Retiring abroad: which health insurance applies

Where you move decides your health insurance

Swiss basic health insurance is linked to residence: anyone who lives in Switzerland must take out insurance, and anyone who leaves usually drops out of it (Art. 5 para. 3 KVG). For pensioners, there is an important exception. If you move to the EU, Iceland, Norway or the United Kingdom with a Swiss pension, the coordination rules of the Agreement on the Free Movement of Persons and its successor agreements apply. They say: health insurance follows the pension, not the place of residence.

For you as one of the pensioners resident in an EU/EFTA state or the UK, this means:

The rules apply to Swiss citizens as well as to nationals of the EU and EFTA who have worked in Switzerland and return home with a Swiss pension. According to the FOPH, non-working family members living in these countries are also insured in Switzerland.

Step by step: sorting out health insurance before you leave

Plan at least three months before the move. Most deadlines start with the move or with your first pension payment, not once you have settled in the new country.

1. Clarify your pension situation. Do you receive only a Swiss pension (OASI, DI, pension fund) or also a pension from your new country of residence? This determines which country is responsible (table above).
2. Deregister with your municipality. You need the deregistration confirmation for your health insurer. The canton informs pensioners who move to the EU, Iceland, Norway or the United Kingdom that the requirement to be insured continues (Art. 6a para. 1 let. c KVG).
3. Ask your health insurer whether it insures people in your country of residence. According to the FOPH, about a third of Swiss health insurers offer insurance for people resident in the EU, EFTA or the United Kingdom, some only for certain countries. You will find contact details in the health insurer profiles.
4. Check the right of option. If you move to Germany, France, Italy, Austria, Spain or Portugal, compare the Swiss premium for your country of residence with the contributions in that country. If you want to be insured there, submit the application for exemption to the Common Institution under the Federal Health Insurance Act.
5. Clarify supplementary insurance. Ask in writing whether your contracts end when you leave, continue or are suspended, and whether they pay benefits in your new country of residence.
6. Keep your documents. The deregistration confirmation, the confirmation from your health insurer, the decision of the Common Institution and proof of insurance in your country of residence. If questions come from two countries, this saves you a lot of time.

The right of option: insurance in your country of residence instead of Switzerland

Switzerland has concluded special arrangements with some countries. Pensioners living there can apply to be exempted from compulsory Swiss health insurance and take out insurance in their country of residence. The FOPH describes the right of option for pension recipients “with EU citizenship”; if you hold only a Swiss passport, check with the Common Institution under the Federal Health Insurance Act before you move whether you can exercise it. The legal basis in Switzerland is Art. 2 para. 6 KVV: you are exempted if you are covered in the event of illness in your country of residence, during a stay in another EU state and in Switzerland.

Source: FOPH, as of 25.09.2026. Three points are important here:

• The application must arrive. The 3-month deadline applies to receipt by the Common Institution under the Federal Health Insurance Act in Olten, not to the date you send it.
• No application, no exemption. You cannot exercise the right of option tacitly by simply registering in your country of residence. Anyone who neither obtains an exemption nor takes out insurance is assigned to a Swiss health insurer by the Common Institution (Art. 6a para. 3 KVG).
• France has its own form. According to the FOPH, the “Choice of health insurance system” form must be confirmed by the French health insurance fund CPAM within 3 months. Send the confirmed copy to your Swiss health insurer straight away.

Whether the right of option is worthwhile depends on the contributions in your country of residence, your income and the benefits. That is a personal calculation. You can find out the contribution rules of your country of residence from its health insurance.

Premium, deductible and models: what is different as a pensioner in the EU

If you remain in Swiss basic health insurance, a few special rules apply:

• Premium per country of residence. The health insurer calculates the premium separately for each country and takes account of the cost differences between countries (Art. 61 para. 4 KVG, FOPH). The premium of your former Swiss municipality no longer plays a role.
• Swiss francs or euros. The health insurer charges the premium in Swiss francs or euros and may require quarterly payment without your consent (Art. 92a KVV).
• No optional deductible, no savings model. Optional deductibles, bonus insurance and models with a restricted choice of service provider such as GP, HMO or telemedicine models are not open to you (Art. 101a KVV). You are insured with the standard deductible.
• Premium subsidy from the Confederation. If you are in modest financial circumstances, the Confederation subsidises the premium, no longer your former canton (Art. 66a KVG). It is administered by the Common Institution under the Federal Health Insurance Act.

The FOPH publishes the premiums per country and health insurer on priminfo.admin.ch. The premium calculator on this website only works with Swiss municipalities; it helps you if you remain resident in Switzerland and only spend part of the year abroad.

Treatment in your country of residence and in Switzerland

In your country of residence, you are treated according to its rules, as if you were insured there. The health insurance of your country of residence settles the costs with your Swiss health insurer; this is called international benefits assistance. For stays in other EU and EFTA states, the European Health Insurance Card (EHIC) serves as proof; the FOPH also mentions it as proof of cover for the right of option.

If you come to Switzerland for hospital treatment, you are free to choose among the listed hospitals (Art. 41 para. 2 KVG). The health insurer and the cantons then pay at most the tariff that applies in a listed hospital of the reference canton set by the Federal Council (Art. 41 para. 2ter KVG). This also applies to your family members. If a treatment is not billed through international benefits assistance, coverage is based on the tariffs at your last place of residence or work in Switzerland (Art. 36 para. 4 KVV).

Example: three couples move away

Example with fictitious people. Three couples, all aged 66, receive an OASI pension and a pension from their pension fund, but no pension from another country. All of them move their residence abroad on 01.04.2026.

The example shows that the same pension leads to three different outcomes depending on the country of residence. The choice between Swiss insurance and insurance in the country of residence is not a formality but a decision with a deadline.

Special cases

Spending the winter in the south, resident in Switzerland

If you spend only part of the year abroad and keep your residence in Switzerland, you remain insured as normal, with an optional deductible and a savings model. In an emergency during a temporary stay abroad, basic health insurance covers the costs, but at most twice the amount that would be paid in Switzerland (Art. 36 para. 2 and 4 KVV). It is not an emergency if you travel abroad for treatment. What else is covered abroad is explained in the article Ill abroad and on holiday.

Supplementary benefits

Supplementary benefits to the OASI require residence and habitual abode in Switzerland (Art. 4 para. 1 ELG). Habitual abode is considered interrupted if you stay abroad for more than 3 months without interruption or for more than 3 months in total in a calendar year (Art. 4 para. 3 ELG). When you leave, supplementary benefits end, and with them the payment of your health insurance premium through supplementary benefits. How premium subsidies and supplementary benefits interact in retirement is explained in the article Premium subsidies and supplementary benefits in retirement.

Supplementary insurance

Supplementary insurance is governed by the ICA and the terms of your health insurer, not by the KVG. Whether a contract ends when you leave, continues or is suspended, and whether it pays benefits in your country of residence, is set out in the general terms and conditions. If you cancel a supplementary insurance and want it back later, the health insurer may ask health questions again and refuse you. What counts are the general terms and conditions and the information from your health insurer.

Returning to Switzerland

If you return and take up residence in Switzerland again, you must take out insurance within 3 months; the insurance then applies from the date you moved in (Art. 3 para. 1 and Art. 5 para. 1 KVG). Every health insurer must accept you for basic health insurance without health questions. If you are late, you pay a premium surcharge (Art. 5 para. 2 KVG). If you were already insured in Switzerland as a pensioner in the EU, your insurance continues; the health insurer adjusts the premium to your new municipality. Everything about deregistering when you leave for good is in the article Moving abroad; the glossary explains the general rules for the Swiss abroad.

Common mistakes

• Cancelling your health insurance when you move to the EU. With only a Swiss pension, you remain required to be insured in Switzerland. Cancelling without a new Swiss health insurer or without an exemption leads to assignment by the Common Institution under the Federal Health Insurance Act.
• Exercising the right of option tacitly. Registering in your country of residence is not enough. A formal application for exemption is required.
• Missing the 3-month deadline. Except in Spain, the choice is over after 3 months. Put the date in your calendar; the deadlines for changing health insurer are shown by the deadline calculator.
• Counting on a CHF 2,500 deductible. If you live in the EU, there is no optional deductible and no savings model.
• Forgetting your supplementary insurance. It follows its own rules and may end when you leave or cost premiums without paying anything abroad.

Planning ahead

Before you leave, it is worth looking at your other insurance in retirement: if you are no longer insured against accidents through your employer after your employment ends, read Retired: including accident cover again. If you stay in Switzerland and are thinking ahead, Nursing home: what health insurance pays explains the costs in old age. If you change health insurer, you will find the procedure and templates under Switching health insurer. All topics around retirement are in the section Retirement and old age.