Published on 1 February 2026

United States of America: Social security and insurance

Switzerland has concluded international social security agreements with 44 countries. The main purpose of these agreements is to ensure that citizens of the states parties to the agreements are treated equally, to determine the applicable legislation and to regulate the payment of social security benefits abroad. The USA and Switzerland have signed a social security agreement.

Social security system

The following information on social security outside of Switzerland provides a general overview. It is no substitute for advice from the foreign insurance institutions, which alone are responsible for providing reliable information on the national insurance system of country in which they operate.

Apart from extremely remote parts of the country, medical care is available in the US, and is of high quality. However, hospital stays are much more expensive than in Switzerland. Even in emergencies, hospitals require a financial guarantee (credit card or advance payment) before treating patients. People usually take out health insurance through their employer, but this is no longer compulsory in certain cases. In view of the high costs of healthcare, we recommend that you take out health insurance.

The state-run social security system includes the U.S. Social Security Administration (SSA), namely old-age, survivors and disability insurance, as well as Medicare/Medicaid (health insurance for people who are elderly, disabled and/or have low incomes). The SSA uses taxes paid into a trust fund to pay out benefits to those entitled to them.

Social security provides people with a source of income when they retire or are no longer able to work. It can also provide financial support to a person's next of kin when the person dies. You need a social security number to be protected by social security.

Medicare is a health insurance programme for people who are 65 or older. People under the age of 65 may also be entitled to Medicare if they suffer from certain chronic diseases. The programme covers most, but not all medical expenses or the cost of most long-term care services.

Pensions / retirement

Thanks to a social security agreement, Swiss nationals are treated the same as US nationals with regard to social security.

Retirement requires a lot of planning and thought. In additional to financial concerns, you also have to think about when and where you want to retire. According to experts, you need up to 80% of your pre-retirement income to maintain your standard of living once retired.

There are various pension plans in the US, two of which are provided for by the Employee Retirement Income Security Act (ERISA): defined benefit plans and defined contribution plans.

• A defined benefit plan guarantees you a certain monthly benefit upon retirement. Such plans may state this guaranteed benefit as an exact amount in dollars, or specify that it will be calculated according to a formula that takes into account factors such as your salary and how long you have worked for your employer.
• A defined contribution plan, on the other hand, does not promise a specific level of benefits upon retirement. Within the framework of such plans, either the employee or the employer (or both) pays into the employee's individual retirement account, sometimes at a predetermined percentage rate.

Health and accident insurance

The cost of medical treatment is very high in the United States. Even in emergency situations, you must prove that you will be able to cover the costs. In view of this, taking out health insurance is strongly recommended.

Medicare is a government health insurance programme for people who are 65 or older, or under 65 with certain medical conditions.

Medicaid is a federal and state health insurance programme for people with low incomes, people with disabilities, pregnant women, and people who are 65 or older.

The Children's Health Insurance Program (CHIP) provides health insurance for children. To be eligible, the family must have a certain level of income.

You should keep in mind that the names of the Medicaid and CHIP programmes vary from state to state.

The Social Security Disability Insurance (SSDI) programme and the Supplemental Security Income (SSI) programme provide support for people with disabilities. SSDI provides benefits for the insured disabled person and some of their family members. To receive the benefits, the person must have worked long enough and paid social security taxes on their income. SSI provides benefits for disabled adults and children with limited income and assets.

Unemployment insurance

The U.S. Department of Labor's unemployment insurance scheme provides unemployment benefits to eligible employees who have lost their employment through no fault of their own and who meet certain other eligibility requirements. Each state sets its own conditions for entitlement to unemployment insurance benefits, but these are generally very similar from state to state.  on the conditions that must be met to qualify for unemployment benefit.

Swiss old-age and survivors' insurance (OASI) and invalidity insurance (IV)

• Payment of ordinary pensions

  Ordinary OASI and IV pension payments (except quarter pensions under the IV scheme) for Swiss nationals can be transferred to their place of residence anywhere in the world. The pension is paid out directly by the Swiss compensation office, generally in the currency of the country of residence. You may also choose to have your pension paid into a personal postal or bank account in Switzerland. Helplessness allowances and supplementary benefits are only paid if you are resident in Switzerland.

• Voluntary OASI/IV

  Swiss nationals who do not live in an EU/EFTA member state may join the voluntary OASI/IV scheme if they had compulsory insurance cover for at least five consecutive years immediately prior to their departure. Enrolment in the Swiss voluntary OASI/IV system does not exempt you from enrolling in a compulsory insurance system in your country of residence or employment. Employed persons contribute 10.1% of their salary to the pension fund. The minimum annual contribution is CHF 950. The voluntary OASI/IV system offers protection against the risks of old age, disability and death, in particular to persons who are not gainfully employed and who in many cases are not entitled to join a foreign social security scheme.

• Special provisions for people employed by a Swiss company

  Special provisions apply to persons who live abroad and are employed and on the payroll of an employer based in Switzerland and to their accompanying spouses abroad provided they are not gainfully employed. For further information, please contact your Swiss Compensation Office (SCO).

  Swiss Compensation Office (SCO)

• OASI pensioners (1st pillar) and pension fund beneficiaries (2nd pillar)

  Make sure that pension payments from your old-age and survivors' insurance (OASI), your pension fund or other insurance policies you have taken out are being properly transferred to you. Whenever you change your address, you must inform the OASI compensation office, your pension fund and insurance provider.

• Taxation of pension fund income

  Switzerland imposes a withholding tax on pension fund income if the beneficiary resides abroad. Double taxation agreements sometimes allow the withholding tax to be waived or to be reclaimed by the pension recipient in their country of residence.

• Social assistance for Swiss citizens abroad

  In certain circumstances, the FDFA's Social Assistance Service for the Swiss Abroad (SAS) provides social assistance to Swiss nationals living abroad who have run into financial difficulty. If you find yourself in financial distress, you must first make every effort to manage with your own resources. If you really cannot manage on your own, you should try to get financial help from your family or from friends or acquaintances. You should also find out what social assistance or other support you can receive from the authorities in your country of residence. Support from the SAS should be a measure of last resort.

  Social security for Swiss citizens abroad

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