Health insurance

Regulations applicable to staff members of the permanent missions (PM), staff members of the international organisations (IO) and their family members relative to the Swiss Federal Law on Compulsory Health Care (LAMal) 

The present information sheet is not applicable to:

  • EU/EFTA nationals employed as locally recruited staff members by EU/EFTA permanent missions (see information sheet for local staff members - fr);

  • Private household employees (see the chapter "Private Household Employees Ordinance");

  • Staff members of the quasi-governmental international organisations and other international bodies

The Swiss Federal Law on Compulsory Health Care (LAMal) instituted a mandatory healthcare insurance. The health insurance provides for payments in case of sickness, accidents (unless covered by a separate accident insurance policy) and maternity. All persons domiciled in Switzerland must, in principle, be insured for sickness within three months of taking up residence, or from the time of birth in Switzerland.

The Ordinance on Compulsory Health Care (OAMal) stipulates therefore that some persons are not required to take out Swiss health insurance or may apply for exemption. This ordinance has been amended on 1 January 2018.

The situation of staff members of the permanent missions, international organisations and their family members is described hereunder (cf. Article 6 OAMal).

1. Persons enjoying privileges and immunities (not required to take out health insurance)

Persons enjoying privileges and immunities are not required to take out health insurance, but they may take out Swiss health insurance on a voluntary basis (cf. Article 6 Paragraph 1 OAMal).  

They have a period of six months within which they must apply for health insurance cover or present an application for affiliation to a Swiss health insurer. This period starts from the date of issue of an FDFA legitimation card; the health insurance becomes effective retroactively as of the date the FDFA legitimation card is received.  

The following persons are not required to take out Swiss health insurance: 

  • Heads of mission (PM), holders of an FDFA legitimation card of type “B”.

  • Members of the senior management (IO), holders of an FDFA legitimation card of type “B”.

  • Diplomatic agents (PM), holders an FDFA legitimation card of type "C”.

  • High ranking officials (IO), holders of an FDFA legitimation card of type a "C".

  • Administrative and technical staff members (PM), holders of an FDFA legitimation card of type "D" (blue).

  • Officials in a professional category (IO), holders of an FDFA legitimation card of type "D" (brown).

  • Service staff (PM), holders of an FDFA legitimation card of type "E".

  • Officials in general services (OI), holders of an FDFA legitimation card of type "E".

  • Short-term staff members  (OI) and seconded staff members (OI), holders of an FDFA legitimation card of type “G”.

  • Staff members of IFRC, holders of an FDFA legitimation card of type "L".

  • Members of the scientific personnel of the CERN, holders of an FDFA legitimation card of type "P".

  • Family members, holders of a legitimation card of a “B”, “C”, “D”, “E”, “G”, “L”, “P” or of a Ci permit, of the above-mentioned persons.
  • Swiss staff members (OI), holders of an FDFA legitimation card of type “S” (except those of the ICRC).

2. Family members, who do not enjoy privileges and immunities, of staff members of the international organisations (applications for exemption)

These provisions do not apply to family members of staff members of the permanent missions.  

Family members, who do not benefit from privileges and immunities, may apply for exemption from the obligation to take out Swiss health insurance if they are covered by the health insurance of the IO to which the principal beneficiary (the staff member) belongs to providing their health insurance cover is equivalent for treatments in Switzerland (cf. Article 6 Paragraph 4 OAMal amended on 1.1.2018).  

The following family members of staff members of the IO (holders of an FDFA legitimation card of type “B”, “C”, “D”, “E”, “L”, “P” or “S”) are concerned:

  • Spouses and children who are Swiss nationals or hold a permit and live in Switzerland (who do not have an FDFA legitimation card);

  • Spouses and children who are Swiss or Community nationals, live in an EU/EFTA member State and work in Switzerland (with a G permit for non-Swiss cross-border commuters) (who do not have an FDFA legitimation card);

  • Spouses (i.e. those not recognised as dependent in the Staff Regulations of the IO), children (unmarried, over 25), relatives in ascending line or other family members who have been admitted to Switzerland for family reunification and hold an FDFA legitimation card of type “H” (cf. section 2.6 – other family members - of the Guidelines for the IO). 

These persons are required to present a written request for exemption to the competent cantonal authority (health insurance Service of the canton of residence or the canton of work for the cross-border commuters). The request must be accompanied by a written attestation from the health insurance of the IO that provides all the necessary information (cover offered for treatments in Switzerland). They have three months (imperative deadline) in which to present a written request for exemption; the period beginning as of the date of affiliation to the health insurance of the IO. Once this period has passed, the person will no longer be exempted.  

The persons who were already affiliated to the health insurance of the IO before the entry into force of the amended ordinance have three months (imperative deadline) as of 1 January 2018 to present a written request for exemption. Once this period has passed, the person will no longer be exempted.  

Persons who are granted exemption from health insurance must, if necessary, terminate in writing their insurance policy (basic coverage according to LAMal). They must enclose with the letter of termination a copy of the decision on exemption issued by the competent cantonal authority. The health insurance policy will be terminated as of the date on which the person is exempted. Persons who have concluded a private supplementary health insurance policy will only be able to terminate this cover in accordance with the procedures set out in the general conditions of insurance.  

In accordance with OAMal, persons who have been granted exemption will no longer be able to reconsider their exemption nor their decision to renounce exemption. This means that as long as they remain affiliated to the health insurance of the IO, they will not be able to ask to be insured by a Swiss health insurer. If the health insurance of the IO terminates the policy because the conditions allowing the person to be insured are no longer met, the person must inform in writing the competent cantonal authority in order to be able to be covered by a Swiss health insurer. If the person is affiliated to the health insurance of another IO (for example, because the principal beneficiary is hired by another IO), they must inform in writing the competent cantonal authority and present a new request for exemption.  

If the person is hired as staff member by an IO, their status will change and they will enjoy privileges and immunities. Their situation is then governed by Article 6 paragraph 1 OAMal. The person must inform in writing the cantonal authority that granted them exemption when they were affiliated as a member of family.

3. Former staff members of the international organisations (applications for exemption)

Staff members who ceased their functions and remain affiliated to the health insurance of their former IO may submit a written request for exemption to the competent cantonal authority providing that their insurance cover is equivalent for treatments in Switzerland (cf. Article 6 paragraph 3 OAMal). The request must be accompanied by a written attestation from the health insurance of the IO and must provide all the necessary information (cover offered for treatments in Switzerland). They have three months (imperative deadline) within which a request must be submitted. The period begins as of the date on which they ceased their functions. Once this period has passed, the person will no longer be eligible for exemption. 

Family members benefit from the same facility and under the same conditions as the principal beneficiary (cf. Article 6 paragraph 4 OAMal). In this case too, the three-month period (imperative deadline) within which a request must be submitted begins as of the date on which the principal beneficiary ceased their functions. Once this period has passed, the person will no longer be eligible for exemption.

In accordance with OAMal, persons who have been granted exemption will no longer be able to reconsider their exemption nor their decision to renounce exemption. This means that they will remain affiliated to the health insurance of the IO and will not be able to ask for insurance cover by a Swiss health insurer. If the health insurance of the IO terminates the contract because the conditions allowing the person to be insured are no longer met, the person concerned must inform in writing the competent cantonal authority in order to be able to be insured by a Swiss health insurer.

4. Persons subject to Swiss health insurance

The following persons are subject to LAMal:  

  • Non-staff members (consultants, interns, volunteers) (OI/MP), holders of an FDFA legitimation card of type “H”.

  • Staff members of ICRC, holders of an FDFA legitimation card of type “I”, or “S”.

  • Swiss staff members of the PM, holders of an FDFA legitimation card of type “S” or “R”.

  • Staff members of the PM, holders of a permit.

  • Family members of the above-mentioned persons.

  • Other family members, holders of an FDFA legitimation card of type “H”, of staff members of the permanente missions.

  • Other family members, holding an FDFA legitimation card of type “H”, of staff members of the international organisations, if they are not covered by the health insurance of the IO and/or if they could not be exempted (cf. section 2).

4.1. Persons who may be exempted from Swiss health insurance (applications for exemption)

  • Interns of the permanent missions and international organisations, holders of an FDFA legitimation card of type “H”

    Persons living in Switzerland for training may submit a written request for exemption to the competent cantonal authority providing that their insurance cover is equivalent for treatments in Switzerland (cf. Article 2 Paragraph 4 OAMal). The request must be accompanied by a written attestation from the foreign health insurer and must provide all the necessary information (cover offered for treatments in Switzerland). Persons who have been granted exemption will no longer be able to reconsider their exemption nor their decision to renounce exemption unless there are special reasons.

     

  • Relatives in ascending line, holders of an FDFA legitimation card of type “H”, of staff members of the permanent missions  (and relatives in ascending line of the staff members of the international organisations if they are not covered by the health insurance of the IO and/or if they could not be exempted, cf. section 2) 

    Persons whose membership to the health insurance scheme would result in a significant deterioration of insurance coverage or coverage of expenses and who could not conclude a private supplementary insurance policy due to their age and/or state of health may submit a written request for exemption to the competent cantonal authority providing that their insurance cover is equivalent for treatments in Switzerland (cf. Article 2 Paragraph 8 OAMal). The request must be accompanied by a written attestation from the foreign health insurer and must provide all the necessary information (cover offered for treatments in Switzerland). Persons who have been granted exemption will no longer be able to reconsider their exemption nor their decision to renounce exemption unless there are special reasons.

Relevant cantonal authorities (applications for exemption)

Service de l'assurance-maladie (Health Insurance Service)
Route de Frontenex 62
CH -1207 Geneva
Tel.: +41 (0)22 546 19 00 
Fax: +41 (0)22 546 19 19 

Office vaudois de l'assurance-maladie (Health Insurance Service) 
Chemin de Mornex 40 
CH-1014 Lausanne
Tel.: +41 (0)21 557 47 47
Fax: +41 (0)21 557 47 50

Specialist Contact

Permanent Mission of Switzerland to UNOG
Office of Privileges & immunities
Rue de Varembé 9-11
P.O. Box 194
CH-1211 Geneva 20
Tel.: +41 (0)58 482 24 24
Fax: +41 (0)58  482 24 37