Insurance for cross-border workers /
Insurance coverage abroad
Does ÖKK offer a KVG insurance plan for cross-border workers?
With ÖKK EUROLINE, ÖKK offers cross-border workers an insurance plan in accordance with the "Abkommen über den Freien Personenverkehr" (agreement regarding the free movement of persons). However, it only guarantees benefits in accordance with the social rate of the country of residence and Switzerland.
If you work in Switzerland, you can insure yourself with ÖKK, even if you live in an EU/EFTA state. Our corresponding offer is called ÖKK EUROLINE
The introduction of the bilateral agreements between Switzerland and the European Union (EU) changed the conditions for taking out a mandatory health insurance policy: cross-border workers that work in Switzerland and their unemployed family members have a choice in all neighbouring countries. You can freely choose whether you want to be insured in Switzerland or in your country of residence. However, employed family members must have insurance plans at their place of work.
Persons who have their residence in Switzerland must take out insurance. An exception are persons and their unemployed family members who live in Germany, France, Italy, Austria, Portugal (only retired persons)
, or Spain (only retired persons) and work in Switzerland or draw a pension in Switzerland. They have the option of obtaining a release from the Swiss insurance obligation upon request. To this purpose, these persons must prove that they are covered for cases of illness in their country of residence during a stay in other EU countries or in Switzerland (Art. 2 Para. 6 KVV).
What deadlines apply to procuring a release from the insurance obligation?
The application for release from the insurance obligation must be completed within 3 months after the insurance obligation takes effect in Switzerland, i.e. 3 months after issue of the work permit for cross-border workers or after the first receipt of a Swiss pension.
Where must I submit the application to exempt myself from the insurance obligation?
It is the canton's responsibility to check and process your application for a cross-border worker exemption. Should you have any questions regarding the deadline or possibility for an exemption, please therefore contact the responsible cantonal department directly. The KVG Joint Institution
in Solothurn is responsible for retirees.
Is a return to the social insurance plan of the country of residence guaranteed?
ÖKK EUROLINE allows a return to the social insurance plan of the country of residence at any time. Cross-border workers who are insured with ÖKK EUROLINE and go into retirement are obligated to switch to the social insurance of the country of residence under certain circumstances (e.g. if they draw a pension from Switzerland and from the country of residence) and cannot take out further insurance policies in Switzerland. If you, as a cross-border worker, go into retirement and draw a pension from your future country of residence, your primary insurance obligation will be in your country of residence. However, it depends on the laws of the country of residence whether or not you can switch to a state health insurance company there.
What do ÖKK EUROLINE members need to process their benefits?
People who are insured with ÖKK EUROLINE require the so-called e-forms in order to process their benefits. You will be provided with e-forms after confirmation of coverage by ÖKK. The e-forms must be submitted to the respective insurance carriers of the country of residence. Afterwards you will receive the insurance cards from the respective insurance company as well as from ÖKK.
Why are most basic insurance premiums of ÖKK EUROLINE higher than those for Swiss citizens?
Premiums in Switzerland vary based on residence and the corresponding benefits required by the local population. Different premiums in each country apply for EU citizens. The size of the premiums was determined based on the expected costs of all groups of people (cross-border workers, retirees, unemployed people and their dependents) and the average costs of the previous years in the respective countries (Art. 93, 94, and 95, Ordinance (EWG) 574/72). In addition, the agreement provides for the fact that the health insurance company must offer benefits abroad (e.g. dental benefits) that are not offered in the Swiss KVG benefits catalogue and are therefore not available to Swiss citizens.