Health insurance for cross-border workers: Swiss or French system?
When you start working in Switzerland, you must choose your health insurance. You make this choice only once and it commits you for a long time: it is worth comparing before you sign.
- You have 3 months after you are hired to choose.
- If you do not choose, Swiss insurance applies by default.
- Compare the two prices before deciding: you can almost never go back.
The two options
| Swiss insurance (LAMal) | French social security ("CMU frontalier") | |
|---|---|---|
| How the cost is calculated | A fixed premium per insured person, depending on the insurer and where you live | 8% of the reference taxable income (revenu fiscal de référence, the amount shown on your tax notice), after a deduction |
| Family | A premium to pay for each family member | A single contribution, which also covers your spouse and dependent children |
| Organisation | Swiss insurer of your choice | Caisse primaire d'assurance maladie (CPAM) and URSSAF |
The deadline not to miss: 3 months
You have 3 months from when you are hired in Switzerland to make your choice. If you take no action within this period, you are automatically covered by Swiss insurance.
If you still keep paying contributions in France, you risk being insured twice. In that case, you can ask to be removed from the French scheme.
Can you change your mind?
In principle, no: the choice is final. However, there are three situations in which you can choose again:
- retiring with only a Swiss pension;
- going back to work in Switzerland after a break (a job or unemployment in France);
- moving to another country of residence.
How to compare in practice
- Find your reference taxable income on your latest tax notice.
- Ask several Swiss insurers for quotes for each member of the household.
- Compare the annual total, but also access to healthcare on both sides of the border.
- Think ahead: a pay rise increases the French contribution, not the Swiss premium.
Calculator: how much does each option cost?
Cost is not everything: also compare reimbursements and access to healthcare on both sides of the border.
Frequently asked questions
How long do I have to choose between Swiss insurance (LAMal) and the CMU?
You have 3 months from when you are hired in Switzerland. If you do not choose, you are automatically covered by Swiss insurance.
Can you change health insurance later?
In principle, no: the choice is final. You can only choose again if you retire with a Swiss-only pension, go back to work in Switzerland after a break, or move to another country of residence.
How is the CMU contribution for cross-border workers calculated?
It is 8% of the household's reference taxable income, after a deduction of 12,015 € in 2026 (a quarter of the annual French social security ceiling).
- Compare Swiss insurers' premiums (official calculator of the Swiss Confederation)
- Assurance Maladie (ameli.fr) for the French option
- URSSAF, which calculates the French contribution
- impots.gouv.fr to find your tax notice
Sources: Frontaliers Grand Est, illness and healthcare · Alptis, right of option