If you emigrate, you are generally no longer liable to compulsory insurance in Switzerland. In that case, international health insurance can be a good solution. Read here when international insurance makes sense and what you need to bear in mind.
Who needs international health insurance?
If you have an accident or become seriously ill without having accident and health insurance, it can quickly become very expensive. Good insurance is essential. You do not always need private international health insurance.
Step 1: Are you automatically or compulsorily insured?
If you live in Switzerland, you are subject to compulsory health insurance under Article 3, paragraph 1 of the Health Insurance Act (KVG).
In other words, you must take out insurance with a Swiss health insurance fund – if you do not do so, you may be assigned a health insurance fund. With this legally regulated basic insurance, you benefit from very good insurance cover compared to many other countries in the world. However, when you emigrate, you give up your Swiss domicile, which basically means that you leave the compulsory insurance scheme and can no longer take out basic insurance in Switzerland. If the health insurance company subsequently finds out that you’ve moved abroad, it doesn’t have to cover medical costs, even if you have always paid the premiums dutifully. Only in special cases do you remain subject to compulsory insurance in Switzerland, for example as a posted person, cross-border commuter, ICRC employee, certain pensioners and globetrotters.
Switzerland is not the only country that has compulsory insurance. In other countries, too, you have to take out insurance or you are automatically covered by health insurance as a taxpayer or resident of the country.
Due to the bilateral agreements between Switzerland and the EU, but also EFTA, there are special rules when taking up residence in the EU or EFTA. These define in which country – Switzerland or the new country of residence – you are subject to compulsory insurance. Due to these rules, you actually always have access to health insurance in the EU/EFTA, at least as a Swiss pensioner and as an employed person. If you are self-employed or non-employed, you need more detailed clarification. You can read more about this here. As a rule, you do not need international health insurance.
In many cases where you are automatically or compulsorily insured, this insurance is sufficient. In other cases, for example, if the state health system is unreliable, it may be worthwhile to take out additional private international insurance. So, before you take out international health insurance, check whether you are obliged to participate in the public health insurance system in the new country or whether international health insurance is accepted as an alternative. If the public benefits in the new country are unsatisfactory, it might be advisable to have dual coverage (public and private/international).
Step 2: Does the country of residence give access to good health insurance?
In certain countries, you will not automatically be covered by health insurance, nor is health insurance compulsory, but you still have options to get good health insurance. This can be a good solution especially if the health care system is sufficiently good and you will primarily be staying in that country. Often these local health insurance solutions, which are basically limited to the country of residence, are cheaper than an international private insurance that covers you (almost) everywhere in the world. If there are no good local insurance options or if you travel a lot and therefore want to have health insurance in more than one country, for example also in Switzerland, then again international health insurance may be a good option.
Step 3: What is the health system like in the country of residence?
You may have the option of accident and sickness insurance in your country of residence, but the health system is not convincing. In this case, you may want to have the option of being treated in another country. In this case, too, international health insurance can make sense.
What kind of international health insurance should it be?
If you come to the conclusion that international health insurance is appropriate, then the question arises as to what kind of insurance it should be. There are many different providers and the differences in costs and benefits are great.
A Swiss or a foreign international insurance solution?
A few Swiss health insurance companies also offer international health insurance. These have the advantage that you can usually convert the insurance to supplementary insurance when you return to Switzerland. The coverage is usually very good. From an administrative point of view, it can also be pleasant to have a Swiss contact person. In order to take out international insurance with a Swiss health insurance company, you must (still) be resident in Switzerland. Therefore, if you have already emigrated, you will generally not be able to do so retroactively. This is because Swiss health insurance companies are generally not allowed to sell insurance abroad due to the regulatory environment. However, this only applies to health insurance policies registered in Switzerland – international providers are not affected.
There are numerous foreign international providers. Some of them are cheaper, but not always really cheaper. So, you have to look carefully.
What can and do you want to afford, what are your priorities?
Expensive is not always good, but a cheap insurance often offers only limited coverage or saves on service. Especially if finances are rather tight, it pays to think carefully about what you want to be covered for.
Depending on the insurance, you can put together a package of insurance benefits according to your needs and, for example, only insure hospital costs or exclude pregnancy. But be careful – think carefully about what it takes. Today, more and more procedures are performed on an outpatient basis and medications can be more expensive than a standard surgery. In some cases, it makes more sense and the risks are more assessable if you control costs through the deductible than by excluding certain areas of insurance.
What are other hurdles?
The biggest hurdle is usually that international insurance doesn’t have to take you. If you have reached a certain age or have pre-existing conditions then the insurance company may reject you – or charge higher premiums. Alternatively, insurance companies can add exclusions to exclude anything related to pre-existing conditions. These exclusions can go a long way and put you in the unpleasant situation of always having to prove that the new condition is not related to the pre-existing condition. You have the same problem with many insurance plans that do not require a health exam. Even with these, any pre-existing conditions are usually excluded. But exceptions prove the rules. For example, there are insurances that cover insured persons without a health check if they have already been privately or semi-privately insured before through supplementary insurances. Again, read the fine print and ask, so there are no unpleasant surprises later.
What is the difference to travel insurance?
Travel insurance is suitable if you are only temporarily leaving Switzerland or your new country to travel or go on vacation. It typically covers cancellation costs, insures your luggage against theft and assists with any necessary repatriation to your country of residence in the event of a medical emergency. Travel insurance policies assume that you have health insurance in your country of residence, which then covers further treatment costs.
Back to Switzerland in case of doubt?
Many Swiss people have in mind to come back to Switzerland in case of illness and then have the costs covered by the mandatory insurance. However, this does not always work. If you travel to Switzerland specifically for treatment, your basic insurance does not have to cover it – and you may not even be able to make the trip and then have to register with the municipality to get covered again. Also, travel insurance or international insurance with repatriation clauses will not necessarily get you back to Switzerland if you did not name Switzerland as your country of residence when you took out the policy and/or do not have coverage in Switzerland.
Take your time
To find an international health insurance plan that is tailored to your needs and affordable, you need enough time. On one side are your needs (which benefits/risks you want to have covered), on the other side are the conditions of the insurance providers, such as the age limit or pre-existing conditions, which can lead to exclusions or rejection by the insurance company.
Last, the costs also play a big role, similar to the conclusion of a domestic supplementary insurance. Then you have to apply and wait for the acceptance decision.
It is therefore worthwhile to take care of this as early as possible before emigrating. The deregistration from the municipality should, whenever possible, be done after the conclusion of the international health insurance, so that you keep your options open as much as possible.