Do you work in Switzerland, live in France and belong to the French health insurance system? Your contribution, often called “cross-border CMU”, is managed by Urssaf. To plan your budget, start by checking which income year is requested and which amounts relate to your circumstances.
Which income year should you use?
Urssaf states that contributions for 2026 are calculated using income received in 2024. Distinguish the year in which you complete the declaration, the year when the income was earned and the contribution year. Follow the year shown in your Urssaf account rather than automatically using your current salary.
Your RFR is not simply the figure to use in the calculation
The declaration has three sections: salaries, pensions and annuities; other income; and French reference taxable income (RFR). Enter amounts in euros, following the official instructions and permitted deductions. The RFR is used to check the consistency of your declaration. It is not, on its own, the amount used to calculate your contribution.
Have your tax notice and supporting records ready. If you file a joint tax return, do not enter all household salaries as your personal income. For income received jointly, follow Urssaf’s allocation rules. The organisation then applies the annual allowance, equal to 25% of the French annual social security ceiling, and the applicable contribution rate.
Partners, children and changes in circumstances
If both partners are cross-border workers insured under the French system, each must submit a separate declaration. Your partner’s and children’s healthcare entitlements should be assessed separately with the health insurance institution. Starting or ending work during the year may lead to an adjustment: send the date and supporting documents to Urssaf. A pay cut does not automatically reduce your next payment by the same amount.
From a contribution to a healthcare budget
To compare your CMU and LAMal budget, use the same period, the same people needing cover and the income relevant to the estimate. Look at both monthly and annual amounts. A simulation helps prepare your decision; your declaration and final contribution calculation remain Urssaf’s responsibility.
Compulsory contributions do not necessarily cover all your healthcare expenses. You can then compare France–Switzerland supplementary health insurance according to your consultations, dental, optical and hospital needs. Budget for this price separately and check which country each benefit applies to.
