Choosing between French or Swiss health insurance

Published on April 19, 2024

As a cross-border worker in Switzerland, you have the option to choose between French health insurance (Cpam) and Swiss health insurance (LAMal). You must make a choice within three months of starting your activity in Switzerland. If you do not make a choice, you will be automatically affiliated with Swiss health insurance.

What is a cross-border worker in Switzerland?

You are considered a cross-border worker in Switzerland if you reside in France and are :

  • employed under a contract in Switzerland ;
  • a recipient of a pension or annuity paid in Switzerland ;
  • a freelancer or micro-entrepreneur in France with a contract in Switzerland ;
  • a freelance professional practicing both in France and Switzerland ;
  • employed under a contract in France and a contract in Switzerland.

What are my health insurance options?

French or Swiss health insurance

As a cross-border worker in Switzerland, you have the option to choose between French health insurance (Cpam – Primary Health Insurance Fund) and Swiss health insurance (LAMal). When you start your activity in Switzerland, you have a three-month period to choose between the two.

If you do not make a choice, you will be automatically affiliated with Swiss health insurance.

If you opt for French health insurance and you are an employee, you will not be able to switch to Swiss health insurance for the duration of your employment contract.

Good to know

Opting for French health insurance means that you have the same rights as any insured individual, including reimbursement for healthcare expenses for yourself and your dependents (within the coordinated care pathway).

You can also benefit from the services of the health insurance.

Special cases

Depending on your situation, different rules apply regarding your affiliation with the French social security system. If you are in one of the following situations:

  • self-employed or micro-entrepreneur working in France with a contract in Switzerland: it's your salaried activity that determines your social security scheme ;
  • self-employed working both in France and in Switzerland: you will be registered in France and will fall under the French social security scheme if your activity in France represents a substantial portion of your total activity ;
  • holder of an employment contract in France and an employment contract in Switzerland.

Please contact the International Mobility service to determine your social security scheme.

How to affiliate with French health insurance

Affiliation with the Cpam

This process must be completed with the Cpam and then the Swiss authorities by following these two steps.

  1. 1

    Demandez votre affiliation auprès de l’assurance maladie française

    Complétez et remettez le formulaire à la Cpam de votre lieu de résidence. Votre affiliation est effective à partir de la date où vous avez remis ce formulaire. 

  2. 2

    Déclarez votre choix pour l’assurance maladie française auprès de l’autorité cantonale suisse compétente : 

    Déposez le formulaire complété par votre Cpam : 

    • si vous êtes travailleur frontalier en Suisse : à l'autorité cantonale responsable de l'assurance maladie du lieu de travail ; 
    • si vous êtes bénéficiaires de rentes suisses : à l'institution commune (LAMal). 

You can request the affiliation of your relatives (spouse, partner, civil union partner, child) as beneficiaries, which will allow them to benefit from the French health insurance services.

The Cpam is responsible for any administrative changes: change of address, marriage, birth, divorce, deregistration from health insurance, etc.
For further details, please contact the Cpam in your area of residence.

Registration with Urssaf

After completing your affiliation, your Cpam sends the necessary information to Urssaf for the creation of your account as a cross-border worker in Switzerland.

Urssaf then communicates your account number to you and invites you to declare your income.

Once your income is recorded, Urssaf calculates the amount of your health insurance contribution and sends you a payment schedule.

You are required to make the payment of your contribution to Urssaf.

Good to know

When your account is being created, you are invited to create your online space on urssaf.fr to carry out your procedures. Before making any online declaration, have your Social Security number ready.

Contact

If you opt for French health insurance, your points of contact are :

Depending on your place of residence, your Urssaf is :

  • residents in the Rhône-Alpes region :
    Urssaf Rhône-Alpes - TSA 50002 - 38046 Grenoble cedex 9
  • residents of other regions :
    Urssaf Franche-Comté - TSA 41037 - 69833 Saint Priest cedex 9