Agreement on the Free Movement of Persons

What is the Agreement on the Free Movement of Persons?

The Agreement on the Free Movement of Persons (AFMP) is a treaty between Switzerland on the one hand and the European Community and its member states on the other. It was signed on 21 June 1999 as part of the Bilateral Agreements I and has been in force since 1 June 2002. Its main aim is to allow nationals of Switzerland and the EU to live and work in each other’s territory.

For this to work, social insurance systems must also fit together. Otherwise someone who works in Basel and lives in Lörrach could have to pay contributions in both states, or in neither. Art. 8 AFMP therefore requires the social security systems to be coordinated, as set out in Annex II. Annex II refers to the EU regulations, today mainly Regulation (EC) No 883/2004 and its implementing Regulation (EC) No 987/2009. Switzerland also applies them to health insurance through Art. 95a of the Federal Health Insurance Act (KVG).

The AFMP does not harmonise the systems. Swiss basic health insurance, with its per-person premium, deductible and free choice of health insurer, stays as it is, and the EU states keep their own systems. The agreement only says which system applies to whom. Who is covered depends on nationality (Switzerland or the EU, plus refugees, stateless persons and family members) and on whether the person is or was covered by the social insurance of a contracting state.

How it works

Coordination follows a few principles:

• Only one state. You are always subject to the legislation of a single state.
• Principle of the place of work. If you work, you are insured where you work. Cross-border commuters who live in the EU and work in Switzerland therefore belong in Swiss basic health insurance, as do their family members who are not in employment.
• The pension follows responsibility. If you receive only a Swiss pension and live in the EU, you remain insured in Switzerland. Details are under pensioners abroad.
• Posting as an exception. If you work temporarily in the EU for your Swiss employer, you remain in the Swiss system for up to 24 months with an A1 certificate. More under posting.
• International benefits assistance. If you are insured in one state and treated in another, you receive benefits under the law of the state of treatment. During a temporary stay, the European Health Insurance Card (EHIC) is used for this.

Switzerland has agreed special rules with Germany, France, Italy and Austria, and for pensioners also with Spain and Portugal: if you live there, you can take out insurance in your country of residence instead of in Switzerland. This is the right of option. It must be exercised by submitting an application.

Insured persons living in the EU do not pay the premium of a Swiss municipality, but the premium that their insurer calculates for their country of residence. Optional deductibles and alternative models are not open to them. On a low income, premium subsidies are available: for cross-border commuters, family members of employed persons and unemployed persons from the canton, for pensioners from the Confederation.

Legal basis

Art. 8 AFMP requires the contracting parties to coordinate social security systems in accordance with Annex II, in particular to ensure equal treatment, to determine the applicable legislation, to aggregate insurance periods and to pay benefits to persons resident in a contracting state. Art. 95a para. 1 KVG declares Regulations (EC) No 883/2004 and No 987/2009, in the version of Annex II binding on Switzerland, applicable to health insurance; para. 2 does the same for the EFTA states.

The Health Insurance Ordinance (KVV) implements this. Art. 1 para. 2 let. d KVV makes persons resident in the EU subject to Swiss insurance where the AFMP requires it; lets. f and g cover short-term residents and persons under the notification procedure. Art. 2 para. 1 lets. c–g KVV exempt persons who are subject to the law of another state under the AFMP, and Art. 2 para. 6 KVV is the basis for the right of option. Premium subsidies for insured persons in the EU are set out in Art. 65a KVG (cantons) and Art. 66a KVG (Confederation for pensioners).

Example: four people, four responsibilities

The table shows which state is responsible for health insurance in 2026. All the people are nationals of Switzerland or an EU state.

What this means for you

With every cross-border step, consider whether responsibility changes:

1. A new job across the border. If you start working in Switzerland and live in the EU, you must take out insurance within three months or exercise the right of option.
2. Moving with a pension. If you move to the EU with a Swiss pension, do not cancel your health insurance; check whether your insurer offers cover in your new country of residence.
3. Posting. Before you leave, apply for the A1 certificate from the AHV compensation office.
4. Holidays and studies. Pack the EHIC. If you do not have one, ask your insurer.

The profiles under health insurers show which insurers offer what. If you live in Switzerland, you can compare premiums in the premium calculator. The deadlines for switching insurer are under deadlines.

Common mistakes

• Automatically cancelling when moving to the EU. If you receive a Swiss pension, work in Switzerland or receive unemployment benefit from Switzerland, you often remain insured in Switzerland.
• Assuming the right of option applies tacitly. It always requires a formal application within a deadline.
• Using the EHIC for planned treatment. It applies to medically necessary treatment during a temporary stay, not to a planned operation abroad.
• Confusing the AFMP with the arrangement for the United Kingdom. Since Brexit, a separate agreement with similar rules applies.

You can find more terms on living abroad and cross-border work in the glossary.