Health insurance exemption in Switzerland: who qualifies

When can you be exempted from Swiss health insurance?

Only on a ground set by the Federal Council (Art. 3 para. 2 KVG; Art. 2 and 6 KVV) or one that, according to the Federal Office of Public Health (FOPH), follows from an agreement. Otherwise the obligation to be insured applies: everyone resident in Switzerland must take out insurance within three months of taking up residence or of birth (Art. 3 para. 1 KVG).

A foreign or private policy alone is not a ground (Art. 4 KVG), not even on a long trip without a new residence. Nor are high premiums; if the premium becomes a burden, look into your canton's premium subsidies.

Who is not required by law to be insured?

Above all the following people. The KVV does not require an application, but SVA Zürich and the Common Institution under the KVG (Gemeinsame Einrichtung KVG) handle some cases as applications; ask the office responsible for you:

• Treatment or health cure: anyone staying in Switzerland solely for that purpose (Art. 2 para. 1 let. b KVV).
• Work or unemployment benefits abroad: anyone who for that reason is subject to the law of another state under an agreement (let. c and d).
• Foreign pension only: anyone entitled to a pension from an EU state, Iceland, Norway or the United Kingdom but not to a Swiss pension (let. e); according to the FOPH, you are then insured in that state. According to the FOPH, any Swiss pension, even a small one, creates the obligation here.
• Family members co-insured abroad: with a right to benefits assistance (Leistungsaushilfe), which according to the Zurich Social Insurance Court only concerns people with statutory insurance (let. g); family members of people under let. c, d or e also with equivalent cover for treatment in Switzerland (let. f).
• Posted workers from the EU/EFTA or the United Kingdom: according to the FOPH, the A1 certificate exempts you for up to 24 months if you are a national of one of these states or of Switzerland.
• People with privileges, such as staff of permanent missions and international organisations; private domestic staff only if insured in the employer's state or a third state (Art. 6 paras. 1 and 2 KVV).
• Short work assignments: up to three months, with equivalent cover for treatment in Switzerland (Art. 1 para. 2 let. b and g KVV).
• Proof for the EU/EFTA (Common Institution): A1 certificate for work, S1 for a pension, U2 for unemployment benefits; with the S1 you register with the Common Institution.

Who can apply for an exemption?

Anyone who meets one of the grounds in the table; Art. 2 paras. 5 and 8 KVV, for example, are also open to Swiss citizens.

Art. 2 para. 8 KVV is a hardship rule: both conditions in the table apply together. According to the Common Institution, your existing cover must be comprehensive and clearly better than under the KVG. If it does not cover nursing care costs, that is a serious deficiency according to the Federal Supreme Court (judgment 9C_8/2017).

Cross-border commuters (Grenzgänger) live abroad: according to the Common Institution, they only have an option right (Optionsrecht) if they live in Germany, France, Italy or Austria; according to the FOPH, the application goes to the canton of work within three months of starting work (Art. 2 para. 6 KVV).

What applies to students from abroad?

That depends on where you come from, whether you work and how you are insured. Offices recognise student insurance policies differently; ask before you sign up. According to the canton of Bern, you cannot switch to one from basic insurance.

• From the EU/EFTA/UK, not working: according to the FOPH, there is no obligation as long as you stay in the system of your state of residence; you are treated with the European Health Insurance Card (EHIC). Bern requires no documents for this, SVA Zürich an application with the EHIC. If you want to stay here after your education, you are required to be insured according to the canton of Bern; if you are co-insured through your parents under statutory insurance, have the Common Institution check this.
• From the EU/EFTA/UK, working: according to the FOPH, you must be insured here; according to SVA Zürich, any paid work counts, even a small side job. According to the canton of Bern, the cover from the statutory insurer then ends. For people with statutory insurance from Germany, France, Italy or Austria, an exemption may be possible, according to the Common Institution with an L permit or with a B permit and your centre of interests in one of these states.
• Privately insured: an application is possible if the cover is equivalent, whether you come from the EU/EFTA/UK or from other states (FOPH).

What does equivalent cover mean?

According to the Aargau Insurance Court, cover is equivalent for treatment in Switzerland if, when a claim arises, you do not bear more, or not significantly more, yourself than under basic insurance (VBE.2025.270); the KVV does not define the term. Each case is assessed individually, for example:

• Scope: all KVG benefits, for example for maternity or nursing care when resident in Switzerland, without limits per day or overall (canton of Thurgau).
• Tariffs: costs at Swiss tariffs, not those of your state of residence (SVA Zürich). Privately insured people have no tariff protection here; without prior approval of costs (Kostengutsprache), hospitals can demand a deposit (canton of Thurgau).
• Exclusions: none for pre-existing conditions, mental illness, own fault or certain sports (canton of Zurich information sheet, undated).

How does the application work?

According to the FOPH, the application goes within three months of the start of the obligation to be insured to the office designated by the canton, which decides on it (Art. 6a para. 3 KVG). The start is taking up residence or, with a permit, registering with the residents' registration office (Einwohnerkontrolle) (Art. 7 para. 1 KVV); Bern gives “as a rule” the date of entry, Geneva the arrival in the canton. This deadline is not in Art. 2 KVV, but according to the Common Institution late applications can be rejected; Geneva then insures you ex officio.

1. 1Find the office: the FOPH keeps the list. In AG, AR, BL, BS, GL, OW, SO, UR and parts of ZG it is the Common Institution, in FR, GR, SG, TG, VS and the rest of ZG the municipality, otherwise a cantonal office.
2. 2Obtain the documents: written confirmation from the foreign body (Art. 2 paras. 2, 4, 7 and 8 KVV), the employer's undertaking (para. 5) or proof of cover in the event of illness (para. 6). In Bern, private insurers must use the office's form.
3. 3Apply early and ask what applies until the decision: SVA Zürich currently gives around five months for the review (as of November 2026), Bern a few weeks. Basel-Stadt gives a fee of CHF 75.
4. 4Check the decision: you can lodge an objection (Einsprache) against the formal decision (Verfügung) free of charge within 30 days, then an appeal (Beschwerde) within 30 days (Art. 52 and 60 ATSG). After a rejection, the office sets a date or a deadline for joining; otherwise you are assigned to an insurer (Art. 6 para. 2 KVG).

What applies when the exemption or cover ends?

Report this to the responsible office immediately, as well as starting work, finishing your studies or a new living situation: for education and under Art. 2 para. 7 KVV, cover must exist throughout the exemption.

An exemption is not basic insurance: only what your own insurance covers is paid. Keep the decision, the policy and the insurer's confirmation. easyall only arranges insurance for people residing in Switzerland.

• Expiry: according to the canton of Thurgau, after at most six years of exemption for education, you are automatically required to be insured.
• Joining: the FOPH speaks in general terms of three months from the start of the obligation to be insured and does not mention the end of an exemption. Clarify with the office beforehand from when you must be insured; if you join late, cover only starts then, and if the delay is not excusable a premium surcharge (Prämienzuschlag) is added (Art. 5 para. 2 KVG).
• Acceptance: every insurer must accept you in its area of operation (Art. 5 let. i KVAG); you can compare in the easyall calculator.
• Moving: report it to the office in the new canton; a new application may be needed there.