Cross-border worker from France: LAMal or CMU, which health insurance should you choose?

The choice only covers medical care (illness, maternity). Work accidents, disability and loss of earnings stay Swiss.

You have 3 months from the start of your work in Switzerland. Fill in the form 'Choice of health insurance system', have it completed by the CPAM (French health insurance office) where you live, then send it to the health insurance office of the canton where you work.

French insurance. The Urssaf (the French contributions office) calculates: 8% × (your income - 25% of the Social Security ceiling), which is an allowance of 12 015 € in 2026. It uses your income from two years before: 2024 for the 2026 contribution.

Which income? Yours only. The declaration is individual: your wages (including your Swiss salary), your pensions and your share of rents or investments (half if they are joint). Your spouse's salary does not count, even if they work in France. If your spouse is also a cross-border worker insured in France, they declare and pay separately. The household's reference tax income (revenu fiscal de référence) is only used as a check.

A spouse and children without work follow your choice and are covered with you, at no extra cost.

LAMal. One premium per person, depending on the insurer. In 2026, for an adult living in France, without accident cover (already covered by the employer's accident insurance, UVG/LAA): from CHF 200.00 to CHF 823.10 per month. On top of that come the deductible (at least CHF 300.00 per year) and 10% of costs, up to CHF 700.00 per year.

Fictional example. Marco, a temporary formwork carpenter in Geneva, lives in Annemasse. Income in 2024: 45 000 €. His partner's French salary does not count.

• French insurance: (45 000 € - 12 015 €) × 8% = 2 638.80 €, so 2 639 € per year.
• LAMal: from CHF 2'400.00 per year (CHF 200.00 × 12) to CHF 8'370.00 depending on the insurer, plus the deductible.

With a partner without a job and two children, the French contribution does not change; the cheapest LAMal goes up to CHF 6'165.60 per year (CHF 513.80 per month). Do the maths with your own figures: Urssaf simulator, premiums on priminfo.ch.

Yes. Changing agency, employer, canton or contract does not reopen the choice, and neither does a marriage or a birth. It only comes back after a period of unemployment followed by new work in Switzerland, a move to France, or retirement with a Swiss pension only.

• Swiss pension only, living in France: a new 3-month choice, with the LAMal Common Institution (Gemeinsame Einrichtung KVG). France: 8% contribution; Switzerland: LAMal premium.
• Swiss pension and French pension, living in France: no choice, France insures you.
• French pension only, living in Switzerland: no LAMal; France stays your insurer (S1 form) and deducts 3.2% from the basic pension and 4.2% from the supplementary pension (tax residence outside France).