Frequently asked questions of border commuters

Anybody who works in Switzerland, has their domicile in an EU/EFTA country and returns to their home every day is deemed to be a border commuter.  

Border commuters usually need a border commuter permit (G permit). Swiss citizens who work in Switzerland but live in an EU/EFTA country do not need this permit.

In principle, you must take out health insurance at your place of work, therefore in Switzerland (place-of-work principle). However, you can apply for exemption from the obligation to take out insurance in Switzerland if you can prove that you are insured in your country of residence. This is possible if you have exercised your right of choice.

The right of choice is a right to choose your insurance. Border commuters from Germany, France, Austria and Italy can choose whether they want to take out insurance in Switzerland or in their country of residence. If the right of choice is not exercised within three months of taking up employment in Switzerland, the border commuter remains obliged to take out insurance in Switzerland. If the right of choice is exercised, the insurance obligation applies to the country of residence.

The right of choice can in principle only be exercised once and is irrevocable. However, there are exceptions. You have the right of choice in the following situations:

• Taking up employment in Switzerland
• Taking up employment in Switzerland again after a period of unemployment
• Taking up residence in Germany (moving from Switzerland to Germany)
• Drawing a new pension from Switzerland

To exercise the right of choice, you must submit an application to the canton where you work within three months of starting work in Switzerland or becoming obliged to take out insurance in Switzerland (see situations mentioned above). Border commuters who work in the cantons of BS, BL, AG, AI and GL as well as pensioners must submit the application to the HIA Collective Institution.

Special case for France: The “Choix du système assurance-maladie applicable” form also has to be completed and must be signed by the competent authorities in France and Switzerland.

According to the decision by the Federal Tribunal of 10 March 2015, border commuters who did not receive formal exemption from their canton have not been legally exempted from the obligation to take out insurance in Switzerland. As border commuters are therefore actually obliged to take out insurance in Switzerland, they can be insured in accordance with the KVG.

If you wish to be insured under the KVG and have not yet been formally exempted from the insurance obligation by the canton, you need a confirmation from the canton in which you work.

In principle, family members who are not gainfully employed (who do not receive cash benefits in their country of residence) and are resident in the EU are also obliged to take out insurance in Switzerland.
Special cases for Germany: Non-gainfully employed family members do not have to be insured together with the employee. The family members have their own joint right of choice and can take out joint insurance in their country of residence.

Non-gainfully employed family members who are obliged to take out insurance in Switzerland must take out insurance with the same health insurer as the border commuter. Family members include spouses, underage children and dependent adult children (the law of the country of residence applies).

If you receive unemployment benefits from Switzerland, you are obliged to take out insurance in Switzerland.

Sympany offers the euroline border commuter product. This social insurance product offers the basic insurance cover required by the KVG in accordance with the bilateral agreements on the free movement of persons between Switzerland and the EU/EFTA. euroline allows customers to receive treatment both in Switzerland in accordance with the KVG benefits list and in their country of residence in accordance with the benefits list legally valid in the country of treatment.

You can obtain a quote for euroline using the contact form or by calling +41 58 262 43 04.

Sympany will send you an invoice with a QR code containing all payment information. To ensure that you can pay your premiums without any problems, you have the following options:

• QR-bill
  If you have a Swiss account, you can easily scan QR-bills and pay them directly. This makes payment much easier and faster.
• Single payment from a foreign account
  In this case you have to enter the details from the QR-bill manually. Please also note that the transfer must be made in Swiss francs and that additional fees may apply.
• Standing order from a foreign account
  Standing orders are possible, but are less advisable, as the amount will need to be adjusted regularly, e.g. in the event of premium adjustments or exchange rate fluctuations.
• Debit via e-bill 
  Receive electronic invoices directly to your online banking for your bank account or post office account, and approve them in just a few clicks. Tip: certain banks allow you to set up automatic payments to pay bills for certain billers.

• Swiss bank account/post office account
  Allows for QR payments, direct debit and access to the TWINT app.
• Virtual Swiss account via foreign banks
  Some banks in Germany offer accounts that enable QR payments to be made in Switzerland.
• Account with neobanks (online banks)
  They also allow QR payments and offer low or no fees. Standing orders are straightforward.

If you do not have a Swiss account, when making payments from foreign accounts you must ensure that the exact invoice amount (calculated using the current exchange rate) is transferred in Swiss francs. In addition, exchange rate fees and other costs are often incurred.

For technical reasons, refunds cannot be automatically transferred to foreign accounts. Refunds are made manually and take longer.

With a Swiss account, you not only settle your bills quickly and easily, you also receive your refunds directly to your account.

A Swiss account offers you several advantages:

• Easy payment of QR-bills
  QR codes can be scanned directly and your payments are processed quickly.
• Direct processing of refunds
  Instead of a manual repayment, refunds to a Swiss account are automated. This means that you get the money faster.
• Avoid currency conversions
  Payments in Swiss francs can be made immediately and precisely without having to convert the current exchange rate each time.

If you pay your premiums at least six months in advance, you benefit from a discount. If you pay annually, you will receive a 2% discount and if you pay every six months, you will receive a 1% discount.

If you pay your premiums annually or every six months in advance, Sympany can reduce the processing work and save on administration costs. We pass this saving directly onto you as a discount.

If you would like to benefit from the discount, you can change your payment frequency using the online form ›

euroline policyholders are insured both in their country of residence and in Switzerland and can get treatment in both countries. 

In Switzerland: Treatment in Switzerland is settled with Sympany. For this purpose, show your Sympany insurance card at the doctor’s surgery, hospital or to other service providers. This also applies if you purchase prescription medications from a Swiss pharmacy using a prescription from a Swiss doctor.

In your country of residence: Choose a statutory health insurance provider in Germany or CPAM as the statutory health insurance provider in France. They will be responsible for benefits and benefit statements in your country of residence. We will issue Form S072 for you and submit it electronically to the insurer assisting you. They will send you an insurance card. Please use this insurance card when you go to the doctor in your country of residence so that you qualify for medical benefits according to the prescribed minimum benefits list.

For treatment in Switzerland, the benefits list and the co-payment regulations of compulsory basic health insurance in accordance with the KVG apply. When seeking treatment in your country of residence, the statutory compulsory benefits and co-payment regulations of the country of residence apply.

Border commuters are also insured for acute sickness or an emergency abroad (outside of their country of residence and Switzerland). Please show your Sympany insurance card when you request medical treatment. The costs are covered worldwide up to a maximum of twice the rate as per the KVG. In EU countries, the benefits list and co-payment regulations of the relevant country apply.

Important information for border commuters working in the canton of Zug: hospital treatment abroad ›

If you no longer work in Switzerland or become unemployed and receive unemployment benefits from your country of residence, you no longer have to be insured in Switzerland. In this case, you have to terminate your insurance contract with Sympany from the date on which your employment in Switzerland ends. There is no notice period. Please send Sympany a written notice of termination, citing the reason for the termination. Sympany will terminate your current insurance contract as soon as it receives confirmation of future insurance cover from a health insurer in your country of residence.

When you retire, you stop working in Switzerland. Where you need to have insurance depends on the country or countries from which you draw a pension or pensions. 

• Retirement with Swiss pension only: These pensioners are obliged to take out insurance in Switzerland. When pension payments begin, they can exercise a new right of choice and request exemption from the Swiss insurance obligation.
• Retirement with pensions from the country of residence and Switzerland: These pensioners are obliged to take out health insurance in their country of residence. It is not possible to take out KVG insurance in Switzerland.
• Retirement with pensions from several countries, but no pension from the country of residence: Please contact the competent authorities in one of the countries from where you receive a pension for more information.
  • Switzerland: HIA Collective Institution
  • Germany: Deutsche Verbindungsstelle Krankenversicherung Ausland (DVKA)
  • France: Centre des liaisons européennes et internationales de sécurité sociale (CLEISS)

We would be happy to help you if you have any questions about the insurance obligation for your family members who are not gainfully employed.