Cross-border commuters
Cross-border commuters living in countries bordering Switzerland (Germany, Austria, France, Italy) can choose between:
- An affiliation to the Swiss health insurance scheme (it is a specific contract which also allows treatment in the country of residence)
- An affiliation to the health insurance scheme or social security of the country of residence, which only allows treatment in Switzerland under certain conditions.
This choice, known as the “droit d’option” (right to choose), is irrevocable except at certain key moments: a period of unemployment (with unemployment benefits), a move to another country, or retirement.
If you live in France, you’ll find more information below.
Explanations and procedure or on this page explanations and procedure
If you live in another European country, link to further information (in French only).
Cross-border commuters living in France
You have 3 months from your 1st day of work as a cross-border commuter to exercise your droit d’option/right to choose. Once this period has passed, the SAM – Service de l’assurance maladie (Health Insurance Service) will start the formalities for an automatic affiliation to the Swiss health insurance scheme (LAMal).
CMU – French system
If you opt for an affiliation to the CMU, the rules of the French Social Security system apply: reimbursement of 70% of costs at the conventional rate.
Medical expenses abroad, including Switzerland, are covered only in emergencies or after prior agreement with the Sécurité Sociale (social security).
You can add your dependants.
The amount of the insurance contribution is calculated by the Urssaf’s Centre National des Travailleurs Frontaliers Suisses (CNTFS), based on your income for year N-2. Please note that this is not just your salary, but all your income. Your tax declaration is what will be used as a reference point.
For example, the CNTFS will calculate the 2024 contribution on the basis of your tax declaration for 2022. Calculation method. Simulator.
LAMal – Swiss system
Care in Switzerland is covered under Swiss law (see “compulsory health insurance” section), and care in France is covered under French law.
The company will provide a Swiss health insurance card or a French “carte Vitale”.
One contract per person: it is not possible to attach dependent family members to a contract, but it is possible to take out a contract for each dependent family member under certain conditions:
- Contract for the spouse: only if the person is not linked in any way to the French social security system.
- Contract for children: only if the other parent is not linked in any way to the French social security system.
Health insurance companies are private, but their activities are strictly governed by the Health Insurance Act (LAMal) (in French only).
Each company sets its own rates. See here a table showing monthly premiums. Rates are not linked to income.
Premiums vary widely from a company to the other, but benefits are identical and defined by law.
Please note that insurance premiums could rise in the near future as a result of a proposal by the Federal Council to include policyholders living abroad in risk compensation (in French only).
Here are the details of the three companies offering the cheapest deals for cross-border commuters.
Helsana (also in German, French and Italian)
https://www.helsana.ch/fr/prives/assurances/assurances-speciales/frontaliers.html
Moove Sympany (no English website)
Swica (also in German, French and Italian)
https://www.swica.ch/fr/prive/assurances/assurances-speciales/assurance-de-frontaliers
Supplementary insurance – mutual insurance companies
Currently, it is no longer possible to take out supplementary health insurance in Switzerland. However, it would appear that some companies are offering packages via companies based in Europe.
Supplementary services can be provided by mutual insurance companies under French law.