Request a quotation for international health insurance

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I am interested in international health insurance. Please send me a quotation.

Form of address

Last name

First name

Street

Postcode

Town/city

Date of birth

E-mail

Telephone

Nationality

Future country of residence (place of residence):

I will deregister from Switzerland on:

I will depart Switzerland on:

Which health insurer provides your basic health insurance?

Are you claiming a pension from Switzerland?

Are you claiming a pension from another country?

Are you a cross-border employee?

Do you work outside Switzerland?

Do you work outside Switzerland for a Swiss employer?

Are you going travelling?

How long will you remain outside Switzerland?

Are you studying outside Switzerland?

Which deductible would you like for international health insurance?

Please also send me quotations for the following people:

Last name

First name

Gender

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