For US expats moving to Switzerland, navigating the Swiss health insurance system can often feel overwhelming.
With its mandatory requirements, supplementary options, and unique considerations, it’s essential to understand how Swiss insurance works to ensure you and your family are adequately protected.
To help break it all down, Arielle Tucker, CFP(r) & EA, recently spoke with Jenny Goodwin, an independent broker and the owner of InSwift, which specializes in helping expats navigate the Swiss insurance landscape. Jenny provided valuable insights into what’s required, what’s recommended, and how to make informed decisions about your coverage.
Mandatory Insurance in Switzerland
Swiss law requires residents to have specific types of insurance to ensure basic protection. Here are the key mandatory insurances:
1. Basic Health Insurance (Lamal/KVG)
Basic health insurance is compulsory for all Swiss residents, whether employed or not. Within 90 days of arrival, new residents must provide proof of coverage, and policies are retroactively applied to the date of entry.
The cost and coverage are standardized across providers, meaning the benefits you receive will be the same, but premiums may vary.
According to the Swiss Federal Office of Public Health (FOPH), basic insurance covers essential medical services, including: (1)
- Visits to general practitioners and specialists
- Hospital stays in the general ward of public hospitals within your canton
- Medications on the approved list
- Maternity care (fully covered without a deductible, including routine antenatal and postnatal check-ups, childbirth, and breastfeeding consultations) (2)
- Some preventive care, including vaccinations
However, policyholders must contribute through deductibles (franchises) and co-payments (10% of costs up to CHF 700 per year for adults).
2. Accident Insurance
If you are employed for at least eight hours per week by the same employer, your accident insurance is covered by them.
However, self-employed individuals, part-time workers below the threshold, and non-working spouses or children must purchase accident coverage separately through their health insurance provider.
3. Third-Party Liability Insurance
While not mandated for all residents, third-party liability insurance is often required when renting a home. It covers damages caused to other people or their property, making it a critical policy for expats. Additionally, liability insurance is mandatory for dog owners, drone operators (depending on the weight of the drone), and vehicle owners.
4. Natural Hazards Insurance
In some Swiss cantons, residents must carry natural hazards insurance, covering fire, flood, and other environmental damages. This requirement varies by location, so be sure to check with your local authorities.
Recommended Swiss Health Insurance for Expats
Beyond the legal requirements, U.S. expats should consider additional policies to ensure comprehensive coverage.
1. Supplementary Health Insurance
Basic health insurance is just that, basic. Supplementary health insurance allows you to access additional benefits such as:
- Coverage for out-of-canton hospital treatment
- Alternative therapies (e.g., acupuncture, osteopathy)
- Orthodontic care for children (must be secured before treatment needs are identified)
- Contributions toward gym memberships or wellness programs
- Private or semi-private hospital rooms
2. Travel Insurance
For expats who travel frequently, having an annual travel insurance policy can be a lifesaver. Travel insurance typically covers:
- Emergency medical expenses abroad
- Trip cancellations or interruptions
- Lost or stolen luggage
- Repatriation costs in case of a medical emergency
3. Legal Insurance
Legal insurance is one of the most valuable yet underrated policies for expats. It provides access to legal advice and assistance in cases of disputes related to employment contracts, rental agreements, consumer rights, and more. (3) It’s a small investment that can save thousands in legal fees.
4. Household Contents Insurance
Contents insurance protects personal belongings from theft, fire, and water damage. U.S. expats should also consider:
- Key insurance: If you lose the key to a rented apartment, you may be liable for replacing the entire building’s lock system.
- Theft away from home: Coverage for stolen personal items while traveling or outside the home.
- Casco (all-risk) coverage: Protection for accidental damage to your valuables.
5. Vehicle Insurance
Car owners in Switzerland are required to have third-party liability insurance. Expats should also consider:
- Partial Casco: Covers theft, natural hazards, and animal-related damage.
- Full Casco: Includes collision coverage for your own vehicle in case of an accident.
- Breakdown assistance: Particularly useful for e-bike owners who rely on their bike for daily transport.
6. Pet Insurance
Vet care in Switzerland can be expensive, making pet insurance a worthwhile consideration. Policies cover routine care, accidents, and serious medical conditions, with premiums increasing as pets age.
7. Ski & Mountain Rescue Coverage
Helicopter rescues are common in Switzerland’s mountains and are not covered under basic insurance. If you ski or hike frequently, ensure that your supplementary or travel insurance includes emergency rescue coverage.
8. Life Insurance
For US expats, securing life insurance before relocating to Switzerland can be beneficial.
Term life insurance in the US is often significantly cheaper than in Switzerland, as Swiss term insurance has a much smaller pool of applicants compared to the US market.
Expats should ensure that their US policy remains valid after a change in residency and that there are no restrictions on payouts due to international status. Consulting with an insurance provider before moving can help avoid gaps in coverage and ensure continued financial protection for loved ones.
Key Considerations for U.S. Expats
Health Insurance Enrollment & Premium Adjustments
Swiss health insurance follows a calendar-year system, and changes to your plan (e.g., switching providers or adjusting your deductible) must be made by the last working day of November for the following year.
Maternity and Newborn Coverage
Under Swiss law, maternity care is fully covered without requiring a deductible or co-payment. This includes:
- Seven routine antenatal check-ups
- Two ultrasound exams (between weeks 12-14 and 20-23 of pregnancy)
- Childbirth (hospital, birthing center, or home)
- Postnatal check-ups between weeks 6-10 after birth
- Breastfeeding consultations
- Newborn care, including routine health checks during the mother's hospital stay (4)
Medicare Considerations for US Expats
For US expats who plan to split their retirement between Switzerland and the US, Medicare enrollment timing is crucial. If you are currently working or plan to work in Switzerland, be sure to review how your Swiss Pillar 2 contributions affect your planning.
Individuals who have worked in the US for at least 10 years (40 quarters) generally qualify for premium-free Medicare Part A. (5) However, failing to enroll in Medicare Part B when first eligible may result in lifelong penalties. More broadly, expats should discuss expat retirement strategies with their tax advisor and review the recent Windfall Elimination Provision repeal.
U.S. expats should carefully evaluate when to start Medicare, especially if they plan to return to the US for extended periods. The Centers for Medicare & Medicaid Services (CMS) provides guidance for US citizens living abroad on Medicare enrollment and coverage. (6)
Final Thoughts
Navigating Swiss insurance can be complex, but understanding the key requirements and available options ensures you have the right coverage for your needs.
Whether you’re securing mandatory health insurance, considering supplementary plans, or protecting yourself with travel and liability insurance, taking the time to assess your policies will provide peace of mind as you settle into your new life in Switzerland.
References
- Health insurance
- Health insurance benefits
- Legal insurance in Switzerland
- See 2.
- Who’s Eligible for Medicare?
- Key Messages for Medicare Enrollment
Meet the Author
Arielle Tucker is a Certified Financial Planner™ and IRS Enrolled Agent with Connected Financial Planning. She's spent over a decade working with U.S. expats on U.S. tax and financial planning issues. She is passionate about working with U.S. expats and their families to help secure a financial future that is reflective of their core values. Arielle grew up in New York and has lived throughout the U.S., Germany, and Switzerland.