1The rule: you insure where you work
Under the agreements with the EU and EFTA, health insurance follows the place of work. If you work in Switzerland, you and the family members who do not work have to take out Swiss basic insurance, even though you live abroad. You have three months from your first working day.
If you let the three months pass, the canton can assign you to a Swiss insurer, and a premium surcharge is possible.
2The right to choose
Switzerland has special agreements with its neighbours. If you live in Germany, France, Italy or Austria, you may stay in the health system of your home country instead.
Decide within three months
The deadline runs from your first working day in Switzerland.
Send a formal request
The request for exemption goes to the health insurance office of the canton where you work. Saying nothing does not count as a choice.
Keep the confirmation
The canton confirms the exemption in writing. Your employer and your insurer at home may ask for it.
3How to decide
| Swiss basic insurance | Home country | |
|---|---|---|
| Price | A premium per person that does not depend on your income | Usually a share of your income |
| Family | Each person pays their own premium | Often insured with you at no extra cost |
| Treatment | In Switzerland and in the country where you live | Mainly in the country where you live |
| Later change | Only if your situation changes | Only if your situation changes |
As a rough guide: singles and couples with two good incomes often pay less in Switzerland, families with one income often pay less at home. Ask both sides for a quote before you decide.
4If you choose Switzerland
- Insurers charge special premiums for each country of residence. They differ from the premiums in Swiss cantons, and not every insurer offers them.
- You can see a doctor in Switzerland and in the country where you live.
- With a modest income you can apply for a premium reduction.
Our calculator shows the premiums for people who live in Switzerland. For cross-border premiums, ask the insurers directly.
5Can you change your mind later?
The choice is normally final. Whether a change in your life opens it again, for example a move to another country, is decided by the canton where you work.
6From outside the EU and EFTA
Cross-border commuters with a G permit who are citizens of other countries are insured in Switzerland only if they ask for it. The request has to be made within three months of the day the permit becomes valid.
Questions and answers
I missed the three months. What now?
The canton can assign you to a Swiss insurer. If you have no good reason for the delay, the premium gets a surcharge, and treatment before you joined is not covered.
Is my family insured with me?
Family members who do not work are normally insured in the same country as you. There are exceptions, for example in Italy, so ask the canton where you work.
Who is my contact at the canton?
Each canton has an office for exemptions from compulsory health insurance. The Federal Office of Public Health publishes the list.
I am moving to Switzerland. Does this still apply?
No. Once you live in Switzerland you are a resident and need Swiss basic insurance like everyone else, within three months of arriving.
Sources: Federal Office of Public Health (FOPH), health insurance for cross-border commuters in Switzerland (page read on 12 November 2026), Agreement on the Free Movement of Persons, Federal Health Insurance Act (KVG). This page is information, not legal advice.