Key points at a glance
- Anyone who takes up residence in Switzerland must take out insurance within 3 months (Art. 3 para. 1 KVG); exemption is the exception.
- Some groups are excluded by law, others only on application if they can prove equivalent insurance for treatment in Switzerland (Art. 2 KVV).
- Students, pupils and trainees can be exempted for a maximum of 3 years, with an extension of no more than 3 further years (Art. 2 para. 4 KVV).
- The responsible cantonal authority decides on applications (Art. 10 para. 2 KVV); you cannot revoke an exemption without a special reason.
What is exemption from the requirement to take out insurance?
Switzerland has a general requirement to take out insurance: anyone who lives here must take out basic health insurance with a health insurer within three months of taking up residence or of birth. Exemption is the exception to this rule. If you are exempted, you do not need Swiss basic health insurance, but in many cases you must prove that you have equivalent cover from abroad.
The law distinguishes between two kinds of exception:
- Exceptions by law. Certain people are not subject to the requirement at all, for example people who are in Switzerland only for medical treatment or a spa stay, or people who are subject to the law of an EU state because they work there. They do not need to apply.
- Exemption on application. Other people are in principle required to take out insurance, but can submit an application to the canton. When people talk about “exemption”, they usually mean these cases.
How it works
The Health Insurance Ordinance lists the groups that can be exempted on application:
| Group | Condition | Article |
|---|---|---|
| People with compulsory insurance in a state without an agreement | Double burden and equivalent cover in Switzerland | Art. 2 para. 2 KVV |
| Students, pupils, trainees, interns and accompanying family members | Equivalent cover; maximum 3 years, extension of no more than 3 years | Art. 2 para. 4 KVV |
| Workers posted to Switzerland and their families | Exemption from old-age and survivors’ insurance and invalidity insurance (AHV/IV), and the employer guarantees at least KVG benefits | Art. 2 para. 5 KVV |
| People resident in an EU state | Exemption possible under the Agreement on the Free Movement of Persons (AFMP) and proof of cover | Art. 2 para. 6 KVV |
| Non-employed people with an EU/EFTA residence permit | Equivalent cover for the entire period of the exemption | Art. 2 para. 7 KVV |
| People whose cover would clearly be worse | Supplementary insurance not affordable or hardly affordable because of age or health | Art. 2 para. 8 KVV |
You submit the application to the responsible cantonal authority, enclosing written confirmation from the foreign insurer with all the necessary details. The authority mainly checks whether your cover for treatment in Switzerland is equivalent. If the application is rejected, you must take out insurance with a Swiss insurer.
Cross-border commuters from EU states have their own choice, the right of option: they decide whether to take out insurance in Switzerland or in their country of residence. Coordination with other countries is handled by the Common Institution under the Federal Health Insurance Act (Gemeinsame Einrichtung KVG).
If you are not exempted and take out insurance late without an excusable reason, you pay a premium surcharge of 30 to 50% for twice the length of the delay, for no more than five years. The canton can also assign people who fail to comply to an insurer.
Legal basis
Art. 3 para. 1 KVG requires everyone resident in Switzerland to take out insurance within three months. Para. 2 allows the Federal Council to provide for exceptions. These are set out in Art. 2 KVV: para. 1 lists the people who are not subject to the requirement, and paras. 2 and 4–8 the exemptions on application. For paras. 4, 7 and 8, the exemption or a waiver of it cannot be revoked without a special reason; for para. 5 it cannot be revoked at all.
Under Art. 6 KVG, the cantons ensure compliance with the requirement to take out insurance and assign people who fail to comply to an insurer. Art. 10 para. 2 KVV states that the responsible cantonal authority decides on applications. The premium surcharge for late enrolment is governed by Art. 8 KVV on the basis of Art. 5 para. 2 KVG.
Example: master’s student from Germany in Zurich
Jonas, 24, moves to Zurich for a two-year master’s degree. He has private insurance in Germany, and his policy covers treatment in Switzerland at least to the extent of basic health insurance. He applies to the canton under Art. 2 para. 4 KVV and encloses confirmation from his insurer.
The 2026 premiums for the city of Zurich (region 1), born in 2002, with accident cover, show what he saves with the exemption; source FOPH:
| Basic health insurance Zurich 2026 | Monthly premium | Annual premium |
|---|---|---|
| Cheapest premium, CHF 2,500 deductible | CHF 242.90 | CHF 2,914.80 |
| Median premium, CHF 2,500 deductible | CHF 318.80 | CHF 3,825.60 |
| Median premium, CHF 300 deductible | CHF 446.10 | CHF 5,353.20 |
What this means for you
- First check whether you fall under an exception at all. The list in Art. 2 KVV is exhaustive.
- Submit your application early. The three-month deadline for joining runs from the date you take up residence. If the canton rejects your application, you must take out insurance immediately.
- Compare honestly. An exemption is only worthwhile if your foreign cover really is equivalent. You can compare Swiss basic health insurance in the premium calculator; you will find the insurers under health insurers.
- Plan for the end. When the exemption expires, register with an insurer. Every insurer must accept you for basic health insurance.
If you are in Switzerland as an international student, it is worth looking at the rules of your university and your canton.
Common mistakes
- Believing travel insurance is enough. What is required is cover that equivalently covers treatment in Switzerland, for the entire period.
- Applying too late. Without an exemption, the requirement to take out insurance applies from the date you take up residence, with a possible premium surcharge.
- Forgetting the extension. Students are exempted for a maximum of three years; after that, a new application is needed.
- Wanting to switch back and forth. Exemption and waiver are final unless there is a special reason.
We explain how we present premiums under How we calculate.
Frequently asked questions
Who can be exempted from compulsory health insurance?
Only the people named in Art. 2 KVV, for example students and trainees with equivalent foreign insurance, posted workers, non-employed people from EU/EFTA states or people whose existing cover would clearly be worse if they switched. For everyone else, the requirement to take out insurance applies without exception.
Where do I submit the exemption application?
To the responsible office in your canton of residence, often the office that checks compliance with the requirement to take out insurance. Enclose written confirmation of your foreign insurance with all the details requested.
What does equivalent insurance cover mean?
Your foreign insurance must cover treatment in Switzerland at least to the extent of basic health insurance, for the entire period of the exemption. Travel insurance with maximum amounts is usually not enough.
Can I take out Swiss insurance later after all?
You cannot revoke an exemption, or a waiver of it, without a special reason. When the exemption ends, for example because the period has expired, you must take out insurance in Switzerland.
Related terms
- Requirement to take out health insuranceThe requirement to take out insurance (Versicherungspflicht) means that anyone who lives in Switzerland must take out basic health insurance under the Health Insurance Act (KVG). You have 3 months from arrival or birth to do so, and cover then applies retroactively. If you join later, you are only insured from the date you join and, depending on the delay, pay a premium surcharge of 30 to 50%.
- Cross-border commuterCross-border commuters live abroad, work in Switzerland and usually return to their place of residence every day or at least once a week. If you come from an EU or EFTA state or the United Kingdom, you generally have to take out health insurance in Switzerland within three months of starting work. If you live in Germany, France, Italy or Austria, you can choose your country of residence instead.
- Right of optionThe right of option allows cross-border commuters resident in Germany, France, Italy or Austria to take out health insurance in their country of residence instead of in Switzerland. You must submit the application within 3 months of starting work in Switzerland. The decision is irrevocable for as long as your cross-border employment continues without interruption.
- International studentsInternational students in Switzerland are in principle required to take out health insurance, but can be exempted if they have equivalent cover. Students from the EU, EFTA and the United Kingdom who do not work stay in their home system with the European Health Insurance Card. Students from other countries apply to the canton for an exemption, for a maximum of three plus three years.
- Common Institution KVG (Gemeinsame Einrichtung KVG)The Common Institution under the Federal Health Insurance Act (Gemeinsame Einrichtung KVG) is a foundation set up by all health insurers and based in Olten. It carries out tasks that no single insurer can take on: it runs risk equalisation, pays benefits if an insurer becomes insolvent, and looks after insured persons with links to the EU, EFTA states and the United Kingdom.
- Short-term residentsShort-term residents are foreign nationals with an L permit who live in Switzerland for a limited period, usually to work. If your permit is valid for at least three months, you must take out basic health insurance within three months of registering with your municipality. For shorter permits, the requirement applies from the day you arrive, unless you have equivalent cover.
Sources
- Health Insurance Ordinance (KVV), Art. 2Art. 2 KVVfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 3Art. 3 KVGfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 6Art. 6 KVGfedlex.admin.ch
- Health Insurance Ordinance (KVV), Art. 8 and 10Art. 8 and 10 KVVfedlex.admin.ch
- FOPH: Health insurance premiums 2026 (opendata.swiss)opendata.swiss