Claims to benefits

The European Health Insurance Card is valid for persons who are staying in Switzerland temporarily. A temporary stay is defined if a person is only staying in Switzerland for a limited period of time and for a specific reason, with the intention of returning to their home country afterwards. The approximate duration of the stay is known in advance; an exact return date is not required (e.g. ‘stay for one and a half years for study purposes’). The requirement is that the centre of life remains in the home country for the duration of the stay.

Possible reasons for a stay in Switzerland can be:

• Posting
• Business travels
• Visiting family or friends
• Gainful employment, if it concerns cross border worker from Germany, France, Italy or Austria who have opted for the statutory health insurance system of their country of residence (option right)
• etcetera

Example European Health Insurance Card

The provisional replacement certificate is an equivalent replacement for the European Health Insurance Card and is used if you are not in the possession of the European Health Insurance Card.

This proof of entitlement applies to persons travelling to Switzerland for the purpose of medical treatment. The reason for crossing the border is for medical treatment.

The S2 form is issued by the health insurance provider in the EU/EFTA or in the UK.

The S1 form serves as proof of entitlement for persons who have moved to Switzerland and continue to be covered by a health insurance scheme in the EU/EFTA or the UK.

The S1 form is issued by the health insurance provider in the EU/EFTA or in the UK.

Persons, who take up residence in Switzerland and continue to be insured in their home country, can be registered at the Gemeinsame Einrichtung KVG by means of the valid certificate S1 issued by their health insurance. Alternatively, your health insurance company can send us the entitlement certificate electronically.

Please send us, as a first step, your valid claim certificate. You will subsequently receive a questionnaire from us. Your statements on the questionnaire are instrumental in clarifying whether a registration is basically possible or whether you are subject to compulsory health insurance in Switzerland. The insurance obligation of employed persons depends on the place of their employment or self-employment (place of employment principle). The insurance obligation of pensioners depends on the origin of their pensions. Children are subject to compulsory insurance in the country of residence if one parent is gainfully employed in the country of residence or receives a pension from it. The duration of the entitlement to international benefits assistance depends on the period of validity of the claim form. If you are subject to compulsory insurance in Switzerland, you will no longer be entitled to have your benefits paid for by your health insurance through international benefits assistance. Should, for any of the afore-mentioned reasons, the registration for benefits assistance be denied, the relevant Cantonal authorities will be notified. Basically, it is their responsibility to control the adherence to the health insurance obligation in Switzerland (Art. 6 KVG).

Claim to benefits

Persons who can be registered for benefits assistance, will receive an insurance card. This serves as proof of a right to benefits for service providers in Switzerland e.g. hospitals, doctors, physiotherapists etc.
With these forms there is a claim to all benefits provided for by the Swiss health insurance system if they prove to be medically necessary – with the exception of cash benefits (daily allowance). The same rule applies to the non-earning, dependent members of the family.