Health insurance – « right of option » for swiss retirees abroad

Autonomie, liberté et responsabilité. Valeurs clés d'une vie digne.

Retirement is the time when you reap the rewards of your hard work. Many pensioners decide to enjoy their retirement outside Switzerland. Whether it’s to return to their families in their home country, or to escape to another country that appeals to them.

Once you’ve arrived in your new country, it’s important to be familiar with the procedures for joining the health insurance scheme as an annuitant. A procedural error can have a snowball effect, leading to difficult situations and turning seniors’ dreams into administrative nightmares. To take advantage of your health care benefits, you need to be in order with your health insurance plan.

In this article, we’ll start by telling you the story of Madame R. (who wrote to us) to give you a concrete example of the administrative difficulties faced by a pensioner abroad. Then we’ll explain the different procedures in different countries. Finally, you’ll find a link to a PDF document from the Swiss Confederation summarizing the various possible scenarios.

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The risks of an incorrect affiliation procedure

Madame R.’s story is not an isolated one. After working for many years in Switzerland, Madame R. decided to retire to the UK. However, a few years later, she moved to France to be closer to her children. Moving near Nantes, Mrs R. had no reason to move to Switzerland. She therefore opted for the CMU, which also had the advantage of costing much less than the LAMal.

When she arrived in Switzerland, it was impossible to exercise her right to opt for CMU. Madame R. discovered that she was automatically affiliated to LAMal, with over 5 years of late penalties to pay! What happened?

In reality, when she moved to the UK, Mrs R. was obliged to join the Swiss health system. Madame R. was unaware of this, and the British health insurance companies affiliated her without question. Unknowingly, Madame R. was in an irregular situation.

When she arrived in France and applied for the CMU, the French health system realized that she had been a pensioner in the UK without being affiliated to the LAMal.

This story sounds complicated, but it’s more common than it seems for Swiss pensioners living abroad to have unpleasant surprises. To avoid this type of situation, it’s important to understand the affiliation procedures for pensioners.

Health insurance for retirees abroad?

Let’s start with an essential point: if a cross-border commuter retires abroad and receives a pension from this new country of residence, then affiliation to the KVG/LAMal is impossible. They will inevitably have to join the health system of the country in which they are retiring.

For other cases, a PDF document on the Swiss Confederation website summarizes the various affiliation obligations for pensioners and their families, depending on the country in which they reside.

As you can see, countries of destination are grouped into three categories, according to the partnerships Switzerland has with them.

  1. Countries that allow an option right for the annuitant.
  2. Countries that require the annuitant to be insured by the health system of the new country of residence.
  3. Countries that require annuitants to take out insurance with KVG/LAMal.

Countries with annuitant option rights

Austria, Germany, France, Italy and Portugal offer a right of option to Swiss pensioners. In other words, annuitants can choose whether to join the health insurance scheme of their country of residence or the Swiss KVG/LAMal.

Note, however, that the right of option is limited in time. In France, for example, the right of option is open for 3 months. After this period, if no choice is made, there will be compulsory affiliations and penalties.

In these same countries, as well as in Finland and Italy, family members (not in gainful employment) of the pensioner can benefit from the right of option.

Countries with affiliation to the local health insurance system

In Liechtenstein, pensioners are obliged to join the country’s health insurance scheme. There is no way to keep the KVG/LAMal.

In Denmark, Liechtenstein, Portugal, Spain, Sweden and the United Kingdom, members of the pensioner’s family who are not gainfully employed must be insured in the pensioner’s country of residence.

Countries with KVG/LAMal affiliation

In most countries, pensioners must join the Swiss healthcare system.

These include Belgium, Bulgaria, Cyprus, the Czech Republic, Denmark, Estonia, Greece, Spain, Finland, Croatia, Hungary, Iceland, Ireland, Lithuania, Luxembourg, Latvia, Malta, the Netherlands, Norway, Poland, Romania, Sweden, Slovenia, Slovakia and the United Kingdom.

Members of the pensioner’s family who are not gainfully employed must also be affiliated in Switzerland. Except in Denmark, Finland, Spain, Sweden and the UK.

Summary table

Droit d'option pour assurance-maladie des rentiers à l'étranger (en allemand)

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