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What type of health coverage should you take out when you move to a new country? In this part of our series, we offer some advice for those planning an extended or indefinite stay outside Switzerland.
This content was published on December 14, 2017 – 5:00 PM
Geraldine Wong Sak Hoi and Tony Ganzer
People who move their permanent residence to another country are no longer requiredExternal link to take out basic health insurance in Switzerland, even if there are exceptions to this rule. People who move temporarily and keep their residence in Switzerland can, however, continue to benefit from their health cover in Switzerland. To illustrate these ground rules, let’s take a look at a few cases sent in by our readers, as well as coverage options for those moving to the United States.
A Swiss retiree
Healthcare in Switzerland and the United States: In this ongoing series, swissinfo.ch answers readers’ questions about the two systems and their intersections. Ask your own question at the bottom of this story. swissinfo.ch
A person receiving a state pension who moves to a country outside the European Union or the European Free Trade Agreement (EFTA) area is included in the category of persons who are no longer subject Swiss health insurance law. They must therefore obtain coverage in their new country of residence.External link.
Retirees who move to an EU / EFTA country are a special case: they must continue to have basic health insurance with a Swiss provider for themselves and their dependents. But an exception exists for retirees residing in a country with which Switzerland has concluded special agreements (for example, Germany, France and Spain) and those who receive a pension from their new adopted country, in order to that they can take out insurance at their place of residence.
A Swiss student
Those who choose to study abroad can keep their Swiss health insuranceExternal link, as long as they also retain their permanent residence in Switzerland. But the coverage they are entitled to varies depending on where they study.
Geraldine Wong Sak Hoi, a Canadian journalist based in Switzerland, will report on the Swiss healthcare system for this series. She also participates in fact-checking projects for swissinfo.ch. swissinfo.ch
Within the EU / EFTA zone, holders of Swiss basic health insurance can expect to receive reimbursements for essential medical servicesExternal link (in the event of illness, accident and maternity) in accordance with the legislation of that country. They can also choose to seek treatment in Switzerland.
The situation is slightly different for students from non-EU / EFTA countries. They receive reimbursements for emergency careExternal link up to twice the amount that the same treatment would have cost in Switzerland, and up to 90% of hospital costs. For example, in places like the United States, where medical care can be particularly expensive, it may be a good idea to purchase supplemental travel insurance or supplemental health insurance.
Regardless of their circumstances, anyone planning to be away for an extended or indefinite period should check coverage options with their current provider. A small number of Swiss insurers actually offer plans specifically for people moving abroad.External link who are no longer entitled to compulsory basic insurance and which can be concluded in the form of private contracts under Swiss law. Some also have international health insurance policiesExternal link.
Moving to the United States
For foreign nationals in the United States, access to health insurance depends a lot on why they are in the country and their legal status.External link. If a Swiss citizen is an employee of a company, the company will likely provide a health insurance plan which can be purchased through premiums. These policies often come into effect for eligible employees at the beginning of the month following the start of the position, although the policies differ. Even though there is an “individual mandate” for people in the United States to have insurance under the Affordable Care Act, or Obamacare, not all foreign nationals can purchase insurance in the markets. Dual nationality can, as can holders of green cards (or legal permanent residents) and holders of certain work permits.External link.
A reader experience
Born in Switzerland, Daniel Fritschi left eastern Switzerland with his American wife and young daughter in 2015. Since they changed their permanent residence to their new home in the US state of Michigan, the family was no longer entitled. compulsory Swiss health insurance. Finding health care coverage on the market for their first month in the United States was “nearly impossible” and involved several phone calls over several days, Fritschi recalls. “We had a little baby and we certainly didn’t want to risk not having insurance.”
They finally managed to get a health insurance planExternal link for two adults and one child at the rate of $ 780 (772 CHF) – for a single month. Once Fritschi started working, they were able to switch their coverage to a more affordable plan through his employer. The family’s insurance bills are now lower than they would have been in Switzerland, but treatment costs are much higher: around double the cost of maternity, according to Fritschi’s own accounting after birth of her second child in the United States.
End of insertion
For those who cannot purchase insurance through the market or exchanges, it is still possible to purchase insurance through a private provider.External link, but can be expensive. And depending on the length of stay, some travel medical insurance plans from private providers may be enough to cover you in an emergency, but again, looking for a good deal may be worth it.
Tony Ganzer is an American journalist based in Cleveland, Ohio who has lived and worked in Switzerland for many years. He examines the intersection between the American and Swiss healthcare systems for this series. swissinfo.ch
Students traveling to the United States are often required to have health insurance External linkthrough college or exchange program, or show proof of other coverage. However, these policies are often not too expensive for students. And for some exchange programsExternal link insurance is part of the complete package.
Once foreign nationals are in the United States, access to medical careExternal link will also depend on your insurance or not and the seriousness of the situation. With employer-sponsored plans and private insurance, medical care is usually organized by a family doctor and a health care network. But there are also emergency care clinics, charity groups, or community health centers, which offer treatment regardless of the patient’s insurance or legal status. As we mentioned in a previous article, there is also a federal requirement that emergency rooms stabilize patients without worrying about payment, but this will not serve minor medical needs or persistent conditions.
The bottom line is that health insurance is not free and is not a given for foreign nationals in the United States. Private insurance is available, but may not be cheap. There are health care options without insurance, but the quality and cost can vary widely.
Ask a question about the Swiss and American healthcare systems and we can cover it in this series:
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