LAMal or CMU: the cross-border health insurance choice
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You live in France and start work in Switzerland: you get three months to choose between LAMal and the French system, once. The window, what can reopen it, how each cost is calculated, care in Switzerland and the form.
AdminLanding Editorial
The calculator is free. The official choice form and the comparison report come with the membership: €6 a month or €59 a year, renewed automatically, cancel any time.
Read the full written guide to this choice on ExpatAdminHub
The full script
You live in France and start work in Switzerland. You get three months to choose your health insurance: the Swiss LAMal, or the French system. You choose once. And the question everyone asks is: which one actually costs less?
The three months start with your first day of Swiss work — or your move to France, if you already work there. Doing nothing isn't a choice that saves you: Swiss and EU nationals are then put on LAMal automatically, and still need a Swiss insurer, with premiums that can run from your first day of work.
Can I change later? Not because you changed your mind. The choice only reopens with a new situation: you start Swiss work again after unemployment, you move to France, or you retire on a Swiss pension only. A new employer, a wedding, a birth — none of these reopen it.
LAMal is a premium per person, whatever your income — each child adds a premium, and some cantons pay a subsidy on modest incomes. The French side is 8% of your own income from two years earlier, after an allowance of roughly €12,000. Your partner's own earnings don't count, and your family is covered at no extra cost. On €57,000, that's about €3,600 a year. So which costs less depends on your income and your family. We recommend neither — compare with your own figures, at 2026 rates.
The second question is care. LAMal covers you in Switzerland, and in France once your S1 form is registered with your CPAM. With the French system, care in Switzerland is limited to emergencies and necessary care — planned treatment needs prior approval. Your employer's accident insurance covers accidents, not illness.
A Swiss reform is expected to push cross-border premiums up from 2028. There's no official figure yet. And no — your premium doesn't drop if you never see a Swiss doctor.
Then one form for both choices. You tick your system. Your CPAM fills in and stamps its part — at the desk, or through its online service. And you send it yourself to the office of your canton of work, within the three months. Go early: the stamp can take weeks.
Comparing is free: try the calculator at adminlanding.com. When you're ready to choose, the AdminLanding membership generates your official choice form and your comparison report as a PDF. It's 6 euros a month or 59 euros a year, and it also covers all our other cross-border documents. Link just below. See you there.
What the film simplifies
- Who has the choice. The option is for Swiss and EU nationals, and automatic LAMal is the rule for them. For British and EFTA frontaliers, the Swiss health office (OFSP) says insurance follows the place of work. Other nationalities are insured in Switzerland on request, within 3 months of the start of the G permit.
- The deadline. The stamped form must reach the Swiss authority before the three months end. Sending it on the last day is not enough.
- Your own income. Half of any income held in common with your partner counts too. Your partner's own earnings don't.
- The €3,600. A rounded example on €57,000 of your own income. Urssaf calculates your actual contribution.
- A new employer. The film says it doesn't reopen the choice. That holds when there was no period of unemployment in between.
- Retirement. The option covers people who draw Swiss pensions only. If you also draw a French pension, you are insured in France, without a choice.