Health, accidents and maternity insurance

According to the Swiss Federal Law on Health Insurance (KVG/LAMal), each person residing in Switzerland must take out health insurance or get insured by their legal representative within three months after taking up residence or after the birth of a child in Switzerland. Since the Swiss insurance obligation begins from the very first day of either arrival or birth in Switzerland, the start date of the insurance contract must coincide with that date. Some categories of people may request the relevant exemption (see following chapter).

Every individual can choose freely between the health insurers (health insurance companies) recognized and authorized to operate by the Swiss Federal Office of Public Health (FOPH). To access the complete list, click here.

Through the websites Priminfo and Comparis.ch it is possible to compare the various offers available and choose the most suitable one.

The insured person bears part of the costs of health by paying:

• the premiums, which vary according to the age, canton of residence, insurer and insurance plan chosen by the insured (for example, for a 20-year-old between 200 CHF and 500 CHF per month);
• the deductible (aka. franchise), which for adults varies between a minimum of 300 CHF and a maximum of 2500 CHF per calendar year (the higher the annual deductible, the lower the monthly premium);
• the co-payment - once the annual deductible has been reached and exceeded, the additional 10% share must be paid on any subsequent expenses up to a maximum of 700 CHF per calendar year;
• contribution to the costs of a hospital stay - 15 CHF per each day spent in hospital (with no time limit).

The remaining costs are borne by the insurer, if covered by the chosen policy.

According to article 2 paragraph 4 of the Swiss Health Insurance Ordinance (KVV/OAMal), on request, foreign students, pupils, trainees and interns who hold the residence permit for study purposes (i.e., the one with the notation “soggiorno per formazione”) can apply for exemption from Swiss compulsory health insurance, provided that they have a policy offering equivalent coverage. The competent cantonal authority (for the Canton of Ticino, it is the Istituto delle assicurazioni sociali in Bellinzona) can exempt these persons from the obligation to take out health insurance in Switzerland for a maximum of 6 years.

Foreign insurances recognized as equivalent to that required by the Swiss Federal Law on Health Insurance (KVG/LAMal) are the following:

• the European Health Insurance Card (EHIC) - accepted only for students who are at the same time citizens and residents of an EU/EFTA state (form TI 6.1);

The only exception relates to students with non-EU/EFTA citizenship who come from Germany and are insured with the German EHIC, as Germany is the only state that still covers the healthcare services obtained in Switzerland by Third-country nationals.

• the Global Health Insurance Card (GHIC) - accepted only for British students coming from the United Kingdom (form TI 6.1);
• foreign private insurances that provide a coverage that is financially unlimited and equivalent to the one guaranteed by the Swiss Federal Law on Health Insurance (KVG/LAMal) - accepted both for students coming from EU/EFTA states (form TI 6.2) and for those who come from non-EU/EFTA states (form TI 6.3).

Foreign students who do not have any of the above-mentioned insurances are subject to compulsory health insurance in Switzerland. As an alternative to the Swiss state health insurance (KVG/LAMal), through USI they have the possibility to take out and apply for exemption with the Swiss private health insurance (VVG/LCA) “Swisscare”. For more details, click here.

The non-subjection/exemption request form, duly filled out, signed (the signature must be handwritten, digital signatures are not accepted) and accompanied by the required attachments, must be delivered to the Istituto delle assicurazioni sociali within three months from the date of entry in Switzerland. The documentation relating to "Swisscare" must instead be submitted to the responsible persons at USI in the office 350 of the main building, who, after having carried out the necessary checks, will forward it to the IAS.

Those students who haven’t received the residence permit for the Canton of Ticino by the aforementioned deadline, instead of it, can submit the Notification of arrival issued by either the Residents’ registration office or by the Migration office. The documentation will have to be completed later on with a copy of the residence permit as soon as the student receives it.

Late requests cannot be accepted and, after the period of three months from the arrival has passed, students are required to take out Swiss compulsory health insurance (KVG/LAMal) for the entire duration of their stay.

If the relevant request is accepted, the exemption is granted until the expiry date of the residence permit. Therefore, the exemption request must be renewed annually by sending, by email, the copy of the front and back of the new residence permit to the IAS.

For more information, please contact:

Istituto delle assicurazioni sociali

Settore obbligo assicurativo

Via C. Ghiringhelli 15a
6501 Bellinzona

Tel. +41 91 821 91 11

e-mail: [email protected]

Web page: www.iasticino.ch

The exemption from Swiss compulsory health insurance can not be granted to:

• PhD students with an employment contract (holders of a residence permit for gainful employment);
• doctoral students and visiting researchers who are beneficiaries of a scholarship awarded by either the Swiss Confederation or by a foreign body.

They are subject to the compulsory health insurance in Switzerland in accordance with the Federal Law on Health Insurance (LAMal/KVG) starting from the day of their arrival in Switzerland and must take out an insurance policy as explained at the top of this page.

Every student who has benefited from the exemption during their studies loses the right to it as soon as he/she:

• ends the studies (graduation, withdrawal, “ex-officio” de-registration or exclusion from the studies), or
• leaves permanently the Canton of Ticino/Switzerland, or
• starts a gainful employment (internship or work) which is not mandatory for the completion of the studies, or
• undertakes the practices for family reunification (e.g., marriage to a Swiss citizen or a foreign citizen residing in Switzerland), or
• reaches 6 years of exemption, which is the maximum duration allowed (KVV/OAMal), or
• no longer meets the criteria for exemption according to the Swiss Health Insurance Ordinance (KVV/OAMal) and becomes subject to compulsory health insurance in Switzerland in accordance with the Swiss Federal Law on Health Insurance (KVG/LAMal) for some other reason.

Please note that the event that determines the termination of the right to exemption is the one which occurs first.

From the day following the end of the exemption, those who remain in Switzerland are subject to the compulsory health insurance (KVG/LAMal) and must take out an insurance policy, as explained at the beginning of this page.

Everyone is required to inform the Istituto delle assicurazioni sociali and, if they have it, their insurance company of any relevant changes, such as:

• change of address;
• issue, renewal, modification or revocation of the residence permit;
• end of studies;
• definitive departure from the Canton of Ticino/Switzerland;
• start of a gainful employment;
• change of marital status;
• any other changes relevant to insurance coverage.

Foreign students and researchers applying for a reduction of the compulsory health insurance premiums, according to the legislation concerning foreigners, show that they lack the financial means required to support themselves in Switzerland during their studies and, as a consequence, their residence permit B or L may be revoked or denied by the relevant cantonal authority.

In the event of an illness or accident, the student who has been exempted from the Swiss compulsory insurance thanks to his/her European Health Insurance Card (EHIC) will be required to pay the expenses in advance (cash or credit card). The reimbursement, with the appropriate deductions, may be requested by sending a copy of the invoice and of the EHIC to the following address:

Gemeinsame Einrichtung KVG

Industriestrasse 78

CH-4600 Olten

For information, please visit the web page www.kvg.org.

Students who maintain their residence in their home country (residence abroad) - e.g., Italian students living in the border area and returning home every day - and who therefore do not hold a residence permit in Switzerland (B or L) are required to be duly informed on the regulations in their country.

These students may receive emergency treatments in Switzerland, but must then, if they are unable to pay the necessary deposit or if they are not sufficiently covered in their home country, return home to undergo further treatment.