Health insurance for cross-border commuters in Switzerland

In principle, anyone who works in Switzerland and lives within the EU/EFTA/UK has to be insured in Switzerland. However, cross-border commuters from Germany, Austria, France or Italy can choose whether to take out insurance in Switzerland or in their home country.

  • Flexible treatment location: Switzerland or your home country
  • Benefit from top-quality medical care in Switzerland
  • Free choice of doctor (outpatient) without a referral
  • Attractive solution with uniform tariff for all

The right insurance for cross-border commuters

Optimal cover in Switzerland and at home. Calculate your premium and request a quote.

When the insurance obligation begins

Once you start your employment, you have three months to select your health insurance. If you live in Germany, Austria, France or Italy, you have the right to choose: you have to make a one-off decision whether to be insured in Switzerland or in your country of residence. 

Would you like to continue to be insured in your country of residence? If so, you must submit an application for exemption from the insurance obligation to the health insurance office of the canton where your employer is based. As a rule, their decision is final. 

Important: if you don’t act before the end of the three-month period, you’ll automatically receive basic insurance in Switzerland. The insurance obligation also applies to any non-working members of your family, provided they have not been released from the insurance obligation in advance. 

How your insurance in Switzerland works

Are you a cross-border commuter looking to take out health insurance in Switzerland? Here’s how your insurance works, step by step.

1. Submit application

Take out BASIS basic insurance. To do so, send us the application and the required documents:

  • A current, signed employment contract
  • If self-employed: Registry of Commerce excerpt or trade licence and OASI registration (copy)
  • If already insured in Switzerland: copy of your previous policy
  • Cross-border commuter permit if you do not have a Swiss passport (this can also be submitted retrospectively)

Missing a document? Get in touch with us on 0844 80 81 82.  

2. Register in your country of residence

Once the insurance has been concluded, we will send you your policy. You will also receive an S1 form

You submit the S1 form to your health insurer in your country of residence to register for international mutual benefits assistance there.

You will then receive an insurance card from your health insurer in your country of residence, along with an insurance card from Helsana. Each insured person receives a separate card for their own use.

3. Which card is valid when?

Treatments in your country of residence: show the insurance card from your local health insurer. Any invoices from your country of residence should be submitted to that insurer. The costs will first be covered by your local insurer and then be charged to Helsana. Please note that you may only be treated by doctors and in hospitals that accept your insurance card. 

Treatment in Switzerland: show your Helsana card. The costs are billed directly in line with the Swiss system. A co-payment applies.

Benefits under Swiss basic insurance

Swiss basic insurance covers key medical benefits. These include visits to the doctor, medication and hospital stays.

Basic insurance only applies abroad in emergencies. It covers emergency treatment by public service providers such as hospitals, doctors’ offices and pharmacies – but up to a maximum cost: within the EU and EFTA/UK (Iceland, Norway and the UK), the social tariff of the respective country applies. In all other countries, basic insurance pays a maximum of twice the amount that would be required for treatment in Switzerland.

For cross-border commuters: in the event of an emergency outside your country of residence, you will receive the relevant social tariff within the EU/EFTA/UK. In all other countries, we will cover a maximum of twice the amount insured in Switzerland.

Basic insurance does not cover emergency transport abroad, nor excesses in the country of treatment.

Tip: take your insurance card with you when travelling within the EU/EFTA/UK. This serves as a European Health Insurance Card. The payment will then be processed directly with Helsana, and you can save yourself the Swiss co-payment such as your deductible and excess.

More about insurance cover abroad

Basic insurance covers the costs throughout Switzerland in accordance with the tariff for treatment by a recognised doctor. This also applies to medically prescribed benefits such as chiropractic, physiotherapy, psychotherapy, occupational therapy, speech therapy and midwives. All benefits are listed in the Health Care Benefits Ordinance (KLV).

Basic insurance pays for hospital costs in the general ward (multi-bed rooms). With your basic insurance, you have a free choice of hospitals from the cantonal list of hospitals. You are insured up to the tariff of the canton in which you work or are a weekly resident. You also pay an additional contribution of CHF 15.– per day in hospital.

For medically necessary emergency transport in an ambulance, basic insurance covers 50% of the costs up to CHF 500.– per calendar year. Basic insurance also covers transport costs for medically necessary treatment in a home nursing vehicle, wheelchair-accessible taxi or disability vehicle.

Medically prescribed medication is covered by basic insurance if it is included in the specialities list (SL) and is used in accordance with its authorisation.

How to save even more: always ask for generic medication as you will pay a lower excess. Medication and generics: what Helsana covers

You receive the contributions specified by law towards medically prescribed aids and equipment such as crutches, blood glucose monitors, inhalation and respiratory therapy equipment, compression stockings, milk pumps, etc. The aids recognised under basic insurance can be found in the medical aids and equipment list.

Medical aids and equipment list

What basic insurance covers in the event of maternity:

  • Check-ups: seven check-ups with a doctor or midwife and two ultrasound scans carried out by a doctor – in a high-risk pregnancy, further check-ups if medically necessary
  • Birth preparation: CHF 150.– for birth preparation classes or a consultation with a midwife
  • Birth: full payment of costs in a general ward (multi-bedroom) in your canton of residence or in a recognised birthing centre; an out-of-canton hospital is possible if necessary for medical reasons or if the hospital is on the hospital list in your canton of residence – please contact us in advance for confirmation of cost coverage.
  • Home birth: full payment of costs according to the valid midwifery tariff
  • Breastfeeding advice: three consultations with a midwife or trained breastfeeding specialist
  • Postnatal period: basic insurance covers care provided by a midwife or specialist carer for eight weeks after the birth. If you require a longer period of care, you will need a medical prescription.
Other basic insurance benefits during pregnancy

Alternative medicine is only partially covered by basic insurance. Basic insurance covers the costs of outpatient treatment using the following methods, provided the doctor has recognised training (Swiss Medical Association (FMH) certificate of proficiency):

  • Acupuncture
  • Anthroposophic medicine
  • Pharmacotherapy within traditional Chinese medicine (TCM)
  • Traditional homoeopathy
  • Phytotherapy

Limit: basic insurance pays for a maximum of 180 minutes per method within six months; additional benefits are covered by supplementary insurance.

Your basic insurance supports medical check-ups such as mammograms for the early detection of illnesses. Basic insurance also pays for prevention, such as vaccinations (e.g. the flu vaccination or tick vaccination), if prescribed and administered by a doctor. Basic insurance pays for a gynaecological check­up every three years. The cost of mammograms is covered by basic insurance under certain conditions.

You are welcome to call us for information about which medical check-ups in Switzerland are covered by basic insurance.

Call Customer Service: 0844 80 81 82

You receive CHF 10.– per day for up to 21 days per calendar year for medically prescribed balneotherapy at recognised therapeutic spas in Switzerland. However, basic insurance does not cover stays in convalescent facilities (inpatient convalescent care).

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Frequently asked questions

Cross-border commuters must take out insurance within three months of commencing work in Switzerland (if they do not exercise their right to choose). If registration occurs after this deadline, a premium surcharge of at least 30% is imposed. This is a legal requirement pursuant to Art. 8 of the Health Insurance Ordinance. The surcharge is applied for twice the duration of the delay (maximum 5 years) and is also levied against any family members to be insured.

This gives cross-border commuters from neighbouring countries – generally Germany, Austria, France or Italy – a one-off right to choose: you can decide within three months of starting work in Switzerland whether you want to be insured in Switzerland pursuant to the Health Insurance Act (KVG) or to apply for an exemption so you can keep your health insurance in your home country. The decision is usually final and applies to all family members to be insured.

That depends on your place of residence. An up-to-date list about the right to choose can be found on the website of the Gemeinsame Einrichtung KVG under “Versicherungspflicht und Optionsrecht”. 

Applications for exemption from the Swiss insurance obligation must be submitted in writing to the canton where your employer is based. As a rule, you and any non-working family members must exercise your right to choose as a single unit.

If you are employed in Switzerland, your non-working dependants are also subject to the Swiss insurance obligation (except in cases where there is a separate right to choose, e.g. in Germany). This includes minors, adults in education and non-working spouses. The insurance obligation does not apply to the parent who is employed in the home country, unemployed people or pension recipients.

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