What is an exemption, and what is an exemption procedure?
The SWISSCARE Student Switzerland insurance plan covers all benefits of the mandatory Swiss national health insurance scheme KVG-LaMal. The exemption is a “waiver” from the obligation to have a Swiss national health insurance and is only possible for a very limited group of individuals (e.g. foreign students, interns, trainees,au-pairs) who are in Switzerland temporarily. After filling out this exemption form and sending all requested documents to SWISSCARE as pdf files and in good quality, our team will stamp, sign and send these documents directly to the responsible cantonal authorities. Upon reception of the documents, the cantonal authority will verify whether you are eligible for exemption according to article 2 paragraph 4 of the Swiss Ordinance on Health Insurance (KVV, OaMal). Depending on the authority concerned, the verification process can take a few weeks or even several months. Once the concerned authorities have rendered a decision, it will be sent directly to the insured. Unfortunately, Swisscare is not informed and can not obtain any information concerning this process.
Does this mean that I can be exempted from paying for my health insurance?
Answer: No, the premiums are due and the exemption procedure has no impact on the obligation to pay for the insurance premiums.
According to Swiss law, it is mandatory for every resident in Switzerland to obtain health insurance coverage in accordance with the regulations set in the Swiss Health Insurance Act. However, for certain individuals such as foreign students, or interns, there is an option to waive this obligation and to obtain private health insurance coverage, as long as the benefits are equivalent to those required by the Swiss Health Insurance Act. During the exemption procedure, this is what the authorities verify.
Do I need to pay for my health insurance during the exemption procedure?
The reason the premiums are still owed during the time the exemption request is being processed, is that should a client not pay and thus lose coverage, Swisscare is obligated to notify the authorities and the exemption process is then automatically stopped and the individual can be assigned to a Swiss national health insurance by the authorities. Additionally, Swiss law requires compliant insurance coverage from the day of arrival. For this reason, it is very important to respect the payment delays. In the case of non-payment, coverage can be suspended and a notification to the authorities can become necessary.
Is it possible that the exemption application is refused by the competent authorities?
The cantonal authorities can refuse an application for exemption based on a lack of eligibility - meaning that the individual does not fulfill the conditions set out in the applicable laws. The refusal decision always states the reasons for refusal, as well as a deadline for an appeal. Should the application be denied, a national Swiss health insurance provider must be found for the concerned individual and Swisscare should be contacted and the termination process initiated.