Pensioners abroad

What is meant by pensioners abroad?

In health insurance, “pensioners abroad” means people who receive a pension from Switzerland, for example an old-age and survivors’ insurance (AHV) or invalidity insurance (IV) pension, and have moved their residence abroad. An exception to the residence principle applies to them: although they no longer live in Switzerland, they can remain subject to compulsory insurance in Swiss basic health insurance under the Federal Health Insurance Act (KVG).

What matters is where you move to. For the EU, Iceland, Norway and the United Kingdom, the coordination rules of the Agreement on the Free Movement of Persons, the EFTA Convention and the agreement with the United Kingdom apply. They state: health insurance follows the pension. If you only have a Swiss pension, you belong to the Swiss system. For all other states, only Swiss law applies, and it is linked to residence. If you move there, you leave Swiss basic health insurance, like any other person moving abroad.

The rules apply to Swiss citizens as well as to nationals of EU and EFTA states. They do not apply to Swiss abroad who do not have a Swiss pension.

How it works

Which state is responsible

The right of option

Switzerland has concluded special arrangements with Germany, France, Italy, Austria and other states such as Spain. Pensioners there can be insured in their country of residence instead of in Switzerland. The FOPH (Federal Office of Public Health) describes the right of option for pension recipients “with EU citizenship”; if you only hold a Swiss passport, check with the Common Institution under the Federal Health Insurance Act before you move whether you can exercise it. To do so, you submit an application for exemption to the Common Institution in Olten. The deadline is three months from your first pension payment or from your move. If you live in Spain, you can exercise the right of option at any time. With Portugal, a right of option only applies to the pensioner themselves; family members who are not gainfully employed take out insurance in Portugal. The right of option cannot be exercised tacitly; a formal application is required. If you do not submit an application, the Common Institution assigns you to a Swiss health insurer.

Premiums, deductible and treatment

If you remain insured in Switzerland, you pay the premium that your health insurer has set for your country of residence. According to the FOPH, around a third of Swiss health insurers offer this insurance, some only for individual states. Optional deductibles, bonus insurance and models with a restricted choice of service provider are not available to you. If your income is low, the federal government grants a premium subsidy, administered by the Common Institution.

In your country of residence, you are treated according to its rules; in Switzerland, you can choose freely among the listed hospitals for inpatient treatment. For travel within Europe, you use the European Health Insurance Card.

Legal basis

Art. 1 para. 2 let. d of the Health Insurance Ordinance (KVV) makes people resident in an EU member state subject to Swiss compulsory insurance if they are subject to Swiss insurance under the Agreement on the Free Movement of Persons and its Annex II; let. e and ebis do the same for Iceland, Norway and states with social security agreements. Art. 2 para. 1 let. e KVV exempts people who do not have a Swiss pension but receive a pension from an EU state, Iceland, Norway or the United Kingdom. Art. 2 para. 6 KVV allows exemption on application if the agreement permits it and you are covered for illness in your state of residence, in other EU states and in Switzerland. This is the legal basis of the right of option.

Art. 92a KVV allows the insurer to charge premiums in Swiss francs or euros and quarterly. Art. 101a KVV excludes the special types of insurance (optional deductibles, bonus, restricted choice of service provider) for insured persons living in the EU, Iceland, Norway or the United Kingdom. Art. 41 para. 2 and 2ter KVG govern the free choice among listed hospitals and reimbursement according to the tariff of the reference canton. Art. 66a KVG requires the federal government to grant premium subsidies to pensioners of modest means.

Example: three couples move away in 2026

Three couples, all 66 years old and receiving an AHV pension, move their residence abroad on 1 April 2026. None of them has ever worked in their new country of residence.

What this means for you

Plan the change at least three months before you move:

1. Clarify responsibility. Check whether you only receive a Swiss pension or also a pension from your new country of residence.
2. Check the right of option. In Germany, France, Italy, Austria, Spain and Portugal, compare the Swiss premium for your country of residence with the contributions in your country of residence. Note the three-month deadline.
3. Inform your health insurer. If your current insurer does not offer insurance in your country of residence, you have to switch. The profiles under Health insurers help you find contact details.
4. Check supplementary insurance. It is governed by private law and continues or ends according to the contract. If you cancel it, you will often only get it back later after a health check.

If you are not moving away and only want to compare premiums in Switzerland, use the premium calculator. How to end your current insurance when you move away permanently is explained under Switching.

Common mistakes

• Cancelling your health insurance when moving to the EU. If you only have a Swiss pension, you usually remain subject to compulsory insurance in Switzerland. A notice of cancellation does not change that.
• Exercising the right of option tacitly. Without a formal application, the choice is not valid. The Federal Supreme Court confirmed this in 2015.
• Missing the deadline. Except in Spain, a three-month deadline applies.
• Calculating with the Swiss municipal premium. The premium depends on the country of residence and can be lower or higher.
• Planning on a high deductible. Optional deductibles are not available to insured persons living in the EU.

You will find further terms relating to living abroad and cross-border commuting in the Glossary.