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Reader question: What happens if I don't buy Swiss health insurance?

Helena Bachmann
Helena Bachmann - [email protected]
Reader question: What happens if I don't buy Swiss health insurance?
You need health insurance to get medical care. Image by Silas Camargo Silão from Pixabay

People who are rarely ill may prefer not to purchase Switzerland’s obligatory basic health policy, and instead pay out of pocket for any medical costs they incur. But is this allowed?

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Say you are a healthy young(ish) person who never, or very rarely, goes to a doctor. You may think that paying several hundred francs a month for your health insurance is an unnecessary and — depending on your financial situation — extravagant expenditure.

You’d rather put aside a bit of money each month just in case you ever need to seek medical help, and pay your bill from that stash.

While this may seem like a reasonable idea and is, in fact, common in countries like the United States, it won’t fly in Switzerland.

As you already know if you live in the country, or should know if you are about to move here, the basic health insurance coverage (KVG in German and LaMal in French and Italian) are compulsory in Switzerland for all permanent residents regardless of their nationality or health status. (There are some exemptions from this rule, though — see below).

Without a health insurance policy, you will not only be refused medical care other than for vital emergencies, but you will also not be able to register at your commune of residence, rent an apartment, get employment, and be denied many other services as well.

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This is what you should know (if you don’t already)

As soon as you settle in Switzerland, you will receive a letter from your canton telling you to purchase, within three months of your arrival, a health insurance policy for you and all the members of your family from one of the dozens of approved providers

After you do so, you must send the authorities a copy of your policy to prove that you have one. All that is required is the KVG / LaMal; a supplemental policy is optional, and you don’t have to provide a copy of it.

It doesn’t matter to the authorities whether you have a ‘regular’ plan or have taken out a cheaper policy like a family doctor model or the Telmed alternative.

What counts is that you have an approved and accepted policy.

READ MORE: How much does health insurance cost in Switzerland

What happens if you don’t?

This means you are breaking the law. And don’t expect to stay under the radar because you never get ill or go to a doctor.

Sooner or later (probably sooner, given the Swiss organisational skills), your non-compliance will be discovered.

If you don’t provide proof of being insured after the three-month period is over, the next step depends on your canton of residence.

Some will ‘play nice’ and send you a reminder by a registered letter. Others won’t.

In both cases, the outcome is the same: authorities will purchase a policy for you and send you the bill. The disadvantage of this ‘forced’ policy is that you will forego the choice of cheaper companies and plans.

As we mentioned above, if you still refuse to pay health insurance, you won't be able to do very much and you will be denied services. 

Why can’t you opt to ‘pay-as-you-go’ rather than take out an insurance?

As mentioned, healthcare policy is compulsory, and you can’t argue with the law.

But there is another point as well.

Switzerland’s scheme is based on the principle of solidarity, the extent of which is rare in other nations’ health insurance systems.

Rather than applying an individual approach to healthcare insurance, Switzerland’s system is based on the idea that all insured people form a group.

You can think of this system in terms of a huge pot to which each resident of Switzerland makes a contribution (that is, premium payments), so that in an emergency there are enough resources available to give someone the help they need when they need it.

However, this system will only work if everyone plays a part in it.

READ MORE: EXPLAINED: How the Swiss health insurance system is based on solidarity

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Who is exempted from the healthcare insurance rule?

You are not required to take out Swiss insurance if:

  • You are retired and get a pension exclusively in an EU or EFTA state
  • You are a cross-border worker with healthcare policy in a EU or EFTA state
  • You are a foreign student and have comparable insurance from your country
  • You work for international organisations or are a diplomat

All others must buy an insurance policy.

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