If you work in Switzerland and live in France, you quickly end up facing the same question: LAMal or the French system? People often call it “LAMal or CMU”, but the legal framework is the right of option, which allows cross-border workers living in France (under certain conditions) to choose between Swiss compulsory health insurance (LAMal/KVG) and the French health-insurance system.
This is not only a price question. It also changes, very practically, how and where you can access care.
The right of option: a decision with long-term consequences
As a general rule, someone working in Switzerland is subject to Swiss health insurance. Cross-border workers living in France, however, have a right of option between LAMal and the French system.
The choice normally has to be made within three months of starting employment in Switzerland. Those who opt for the French system must formally request exemption from the Swiss insurance obligation.
The key point is that once exercised, the right of option is generally not freely reversible. You cannot simply switch because premiums rise, your salary changes or the other system later looks more attractive.
A new right of option only arises in certain situations (for example a first job in Switzerland, a return to Swiss employment after unemployment, a change in status or a change of country of residence). A simple change of Swiss employer does not automatically reopen the choice.
If your situation is not straightforward, it is worth checking it with the competent cantonal authority and the French health-insurance authorities before making any decision.
How much does LAMal cost for a cross-border worker living in France in 2026?
LAMal premiums for cross-border workers are not directly linked to salary. They depend mainly on the insurer and age category.
According to the official 2026 premiums published by the Swiss Federal Office of Public Health, an adult resident in France can, for example, be insured with Helsana for around CHF 200 per month without accident cover. Other insurers also offer LAMal cover for cross-border workers.
Basic-insurance benefits are defined by law, so a lower premium does not mean reduced statutory benefits.
Deductible and co-payment in Switzerland
For adults, the standard deductible is CHF 300 per calendar year. Cross-border workers living abroad cannot choose a higher optional deductible to reduce the premium.
After that, there is a 10% co-payment (capped at CHF 700 per year for adults). In the standard situation, ordinary annual cost participation is therefore limited to CHF 1,000.
How does the French system work?
Cross-border workers who choose the French system pay their health-insurance contribution through Urssaf.
For 2026, the contribution rate is 8%. Importantly, this is not simply 8% of the Swiss salary.
For the 2026 calculation, Urssaf uses income declared for 2024, after applying a statutory allowance equal to 25% of the French social-security ceiling.
Why can LAMal be attractive for cross-border workers?
1. Access to healthcare in Switzerland
A LAMal-insured person living in France can receive healthcare in Switzerland under Swiss rules. This is particularly practical for someone who works every day in Basel and wants to see a doctor, specialist or physiotherapist close to the workplace.
2. Continued access to healthcare in France
Choosing LAMal does not mean losing access to the French healthcare system.
The Swiss insurer issues an S1 form. Once it is registered with the CPAM, the cross-border worker can access healthcare in France, with costs coordinated between the competent insurance systems.
A LAMal-insured cross-border worker can therefore keep a GP in France while receiving selected treatment in Switzerland.
A French complementary health policy may still be useful
Whether you choose LAMal or the French system, healthcare received in France may leave out-of-pocket costs. A French complementary policy (“mutuelle”) can therefore still be useful.
Depending on the contract, it may contribute towards dental care, glasses, hearing aids, fee supplements or other expenses not fully reimbursed by the basic system.
3. Premiums are not linked to salary
LAMal premiums are fixed according to the applicable country-of-residence tariff and insurer, rather than being calculated as a percentage of income. For higher earners this can be financially attractive, while in other family or income situations the French system may be preferable.
4. Convenient access to Swiss healthcare during the working week
For someone living in Alsace and working in Basel, receiving treatment in Switzerland can make appointments easier to integrate into the working day. This applies to planned care as well as situations that need prompt medical assessment.
What happens in the event of an accident?
Accident insurance must be considered separately from health insurance.
Employees in Switzerland are compulsorily insured against occupational accidents. If they work at least eight hours per week for the same employer, they are also covered for non-occupational accidents.
This is important for cross-border workers who chose the French health-insurance system: the right of option concerns health insurance, not compulsory Swiss accident insurance. If an accident is covered under Swiss accident insurance (UVG/LAA), the cross-border worker may receive treatment in Switzerland even if their ordinary health insurance is French.
For a recognised accident-insurance case, the ordinary LAMal deductible and co-payment do not apply.
A useful simplification is: illness = the system chosen under the right of option; covered accident = the employer’s Swiss accident insurance.
LAMal and physiotherapy in Basel
A LAMal-insured cross-border worker can receive physiotherapy in Switzerland when the requirements of compulsory health insurance are met.
Physiotherapy under LAMal is generally prescribed in series of nine sessions. For an accident covered under UVG/LAA, treatment is billed to the responsible accident insurer.
For more details, see our article Physiotherapy prescription in Switzerland: accident or illness?.
You can also view our physiotherapy services in Basel or book an appointment online.
A useful local resource: the CDTF in Saint-Louis
For people living in the Haut-Rhin and working in Switzerland, the Comité de Défense des Travailleurs Frontaliers du Haut-Rhin (CDTF) is a useful local organisation. It supports cross-border workers with health insurance, the right of option, taxation, unemployment, pensions and administrative matters.
More information: CDTF (Comité de Défense des Travailleurs Frontaliers du Haut-Rhin).
Official sources (2026)
- Swiss Federal Office of Public Health – cross-border workers
- FOPH – EU/EFTA/UK premiums 2026
- Urssaf – 2026 contribution calculation
- Assurance Maladie – Swiss cross-border workers
- CDTF – health insurance
General information, updated for 2026. This article does not constitute individual legal or insurance advice.
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