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Who is obliged to subscribe to the basic health insurance (LAMal)

Do you live in Switzerland? Then you should certainly subscribe to LAMal. From the date of your arrival in Heidi’s country or the date of your birth, you (or your parents, in the 2nd case) have 3 months to get affiliated to basic health insurance.

While we’re at it… Why not wait 2 months and 29 days to join, and avoid two months of premiums, you might ask? Well, because these three months are simply a tolerance period for you to join, not an exemption period. In other words, once you join, you’ll receive your premium invoices retroactively from the date you joined.

Be careful, because if you forget (however sincere and innocent), once the 3-month deadline has passed, it’s even worse. Your health insurer will not simply charge you the premium for the few months that have passed, but will calculate a penalty (a surcharge of between 30% and 50%) for twice the length of the delay. Let’s illustrate this obscure mechanism with an example:

Your residence permit indicates a date of entry into Switzerland of February 01, 2024. Theoretically, you therefore have until April 30, 2024 to register with the health insurance fund of your choice. Overwhelmed by administrative tasks and the unpacking of boxes, the months go by at breakneck speed: your application for affiliation arrives at the health insurance fund on June 30, 2024. Instead of receiving 5 standard premium invoices, say 5 x CHF 360 for the months of February to June, you’re notified of your late enrolment. Ouch!

  • You arrived in Switzerland 151 days ago, so you’re 151 days late. The penalty will be applied for double this period, i.e. 302 days.
  • Your premium surcharge is 30% (the minimum, but still).

The verdict? From July 2024 to May 2025, your premiums will be increased by a penalty of 30%, i.e. CHF 468 rather than CHF 360, according to our example. An extra CHF 108, for ten months or so, that’s enough to push affiliation to the LAMal up a few places on the priority list, isn’t it?

As always, there are a couple of exceptions, including:

– Federal employees (as they are subject to military insurance)

– People staying in Switzerland for medical treatment or training (to avoid unpleasant surprises, be sure to request an exemption certificate from the cantonal health insurance office in your canton of residence)

– Under the Agreement on the Free Movement of Persons, all persons who are gainfully employed in another country, who have the right of residence without gainful employment or who are entitled to a pension in an EU country (including Norway and Iceland)

– People who enjoy privileges under international law.

Some people may also apply for exemption from the insurance obligation if they have equivalent insurance coverage, for example

– Students who are temporarily staying in Switzerland,

– Or cross-border commuters and pensioners who have the right to select the health insurance of preferred country because they live in Germany, Austria, France or Italy for example.

The outlay required for basic health insurance coverage, which is itself compulsory for the vast majority of people, is substantial (even without additional premiums!). Households on modest incomes can apply for assistance from their canton of residence, and receive a contribution called a “subsidy”. Depending on your situation and incomes, the federal Administration will give you a monthly amount to help cover the premiums.