As a cross-border worker in Switzerland, the question of the choice of health insurance arises. Each has its advantages and disadvantages. To know which one to choose, you have to compare the benefits of Swiss health insurance to that of France.
The main difference between Swiss and French health insurance concerns its operation. Frontier workers are required to take out health insurance when they begin to practice in Switzerland. 2 regimes are possible: the LAMal and the CMU.
The first corresponds to compulsory health insurance on the Swiss side. It is an alternative to French health insurance. Unlike French social security, Swiss health insurance is individual and therefore does not allow you to affiliate your family. Each member of the family must take out their own insurance, which generates an additional cost. By subscribing to Swiss health insurance, this allows you to benefit from care in Switzerland and France.
Offered to cross-border workers, the cross-border CMU corresponds to Universal Health Coverage and covers basic health care for insured persons (not to be confused with the CMU reserved for people in a precarious situation in France). Expensive care such as optical costs, dental care or hospitalization costs are therefore not taken into account. The amount due each month corresponds to 8% of the reference taxable income, after deduction of a fixed annual amount, revalued each year.
However, depending on the composition of the household, the method of calculation changes. For a single cross-border commuter, all income must be taken into account (rental property, wages, etc.). A couple of cross-border commuters, both incomes will be taken into account. Finally, a cross-border worker married to someone insured in France, only the cross-border worker’s reference tax income will be used as the basis for calculating contributions. With this system, it is not possible to benefit from care in Switzerland, except for emergencies. It is for this reason that, very often, this insurance plan is insufficient and it is advisable to subscribe to complementary health insurance. The other advantage of complementary health insurance is that it allows you to be treated in all facilities, even those located in Switzerland.
With regard to complementary health insurance, a new difference remains between France and Switzerland. To subscribe to a Swiss mutual, you must fill out a questionnaire on your state of health. Consequently, the insurer may refuse to cover an insured if his state of health is fragile. Taking advantage of low prices to join a complementary health insurance can therefore be more complicated.
Read also: Complementary health: how it works
How to choose health insurance
A new cross-border worker has three months after taking up his post to choose between the two health insurance systems. His choice must be communicated to the cantonal authority.
It will depend on 3 main criteria : income, family and general health status. It is also necessary to take into account career developments which can impact the salary and therefore make the French system less attractive than at the start. It should be noted that if the cross-border worker does not express his choice, he will automatically be affiliated to the compulsory Swiss health insurance.
To sum up, in Switzerland, health insurance is based on premiums, the amount of which is defined according to the subscriber’s sex, age and canton of residence. In France, it is the income of employees that will determine the amount of contributions, calculated as a percentage at the Caisse Primaire d’Assurance Maladie. An insured person who receives a high salary will have more interest in taking advantage of the Swiss system, while an insured person with a lower salary will have more advantages in joining the French system.