Right of option

What is the right of option?

The right of option (Optionsrecht) is a choice available to cross-border commuters. It allows you to be exempted from compulsory insurance in Switzerland and to remain in, or join, the health insurance system of your country of residence.

The starting point is compulsory insurance. Under the Agreement on the Free Movement of Persons between Switzerland and the EU, social security is in principle governed by the law of the state in which you work. If you work in Switzerland and live in an EU state, you are therefore subject to compulsory Swiss basic health insurance, as are your family members who are not in gainful employment. Annex II of the agreement, however, allows exceptions: Switzerland has agreed with Germany, France, Italy and Austria that cross-border commuters from these countries can choose. Cross-border commuters from all other EU/EFTA states do not have this choice.

The right of option is a form of exemption from compulsory insurance. It does not take effect automatically: you have to actively submit an application. If you do nothing, you remain subject to compulsory insurance in Switzerland. According to the FOPH (Federal Office of Public Health), exercising the right of option tacitly is not legally valid.

Similar rights of choice exist for other groups, for example for pensioners with a Swiss pension in certain EU states or for family members of people working in Switzerland. This page covers the most common case, cross-border commuters.

How it works

1. Starting work. Compulsory insurance begins when you start working in Switzerland. The 3-month deadline runs from that day.
2. Making your decision. You compare Swiss basic health insurance with insurance in your country of residence: premiums, benefits, treatment in your country of residence and in Switzerland, family.
3. Submitting the application. If you want to be insured in your country of residence, you submit an application for exemption to the competent canton where you work within 3 months. Depending on the canton, the application goes through the cantonal office or through the web portal of the Common Institution under the Federal Health Insurance Act (Gemeinsame Einrichtung KVG). You enclose a notification form, proof of insurance cover in your state of residence and in Switzerland, and proof of your cross-border employment, such as the G permit.
4. France: cross-border commuters resident in France also have the form “Choix du système d’assurance-maladie” (choice of health insurance system) confirmed by the French health insurance fund CPAM within 3 months.
5. Decision of the canton. The cantonal authority decides on the exemption.

If you choose Switzerland, you must take out insurance with a Swiss health insurer within 3 months. Cover then starts retroactively from the date you became subject to insurance. You pay the premiums that apply to your country of residence, not those of a Swiss premium region. If you miss the deadline altogether, the competent cantonal authority assigns you to a health insurer.

Legal basis

Compulsory insurance for people resident in the EU who are subject to Swiss insurance under the Agreement on the Free Movement of Persons and its Annex II is set out in Art. 1 para. 2 let. d of the Health Insurance Ordinance (KVV). Under Art. 7 para. 8 KVV, they must take out insurance within 3 months of becoming subject to compulsory insurance; cover then starts from that date, otherwise only from the date they join.

The right of option itself derives from Annex II of the Agreement on the Free Movement of Persons. In Switzerland, it is implemented by Art. 2 para. 6 KVV: people resident in an EU state who can be exempted under the agreement and prove that they are covered in the event of illness in their state of residence and during a stay in another EU state and in Switzerland are exempted from compulsory insurance on application.

The cantons are responsible. Art. 6a of the Federal Health Insurance Act (KVG/LAMal) obliges them to inform cross-border commuters about compulsory insurance. The authority designated by the canton decides on applications for exemption and assigns people who do not take out insurance in time to a health insurer (Art. 6a para. 3 KVG).

The 3-month deadline from the start of employment, the irrevocability and the special rules for family members are described by the FOPH and the Common Institution under the Federal Health Insurance Act in their information sheets (see sources).

Example: starting a job in Basel

Tobias, 31, lives in Lörrach (Germany) and starts a job in Basel on 01.02.2026. His partner does not work; they have one child.

What this means for you

The right of option is a decision for many years. Before the 3 months are up, clarify these questions:

1. What does Swiss basic health insurance cost for your country of residence? Health insurers have separate premiums for insured persons in the EU. The overview of health insurers takes you to the individual insurers; the premium calculator shows Swiss premiums for residents of Switzerland.
2. Where do you want to get treatment? Cover for treatment in your country of residence and in Switzerland differs depending on the country and system.
3. How is your family insured? If your spouse works in your country of residence, they and the children must be insured there; Swiss insurance for the children is then not possible.
4. How long will you remain a cross-border commuter? As long as you work without interruption, your choice applies. A change of employer does not change anything.

If you choose Switzerland, the normal rules of basic health insurance apply, such as the deductible, the retention fee and premiums that depend on your place of residence. The page Switching explains when you can change health insurer. If you have questions about your situation, you can submit a request.

Common mistakes

• Missing the deadline. After 3 months, the right of option is gone and the canton can assign you to a Swiss health insurer.
• Believing that doing nothing is a choice. Exercising the option tacitly is not valid. Without an application, you remain subject to compulsory insurance in Switzerland.
• Being insured twice. If you act too late, you may end up paying premiums both in your country of residence and in Switzerland.
• Hoping to switch later. Higher premiums, a new employer or a different canton of work do not give you a new right of option.
• Forgetting the family. Clarify whether your family members choose together with you or, as with Germany, separately.

How we build sources and examples is explained under How we calculate.