your country of residence. This means that your Swiss employer is required to deduct and transfer social security levies in accordance with the law of your country of residence.

Multilateral agreement since 1 July 2023
For countries that have signed the multilateral agreement, as of 1 July 2023 there is no change in social security status for people who work remotely up to 49.9% of the time.

• Information from the Federal Social Insurance Office (in German)
• List of states with an agreement

if you are a cross-border commuter who is already insured with another health insurer in Switzerland (KVG), you can switch to SWICA with effect from 1 January or 1 July of any year.

• To switch with effect from 1 January, your existing insurer must receive your notice of termination by 30 November at the latest.
• To switch with effect from 1 July, your existing insurer must receive your notice of termination by 31 March at the latest.

Please note that you can only switch insurer if you do not have any premium arrears with your existing insurer. The same cut-off dates apply if you wish to switch from SWICA to a competitor. Your termination is deemed to have been received on time if it reaches SWICA before the close of business hours on the last working day before the cut-off date.

When changing your country of residence to Switzerland, it is a requirement to change your insurance cover; we give you a right of extraordinary termination to do so. You have three months from the date of your return to retroactively switch your insurance with SWICA back to a Swiss-resident model (this may mean an alternative insurance model and/or higher excess), or to retroactively switch to a competitor from the date of your change of residence.

After three months, the ordinary notice periods apply when switching to a competitor, and we are no longer allowed to retroactively change your insurance cover (no alternative insurance model or higher excess).

Your insurance obligation in Switzerland ceases on the exact day that you stop working in Switzerland. It is not possible to voluntarily continue the insurance. We require a questionnaire to allow us to terminate your contract; please provide us with this in good time and contact us if you have any questions.

• Questionnaire: Cessation of employment activity
• Contact us

You must register with a statutory health insurer of your choice in your country of residence in order to obtain an insurance card from this health insurer for the treatments you plan to receive in your country of residence. You must not use your SWICA insurance card in your country of residence.

If you duly authorised us to do so and gave us the name of your chosen statutory health insurer, we will have already completed your registration for you. If not, you will receive a paper Form S1 from us; please forward this to a statutory health insurer.

The same procedure also applies for your family members not in gainful employment. The health insurer in your country of residence also checks whether the requirements for registration of your family members have been met. If this is not the case, your family's health insurance in Switzerland cannot be continued. If you have any questions in this regard, please contact your health insurer in your country of residence.

An AHV number is an essential prerequisite for issuing an insurance card. If you are starting work in Switzerland for the first time, your employer normally applies for an AHV number. You usually have to then wait up to four weeks for your insurance card. Please let us know if you have already been waiting for significantly longer. We will then check the personal and address data that has been entered with you and make any necessary corrections or order a new insurance card for you.

Important information
Your employer will not normally apply for AHV numbers for your family members not in gainful employment. We are unable to create an insurance card until we have these numbers. We would be pleased to apply for these numbers on your behalf, just get in touch with us.

Contact us

It normally takes up to four weeks for your insurance card to arrive. If you require treatment before you receive your SWICA insurance card, you can get in touch with us and request a provisional replacement certificate.

Once you have been accepted by SWICA and registered with your chosen health insurer in your country of residence, that insurer will provide you with the necessary insurance card to use services in your country of residence. You should contact that insurer directly if you require a replacement certificate.

Contact us

Under the right to choose a country for treatment, you can decide to receive your treatment in Switzerland or in your country of residence. For treatments in Switzerland, use your SWICA insurance card. In your country of residence, please only use your foreign health insurance.

You can use the mySWICA customer portal to gain convenient online access to a digital version of your SWICA insurance card.

Any changes that could potentially affect your insurance relationship must be reported to SWICA within one month. Such changes include in particular:

• Changes of name and family circumstances (marriage/divorce, birth of a child)
• Changes of address (particularly if changing your place of residence to another country)

Changes in professional/income circumstances should also be reported, including those of your family members

• Cessation of your employment in Switzerland (including temporarily)
• Starting a new or additional activity (including outside Switzerland)
• Change of canton in which you work
• Working from home/remote working
• Drawing a pension or daily benefits

eBill is a quick and easy way to pay your invoices. You check your invoice in your e-banking/e-finance app, then approve the payment with just two clicks. If you wish, you can also set up automatic invoice approval up to a certain invoice total.

How to register for SWICA eBill invoices

• Log in to your e-banking/e-finance app as usual
• Select «eBill/e-billing» in the menu
• Register for the eBill service if you haven't already done so
• For identification purposes, please enter your insurance number or your most recent premium invoice number

Please note:
After switching to e-billing, you will no longer receive any paper invoices from SWICA. However, you can view your invoices in the mySWICA customer portal at any time.
eBill invoices can only be paid from a Swiss account.

As an alternative to eBill, you can also pay your premium invoices via direct debit or PostFinance Direct Debit. The invoice amount will be debited automatically from your account on the due date. Please complete the application form to set up your instruction, then send the signed original to your bank. If you have an account with PostFinance, you can simply provide us with the form. We will send you payment slips for payment of your premiums and co-payments until your bank authorises the direct debit facility.

Please note:

• A direct debit can only be set up with a Swiss account.
• No direct debits can be made from a foreign account, even if it has a CH-IBAN.

Direct debit application form

SWICA issues invoices with a QR code containing all the information needed for payment. Following receipt, you must take active steps to pay the invoice by its due date.

Note regarding payments from outside Switzerland
The QR IBAN printed on the premium invoice does not work for payments made from other countries. Please use the payment information provided at the top of your QR invoice.

Alternatively, you can make payments from outside Switzerland to the following account, citing your insurance number and invoice number:

• IBAN: CH 10 0483 5082 6327 1100 0
• BIC: SWIFT CRESCHZZ80A
• Bank: Credit Suisse AG, 8070 Zurich

Please note: The amount transferred must precisely match the amount in Swiss francs. You must bear any fees for foreign currency transactions yourself.