German health insurance in Switzerland: Your comprehensive guide to validity and options
6 Jun 2025
Katrin Straub
Managing Director at nextsure
Are you planning a stay in Switzerland or working there as a cross-border commuter? Health insurance is a central issue in this regard. This article explains the validity of your German health insurance in Switzerland and outlines the steps necessary for seamless coverage.
The topic in brief and concise terms
For tourist stays in Switzerland, the German EHIC card is usually sufficient for medically necessary treatments.
Cross-border commuters have an option and can choose within three months whether they want to be insured in Germany or Switzerland; this decision is usually binding.
Residents in Switzerland are subject to a mandatory health insurance obligation under the Swiss KVG; employers do not pay contributions.
Understanding the Basics of the Validity of German Policies in Switzerland
For people with German health insurance, the question of its validity in Switzerland often arises. During short tourist stays or business trips of up to three months, you are generally covered by your European Health Insurance Card (EHIC). This card, usually on the back of your German health insurance card, covers medically necessary treatments under the conditions of the Swiss system. It is important to know that the EHIC only includes public healthcare services and does not cover private treatments or repatriation. For more comprehensive protection, a private overseas health insurance can be worthwhile, often including additional services like repatriation, which the EHIC does not cover. This regulation is based on social security agreements between Switzerland and the EU/EFTA states. However, the EHIC does not guarantee free treatment, as health systems are different, and co-payments may be required. Note that if you relocate your habitual residence to Switzerland, different regulations apply. Clarifying these details before your trip ensures a worry-free time in Switzerland.
Specific regulations for cross-border commuters and utilizing the right to opt
Do you work in Switzerland but continue to live in Germany? If so, you are considered a cross-border commuter and there are special regulations for health insurance for you. Generally, employees in Switzerland are subject to the local mandatory insurance under the Health Insurance Act (KVG). However, Germany has made special arrangements with Switzerland, as well as with other neighbouring countries, which grant cross-border commuters a so-called opt-out right. This right allows you to be exempt from the Swiss insurance obligation within three months of starting your employment in Switzerland and instead remain with your German health insurance. This decision is usually irrevocable and should be carefully considered. A formal request for exemption must be submitted to the competent cantonal authority in Switzerland. If you miss this deadline or do not apply, you will be automatically assigned to a Swiss health insurance fund. Over eighty percent of cross-border commuters opt for the Swiss compulsory insurance (KVG) with additional insurances, as this often offers the best value for money. The costs for cross-border health insurance in Switzerland will start at about 156 Swiss francs per month in 2025. A comprehensive consultation can help you make the right choice for you.
The Swiss Health Insurance (KVG) in Detail
If you choose Swiss health insurance or need to be insured there, the Federal Health Insurance Act (KVG) applies. Every individual residing or working in Switzerland must take out basic insurance. Unlike in Germany, employers in Switzerland do not contribute to health insurance premiums; these are entirely borne by the insured person. Premiums are independent of income and vary depending on the canton, insurer, and chosen insurance model (e.g., standard, family doctor model, Telmed). The basic insurance under KVG covers a legally defined range of services that is identical across all providers. These services include outpatient and inpatient treatments, medications, and maternity benefits. There is an annual deductible (excess) that can be chosen between 300 and 2,500 Swiss francs for adults, as well as an excess of ten percent of costs beyond that (up to a maximum of 700 francs per year). For cross-border commuters, there are special KVG tariffs tailored to their needs. It is advisable to carefully compare the different offers and models to find the optimal coverage. A travel health insurance can also provide additional security, especially when travelling outside of Switzerland and Germany.
Here are some important aspects of the KVG basic insurance:
Free choice of insurer (among those operating at the place of residence).
Each family member must be insured separately.
Children must be insured within three months of birth.
The insurance obligation starts with taking up residence or employment.
Benefits in case of illness, accident (if there is no other accident insurance coverage), and maternity.
The choice of the right deductible and suitable model can significantly affect your annual costs.
Comparison: German GKV vs. Swiss KVG for Cross-Border Commuters
Cross-border commuters have a choice: stay with the German statutory health insurance (GKV) or switch to the Swiss KVG? Both systems have their advantages and disadvantages. The German GKV often offers the benefit of family insurance, where non-working spouses and children are included free of charge - a model that Switzerland does not recognize, as each family member must be insured individually and pay their own premiums. Contributions to the German GKV are income-dependent, whereas KVG premiums are not, and can vary greatly depending on the canton and model. With the KVG, cross-border commuters can often benefit from cheaper rates and have access to medical care in both countries. [4,ä5] An important factor is the cost-sharing: In Switzerland, there is the deductible and a percentage co-payment. The benefits of basic insurance are legally defined in Switzerland and are the same with all providers. In Germany, the additional benefits of the providers can differ. Less than one percent of cross-border commuters remain with the German GKV, as it is often more expensive without offering significant advantages. [ä5] An annual travel health insurance can be sensible for overseas travel regardless of the chosen system. The decision should be made after careful consideration of personal and family circumstances, desired benefits and costs.
Social security agreements and their impacts
The coordination of health insurance systems between Germany and Switzerland is primarily based on bilateral social security agreements and EU/EFTA regulations. [7,4] These agreements ensure that individuals who live or work across borders do not suffer disadvantages, such as double insurance coverage or loss of entitlements. A central principle is the principle of employment location, according to which the insurance obligation generally exists in the country of employment. For cross-border commuters, this principle is modified by the right of option. The European Health Insurance Card (EHIC) is a result of this coordination and allows access to medically necessary services in the other contracting state during temporary stays. The agreements also stipulate which state is responsible for which benefits and how reimbursement occurs. For example, pensioners are typically insured in the state that pays the pension, or in the residence state if there are multiple pensions and one is received there. For detailed information and specific forms, the Deutsche Verbindungsstelle Krankenversicherung - Ausland (DVKA) is an important contact point. [3] It is important to stay informed about current regulations, as details may change, for example, due to new agreements or court rulings. [5,7] An understanding of these European regulations is crucial.
Permanent Stay in Switzerland: What Changes?
If you permanently move your residence to Switzerland, you are fully subject to Swiss health insurance requirements under KVG. The option for cross-border commuters does not apply here. You must register with a Swiss health insurance company within three months of registration at the resident's registration office. German health insurance, whether statutory or private, usually ends when you give up your residence in Germany, unless there are special continuation options, which are rare. Make sure to inform your German health insurance provider in good time about your move. [7] As mentioned, premiums in Switzerland are not income-dependent and must be fully borne by you. It is important to arrange Swiss health insurance early to avoid gaps in coverage and potential premium surcharges for late entry. To choose the right tariff, you should compare various offers. Also consider necessary supplementary insurance, as basic insurance does not cover all conceivable services. An overseas insurance is then only relevant for trips from Switzerland to other countries. Re-registration and conclusion of the new insurance are important steps when relocating.
nextsure: Your partner for bespoke insurance solutions
Choosing the right health insurance in the Germany-Switzerland context requires a thorough analysis of your personal situation. At nextsure, we understand the complexity of this decision. As a digital insurance portal, we provide you with comprehensive information and access to niche insurances as well as individual protection solutions. Even though we do not directly broker Swiss health insurances, we support you with our expertise and can help you understand the impact on your existing German insurances or find the appropriate protection for your time abroad, for example, through a foreign health insurance. Our mission is to provide you with tailored and easily understandable insurance solutions. We help you keep track and make the optimal decision for you. The right coverage is an important cornerstone for your financial security and well-being, no matter which side of the border you are on. Utilise our expertise for your peace of mind.
Request an individual risk analysis now: Have your insurance situation reviewed for free and receive concrete optimisation suggestions.
More useful links
Auswärtiges Amt provides the latest travel and security advice for Switzerland.
Deutsche Verbindungsstelle Krankenversicherung - Ausland (DVKA) provides information about accident insurance in Switzerland for employers and employees.
Deutsche Rentenversicherung offers detailed information on social security agreements, including the agreement with Switzerland.
Wikipedia provides a comprehensive overview of health insurance in Switzerland.
GKV-Spitzenverband provides important information about the European Health Insurance Card (EHIC).
Wikipedia explains the basics and implications of social security agreements.
FAQ
Wie lange ist meine deutsche Krankenversicherung bei einem Urlaub in der Schweiz gültig?
Für die Dauer Ihres touristischen Aufenthalts sind Sie über die Europäische Krankenversicherungskarte (EHIC) für medizinisch notwendige Behandlungen abgesichert. Für längere Aufenthalte oder Erwerbstätigkeit gelten andere Regeln.
Was passiert, wenn ich als Grenzgänger die Frist für das Optionsrecht verpasse?
Wenn Sie die Dreimonatsfrist für das Optionsrecht verpassen, werden Sie in der Regel automatisch dem schweizerischen Krankenversicherungssystem (KVG) zugewiesen und müssen sich dort versichern.
Kann ich meine Familie in der Schweizer KVG mitversichern?
Nein, eine Familienmitversicherung wie in der deutschen GKV gibt es in der Schweiz nicht. Jedes Familienmitglied, auch Kinder, muss einzeln versichert werden und eigene Prämien zahlen.
Welche Kosten kommen bei der Schweizer Krankenversicherung auf mich zu?
Die Prämien sind einkommensunabhängig und variieren nach Kanton, Versicherer und gewähltem Modell (Franchise). Zusätzlich zur Prämie gibt es eine jährliche Franchise (Selbstbehalt von 300 bis 2.500 CHF) und einen Selbstbehalt von zehn Prozent der darüberhinausgehenden Kosten.
Deckt die EHIC auch einen Krankenrücktransport aus der Schweiz ab?
Nein, die EHIC deckt medizinisch notwendige Behandlungen vor Ort ab, aber keinen Krankenrücktransport nach Deutschland. Hierfür ist eine private Auslandskrankenversicherung empfehlenswert.
Kann ich als Rentner mit deutscher Rente in der Schweiz leben und meine deutsche Krankenversicherung behalten?
Wenn Sie als Rentner Ihren Wohnsitz in die Schweiz verlegen und eine deutsche Rente beziehen, müssen Sie sich in der Regel in der Schweiz krankenversichern. Es gibt jedoch spezielle Regelungen im Rahmen der Sozialversicherungsabkommen. Klären Sie dies unbedingt vorab mit Ihrer Krankenkasse.
