Sorry about the length of this post.


My partner and I are retired and our main home is in the UK (where we are at the moment). We also rent an apartment in Switzerland. We got B permits some years ago to allow us to occasionally stay for over 90 days continuously, and we are on the Gemeinde residents list. However, the Kantonal tax office agreed with our request that we continue to pay all our taxes in the UK and pay no tax in Switzerland.


We obtain all our routine medical care in the UK, and until now, we have been relying on our EHICs to cover us for urgent health needs when in Switzerland, but these ceased to be valid in CH on 1/1/21. Travel insurance is problematic, as I can find no policy which allows a trip length longer than 90 days for over 65s with cover for my hobbies of ski mountaineering and paragliding.Using the Form S1 process would (I think) require us to declare that we live in CH, which isn’t true, and we’d then loseour right to use the NHS.


So I’m wondering aboutKrankenkasse, but obviously that’s quite costly, and my impression is that if we ever signed up for that, it would be year-round, and impossible to stop the payments without a departure certificate, in which case we’d lose our residence permits.


My question is: which of the following applies?


1) As we have B permits, Krankenkasse is compulsory for us.
2) As we are UK domiciled, we’re not eligible for Krankenkasse.
3) It’s up to us whether we take out Krankenkasse or not.
4) Our situation is anomalous and we’re in a legal limbo.


Thanks for any advice!

I suspect all of the above.

Tom

How about an international health insurance with a high deductible for non accident? I am not sure if they exist but I would start with Bupa and explain the situation.

How on earth did you get a B permit without being resident in Switzerland and without health insurance That must be a first!!!

Thanks for the replies so far.


@kri, I couldn't find a suitable international health policy, but will look into the Bupa option; perhaps I need to approach them directly.


@doropfiz, thanks for the link to that thread. I had a face-to-face meeting with two officials at the Kantonal tax offices to negotiate continuing to pay all our tax in UK rather than CH, and convincing them that our centre of life was in the UK was the key issue! So I'm relieved that they didn't then say that meant we had to give up our permits.


@Island Monkey, because we applied for permits that didn't entitle us to work in CH, we only had to show proof of sufficient regular income to avoid us needing state support, and medical/accident insurance. Our EHICs were accepted as evidence of the latter.

I guess there are 3 options.

1. Take a 90 day travel insurance policy. Fly home for a few days. Come back with new 90 day policy.

2. As suggested get insurance with BUPA etc.

3. Become fully resident in Switzerland. Note Krankenkasse does not automatically cover you for accidents, you have to add it on. Also accident insurance through krankenkasse does not cover a large amount of mountain rescue and helicopter rescue, so you’d also need to become a Rega member or similar.

Sorry for the irrelevant question, but I had this long in mind.

Does "not having accident insurance" mean that your insurer will refuse to pay at all, for problems caused by an accident, or that they will be treated "normally" and counted on your normal deductible (the max 2500.- CHF one)?

Because I believe health problems accepted by accident insurance are not counted on the normal deductible.

Yes. If you don’t have accident insurance through your employer, or your personal health insurance and you have an accident, you will have to pay out of your own pocket.

If you have accident added to your health insurance, your normal deductibles etc apply. Through your employer, then no deductible.

@Island Monkey, your suggestion of returning to the UK every 90 days is our current "least worst option". An annual multi-trip policy including cover for my risky hobbies would set us back around a fifth of the cost of Krankenkasse. At the moment we'd have to quarantine for 10 days in both directions, which is an unattractive prospect, but obviously that shouldn't be a permanent requirement.

I would be prepared to bite the bullet and shell out for Krankenkasse if we could just stop paying as soon as travelling back and forth became easier. However, what I've read about the process suggests (as I wrote above) that this could jeopardise our permits and hence the amount of time we could (legally) spend in CH. BTW, I've emailed a few of the companies which provide Krankenkasse to ask if they offer a suitable product for our needs, and had negative replies.

I certainly agree about Rega. We've been patrons for a long time; it's a fantastic service and amazingly good value for money.

If you are retired & getting a UK pension, the UK would cover your health & accident insurance in CH with a 300 excess. Having a B permit means you are living in CH, UK may judge you dual tax resident.

Rega is NOT insurance.

Any Medical costs would be in addition to the emergency service.

From Rega.ch website

@fatmanfilms, my understanding of the process for using the fact that I am receiving a UK pension to get the UK to cover medical and accident costs in CH is that I would have to obtain a form S1 in the UK and then register it with the Gemeinsame Einrichtung KVG. I'm rather frustrated to be unable to find written details anywhere of the (UK) regulations applying to this entitlement, so if anyone can point me towards those I would be delighted!

As I wrote in my original post, I think we would have to declare that CH is our home (which is untrue) and give up our access to the NHS if we went down that path. Also, the KVG website (regarding the form S1 process) includes the rather scary "Your statements on the questionnaire are instrumental in clarifying whether a registration is basically possible or whether you are subject to compulsory health insurance in Switzerland", so I'm concerned there is a small risk that we could end up being told we've been illegal for years, and must not only pay for Krankenkasse from now on but also cough up retrospectively. It could be argued that if we're deemed to have been Swiss residents all this time, then we've never been entitled to UK-issued EHICs.

Wow- never heard of anyone having B permit and living in UK and only paying taxes in UK. As others have said, I am really not sure this can be legitimate.

Form S1 is for those of UK retirement age and above, and dependant spouse even if below that age- so does not apply if you have taken early retirement. But you have to be living, be resident in Switzerland, have no Swiss pension or income. You also retain the right to use the NHS in UK. Insurance covers both health and accidents, you have to pay 300.- franchise before it kicks in, then 10% up to 1000.-, per year. However, I believe you had to apply before end of December last year- but not sure.

When we came to live here (having retained a small home in UK) - OH was not of official retirement age- as he retired at 62 and we moved when he was 63. So we had to pay full Swiss insurance until he became 65- and could then take up S1 exemption, and me (5 years younger) as his dependant.

We have to pay for all medical care, send bills to KVG Soleure- and they reimburse us minus franchise and 10% as described above.There are no limits re dangerous sports, etc. We also have EHIC for partial cover in Europe. Only problem is, as all people with compulsory health insurance in CH are automatically covered for up to double Swiss estimated cost abroad- we cannot find an insurance product to top up EHIC for Europe, and none at all to cover us at all outsdide Europe. Some are available, but not for our age (70/75) and especially pre-existing conditons. So when we travel to Europe- we take a large risk, and would have to be repatriated as fast as poss to UK or CH. We are also members of REGA. But our dreams of returning to US, go to Tasmania OZ and NZ as planned, etc, will just have to be shelved. The only other option would be to pay for Swiss Insurance all year- just to cover this. We could use our UK address for Travel Insurance- and they would be happy to take out premiums- but should anything happen, I am sure they would cotton on, shout 'fraud' and refuse to pay.

We are trying to find an Insurer who would accept up on a special contract, to cover excess above EHIC - but so far, no good.

REGA is happy to have people as a members/donors (and OH loves that his card says 'Gonner' on it) - as long as you have a Swiss address, and will only repatriate you to that Swiss adress or a Swiss hospital- and then if you are not covered for Swiss health/accident you'd be in big trouble.

@JackieH, many thanks for your detailed advice. It sounds as if I was very lucky with the tax officials whom I saw. I have to say I was totally blown away that they would not only talk to me face to face, which would be quite impossible in the UK, but also in English! Regarding legitimacy, one of the officials was the head of the department. They wrote to the Gemeinde to tell them to rescind the tax bill they had sent me which had arrived a couple of weeks after our B permits. However, they made it very clear that if our circumstances changed, e.g. we bought a property in CH rather than renting a flat (described in the contract as a "Ferienwohnung") then we would have to have another conversation.

What you've written confirms that to use the S1 process we would have to declare that we are Swiss residents, which is untrue and could lose us our exceptional CH tax-free status. We spend too much time in the UK for HMRC to accept that we aren't liable for tax here, so we might then end up with a choice between double taxation or giving up our permits.

Regarding Rega, we used to be registered with them at our UK address, and the answer to the fourth question on www.rega.ch/en/rega-patron/patron-service?rnw-widget=goenner-service makes it clear that non-residents can be patrons. However, their repatriation benefits are for Swiss citizens and residents only. Yes, we were also entertained by "Gonner"!

I'm a patron of Rega for many years and unfortunately needed their help a few years back. I can confim they do not pay any medical costs - the health insurance deals with that. And when you're in a foreign country, be prepared to pay up front for help.

Rega sends a bill for the administrative and transport costs, which you then submit to your insurance. Insurance pays what they pay (mine paid a small amount of transport but not admin). Then Rega decides whether or not to write off the balance.