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HEALTH INSURANCE

Why cross-border workers could pay higher Swiss health insurance premiums?

Swiss MPs are set to decide on the new method of determining health insurance premiums in cantons where many cross-border workers are employed.

Published: 15 February 2024 11:31 CET
Why cross-border workers could pay higher Swiss health insurance premiums?
Cross-border workers should calculate which country's health system is more affordable. Photo by Fabrice COFFRINI / AFP

During its spring session, which will be held from February 26th to March 15th, the parliament will vote on whether G permit holders will be included in the overall health insurance scheme’s calculation of risk — a change that has been in the works for several years.

If it passes — as it is expected to — local residents  of border cantons will benefit from some premium reductions, while border commuters who have opted for the Swiss insurance will pay more (see below).

Are cross-border workers obligated to take up Swiss insurance?

Basic health coverage (KVG / LaMal) is obligatory for everyone working in Switzerland.

Unlike permanent residents, however, cross-border commuters have a choice of being affiliated with the health insurance system in their home countries,  or purchasing a Swiss policy, which covers their medical treatment in both nations.

Why is Switzerland including G permit holders in the overall calculation of  risk?

According to the Federal Office of Public Health (FOPH), “many cross-border workers choose to seek treatment in Switzerland, which contributes to increasing health costs. This is why the Federal Council is putting forward the principle of solidarity to include cross-border policyholders in the calculation of risk compensation.” 

The ‘principle of solidarity’ means that, rather than applying an individual approach to healthcare insurance, Switzerland’s system is based on the idea that all insured people form a group.

READ ALSO : How the Swiss health insurance system is based on solidarity

As a result of including G permit holders in the overall scheme, local residents will benefit from some premium reductions, while border commuters who have opted for the Swiss insurance will pay more.

For instance, basic insurance premium for residents of Basel-City will cost 13 francs less each month, and in Geneva, it will decrease by 14 francs. 

At the national level, however, premiums for permanent residents  are expected to decrease by an average of only 1.60 francs per month.

On the other hand, the average premium for cross-border commuters domiciled in Germany will increase by around 45 francs, and for those living in France by around 129 francs per month.

Concretely, this means that G  permit holders from Germany will pay 295 francs a month, and those from France 336 francs.

Is Swiss insurance scheme more expensive  for cross-border workers than the one in their country?

It depends.

As an example, according to an information website for G permit holders from France, it is not necessarily the case.

That’s because  “in the case of French health insurance, the price is indexed to your salary. The higher your salary, the more you pay.”

In Switzerland, on the other hand, health insurance is not income-based.

It follows that cross-border employees from Italy, Germany, and Austria, should also calculate which country’s insurance system is more beneficial for them.

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For members

HEALTH INSURANCE

How Switzerland’s two crucial health insurance referendums could impact you

The price of Swiss health insurance premiums has been rising significantly in the past few years, prompting political parties to launch two cost-cutting initiatives. The votes will take place in June and there's a lot at stake.

Published: 24 April 2024 15:33 CEST
Updated: 28 April 2024 08:44 CEST
How Switzerland's two crucial health insurance referendums could impact you

On June 9th, the Swiss will cast their votes on two issues aiming, though in different ways, to curb the continually increasing cost of the obligatory health insurance (KVG / LaMal).

This is what’s at stake.

The ’10-percent’ initiative

In view of the high (and rising) premiums and other costs of living, which eat up a big chunk of the budgets of low- and middle-income consumers, the Social Democratic Party has spearheaded a national vote to cap the insurance rates at 10 percent of income.

Anything over this limit should be paid for by the federal and cantonal government, the party says.

While this strategy may sound enticing to everyone tired of paying high premiums, the government warns that while this proposal looks good on paper, the ‘yes’ vote could unleash some serious consequences.

Its main argument is that this measure would cost several billion francs per year, and does not provide any incentives to control health costs.

Instead, the Federal Council and the parliament have concocted their own ‘counter initiative’ that they want voters to approve.

Under this proposal, cantons will have to increase the amount of financial help they pay toward health premiums for low-income people. 

READ ALSO: How do I apply for health insurance benefits in Switzerland?

‘For Lower Premiums’ initiative

For its part, the Centre party has come up with its own proposal to reduce health insurance costs, which will also be voted on June 9th.

It provides for a ‘brake’ on health costs, which should evolve according to the economy and wages.

This brake would work in the same way as the federal spending brake. Therefore, when healthcare costs exceed wages for a given year by 20 percent, the government must take action to bring the  costs down.

The government is asking voters to turn down the Centre’s proposal because it doesn’t take into account factors such as demography, technological progress in healthcare, as well as the dependence of salaries on economic developments.

Here too, the Federal Council and parliament have put out their own counter-project, providing for more targeted measures, including specific cost control objectives for healthcare services.

Are there any other proposals on the table aiming to curb the cost of insurance premiums?

Yes.

While they are not on the ballot, two ideas have been debated in past months.

One calls for scrapping multiple private carriers  in favour of a government-run single health insurance scheme, similar to that in the EU. 

The other idea floating around is to replace the current system where rates are determined by factors such as age and canton of residence, and base them on wages instead. 

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