Starting work in Switzerland raises two questions you should settle early: how you get health insurance and which tax applies to your salary. Both depend on your place of residence and your residence permit, so it is worth checking them before your first working day.
Short answer: If you live in Switzerland, you must take out basic health insurance under the KVG within three months of arriving. Premiums depend on your age, your place of residence and your health insurer, not on your income, and your employer does not pay them. For tax, your permit matters. With a B or L permit, withholding tax is often deducted. Last updated: October 2026.
Key points
- If you live in Switzerland, health insurance is compulsory. Basic cover under the KVG must be in place within three months of arrival.
- You choose your insurer and model. Premiums depend on age, place of residence and insurer, not on your salary.
- Your employer does not pay the health insurance premium.
- Your permit determines whether withholding tax applies. The rules are set by the canton.
- If you live in Germany and work in Switzerland, a different legal framework applies. Clarify it before you start.
Do I have to take out health insurance in Switzerland?
People with a residence in Switzerland are generally required to have health insurance. The Federal Social Insurance Office (BSV) states a clear deadline: basic cover under the Health Insurance Act (KVG) must be concluded no later than three months after arrival. The choice and the conclusion of the policy are your responsibility. The canton decides which insurer is assigned if you do not register.
| Situation | Health insurance | What to do |
|---|---|---|
| Residence in Switzerland | Basic cover under the KVG, concluded within three months of arrival | Choose your insurer and model yourself and compare premiums where you live |
| Residence in Germany, work in Switzerland (cross-border worker) | Rules under the agreement between the EU and Switzerland, usually via your German residence | Ask your German health insurer before you start and inform your employer of your situation |
The table does not replace individual advice. For cross-border workers in particular, responsibility depends on the exact residence and the type of employment.
How are premiums calculated and who pays them?
The premium does not depend on your salary. It depends on your age, your place of residence and the insurer you choose. Your employer does not handle it through payroll. You pay the premium directly to your insurer. You can freely choose an insurer at your place of residence. The federal premium calculator at priminfo.admin.ch shows the differences where you live.
Besides the insurer, you choose the insurance model and the deductible (Franchise). Both affect how much you pay yourself when you are ill and how high your monthly premium is. Compare the terms, not only the price, before you decide.
Which tax applies to your salary?
Taxation in Switzerland depends on your residence status. Foreign employees without a settlement permit C are often subject to withholding tax (Quellensteuer) with a B, B EU/EFTA, F, N, L or L EU/EFTA permit. In this case, the employer deducts the tax directly from your salary. The tax guide of the canton of Schwyz, status 1 January 2026, shows this logic with an example. Other cantons regulate the details differently.
With a settlement permit C, withholding tax generally does not apply, and the tax is set in an ordinary assessment. In the canton of Schwyz there is an additional exception if you live in an undivided marriage with a spouse who holds Swiss citizenship or a settlement permit.
Your place of residence determines which canton is responsible. Withholding tax is settled with the canton of residence or stay, which also answers questions about tariffs. Your employer must clarify tax liability and the applicable tariff before it pays out your salary. The deadlines for settlement and for reporting new employees are also set by the canton.
Cross-border workers: living in Germany, working in Switzerland
In the canton of Schwyz, people with a residence abroad who work for an employer based in or operating from the canton also fall under withholding tax. This includes cross-border workers. Double taxation agreements can provide a different rule, so the question of which tax applies is not purely a cantonal matter.
Before your first working day, clarify whether Swiss withholding tax or German income tax applies. The tax office or a tax adviser with experience in cross-border cases can tell you what applies to you. Ask your employer how it handles the settlement, because that determines deadlines for proofs.
What appears on a Swiss payslip?
Your payslip shows the deductions your employer withholds. These include contributions to old-age provision and unemployment insurance, and withholding tax where applicable. The health insurance premium is not among them, because you pay it directly to your insurer. Do not compare the deductions one-to-one with German rates, because the systems are built differently.
Ask for an explanation of your payslip in the first months. Ask specifically which contributions are deducted, on what basis, and in which canton the tax is settled.
Frequently asked questions
Do I have to be insured in Switzerland within three months?
Yes, if you take up residence in Switzerland. Basic cover under the KVG must be concluded no later than three months after arrival. The canton decides what happens if the deadline is missed. The BSV does not give details on its page.
Can I keep my German health insurance?
Not automatically if you live in Switzerland. Cross-border workers living in Germany are subject to different rules. Clarify this with your German health insurer before you sign the employment contract, so that no gap arises.
Is there a premium reduction?
Yes, insured persons resident in Switzerland can receive a premium reduction depending on the canton and their income. The residence canton sets the conditions and the application process, so ask there before you treat the premium as a fixed figure in your budget.
Is withholding tax cheaper or more expensive?
This cannot be answered in general terms. Withholding tax is deducted from your salary as a monthly tariff. An ordinary assessment can produce a different result depending on your family situation and deductions. A comparison is worthwhile once you know your situation exactly.
What to do next
- Clarify your residence and your permit before you start, because health insurance and tax depend on them.
- Compare health insurers where you live with the federal premium calculator and choose your insurer and model within the three-month deadline.
- Ask your employer whether withholding tax applies and have the first months of your payslip explained.
- If you are a cross-border worker, get advice from the tax office or a tax adviser on double taxation before you sign.
Related articles
- Working abroad after your studies: health insurance and pension
- Private or statutory health insurance for your first job (in German)
- Checklist: review your health insurance after graduation
- Understanding your first payslip
Sources: Federal Social Insurance Office, FAQ on health insurance after moving to Switzerland (accessed October 2026); Federal premium calculator, priminfo.admin.ch (accessed October 2026); Canton of Schwyz, guide to withholding tax with examples (status 1 January 2026).
Last updated: October 2026. This guide is general information, not individual advice.
