Regulations applicable to members of personnel of the permanent missions (PM) and international organisations (IO) relative to the federal law on health insurance (LAMal)

Member States of the European Union (EU) or European Free Trade association (EFTA) and their nationals 

The present information note is not applicable to the above mentioned persons; they must consult the following information notes:

Principle

On 1 January 1996 the Swiss Federal Law on Compulsory Health Care (LAMal) of 18 March 1994 entered into force. This law instituted mandatory healthcare insurance and an optional insurance scheme to compensate for the loss of daily earnings. 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 be insured for sickness and accidents within three months of taking up residence, or from the time of birth in Switzerland. However, in accordance with article 3, par. 2, of LAMal, the Federal Council may exempt certain categories of persons from mandatory health insurance, in particular representatives of foreign State and officials of international organisations.

Exempt persons

In its Ordinance on Health Insurance (OAMal) of 27 June 1995, the Federal Council exercised its powers to grant exemptions. Article 6, par. 1 of this ordinance states that members of personnel of the permanent missions and international organisations, together with members of their families enjoying the same status, are not required to be covered by health insurance. Are considered as family members the spouses, with a legitimation card or Swiss nationals, as well as the children, with legitimation card of Swiss nationals, under 18 years old and the children under 25 years old and who are attending a school or a training.

The following persons are not required to take out insurance:

• Heads of mission (PM) - members of the senior management (IO) (holders of a "B" legitimation card)
• Diplomatic agents (PM) - high ranking officials (IO) (holders of a "C" legitimation card)
• Administrative and technical staff members (PM) - officials in a professional category (IO) (holders of a "D" legitimation card)
• Service staff (PM) – officials in general services (holders of an "E" legitimation card)
• Non-Swiss members of personnel of the IFRCS (holders of a "L" legitimation card)
• Swiss civil servants (IO) (holders of a "S" legitimation card)
• Non-Swiss members of personnel of the Permanent Mission of Palestine (holders of an "O" legitimation card)
• Members of the scientific personnel of the CERN (holders of a "P" legitimation card)
• Family members who enjoy the same status (holders of a legitimation card or Ci permit)

International civil servants on a "short-term" contract (holders of a "G" legitimation card) are exempt from the Swiss health insurance requirement if they belong to a foreign healthcare plan or to one offered by the organisation employing them.

It was not the intention of the Federal Council to entirely exclude the above-mentioned from Swiss health insurance, and indeed these persons may request to join such plans. Article 7, par. 6 of the present ruling states that persons who intend to be covered by Swiss health insurance must request to do so within six months of the date receiving a legitimation card. In such cases the health insurance becomes effective retroactively as of the date the legitimation card is received. The health insurance becomes invalid upon expiry of the term of office in Switzerland, upon the death of the insured or upon renunciation of the eligibility for health insurance. In the last case, barring exceptional circumstances, a new request may not be submitted. Requests for voluntary affiliation must be addressed to the relevant cantonal authority (see details below).


Eligible persons

The following persons are subject to mandatory Swiss health insurance :

• Non-Swiss members of personnel of the ICRC (holders of an "I" legitimation card)
• Swiss members of personnel of the ICRC (holders of a "S" legitimation card)
• Swiss members of personnel (PM) (holders of a "S" legitimation card)
• Members of personnel of the permanent missions permanently resident in Switzerland (holders of a temporary or permanent B or C residence permits)
• Members of their families.

The Private Household Employees Ordinance stipulates that such household employee (holder of a "F" legitimation card) is subject to mandatory Swiss health insurance unless he is already insured in another State.


Retired international civil servants

According to article 6, par. 3 of the OAMal, international civil servants who have retired, as well as members of their families, may request to be exempted from mandatory health insurance if they are already covered for healthcare in Switzerland by a similar plan as offered by the organisation which employed them.

Are considered as family members the spouses as well as the children under 18 years old and the children under 25 years old and who are attending a school or a training (cf. article 3, alinea 2, OAMal).

The request, providing all necessary information, must be accompanied by a written attestation from the section of the international organisation responsible for the plan. It should be addressed directly to the appropriate cantonal authority (see details below).


Swiss system of health insurance

Health insurance in Switzerland is not an integral part of the social insurance system. It is a personal insurance, and everyone domiciled in Switzerland with the exception of the categories mentioned in the information note is required to join one of the recognised Swiss health insurance.

Health insurance

Health insurance covers the insured person's medical costs and hospitalisation. However, those insured must pay a share of the costs incurred each year. These consist of a "franchise", a basic amount for which they have chosen to be responsible and which covers initial costs, and 10% of any costs in excess of the franchise (maximum CHF. 700.-- per year).

Franchise

A franchise is mandatory. The annual franchise amounted to a minimum of CHF 300.--. If preferred, any of the following amounts may be selected : CHF 500.--, CHF 1'000.--, CHF 1'500, CHF 2'000 or CHF 2'500.-- (maximum authorised rate). In general, the higher the franchise the lower the premium.

Premiums

The premiums for health insurance vary from one plan to another in terms of the franchise, place of domicile, and any additional coverage required (e.g. dental costs, hospitalisation in a private ward, alternative medicine, etc.).