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Are you looking for information about cross-border retirement and health insurance? If you live in France, retiring with a pension solely from the Swiss system may allow you to reconsider your choice of health insurance. Check your situation with the competent authorities before assuming which system applies.
Right of choice at retirement: who is affected?
The right of choice allows, among others, EU and Swiss nationals living in France who receive pensions or annuities solely from Switzerland to request affiliation with French health insurance rather than Swiss health insurance. Switzerland is the state primarily responsible.
Cleiss lists AVS, AI, LAA, AM and LPP occupational pension benefits among the pensions and annuities concerned. If you also receive a pension from another system or are employed, request an assessment of your situation before concluding that you are entitled to this right.
Once exercised, the choice is irrevocable, but retiring with a pension solely from the Swiss system is among the changes that allow you to reconsider that decision. It is therefore useful to review your file even if you already chose cover while working across the border.
Cleiss also specifies that changes in civil status, family composition or professional activity without a period of unemployment between activities are not considered changes in circumstances allowing you to reconsider the decision. When assessing your case, therefore distinguish retirement from other changes in your personal or professional life.
What is the deadline for taking action?
For a person already living in France and receiving a pension or annuity solely from the Swiss system, Cleiss states that the deadline is 3 months from notification of the Swiss pension or annuity, which it specifies as the first payment of the Swiss benefit. For a recipient of a pension or annuity solely from the Swiss system who moves to France, the deadline runs from the date of that move.
If the recipient of a Swiss annuity has not indicated a preference for the French system by the end of the 3-month deadline, they are automatically affiliated in Switzerland. Promptly ask the competent authority to confirm the dates and procedures applicable to your case.
To prepare for your discussion, note the date you moved to France if relevant, and the date of notification or first payment of your Swiss pension. Ask which date applies in your case and how to submit your file within the applicable deadline.
How do you make your choice?
To request French health insurance
Ameli says to complete the “Choice of health insurance system” form, attach the requested supporting documents and send the file to the CPAM of your department of residence. The CPAM completes the form and registers you with it.
The form completed by the CPAM must then be submitted to the competent Swiss authority: for a recipient of a Swiss pension or annuity, this is the LAMal Joint Institution. Cleiss specifies that the form must be sent to the competent Swiss authority within the 3-month deadline.
In practice, check the documents requested in the form’s appendix before sending the file to your CPAM. Then arrange to send the completed form to the LAMal Joint Institution: this is a separate step from sending it to the French health insurance fund.
To choose Swiss health insurance
Ameli says to complete the choice form, then provide the CPAM with a certificate or a copy of the S1 document issued by the Swiss health insurer and have it complete the form. The form must then be sent within the 3-month deadline to the competent Swiss authority: for pensioners receiving a pension solely from the Swiss system, this is the LAMal Joint Institution.
According to Cleiss, the S1 document enables healthcare in France to be covered by the French system on behalf of the Swiss system. It must be presented to the CPAM of your place of residence.
For this process, ask your Swiss insurer for the necessary document and have the CPAM confirm which documents you need to provide. Then check with the competent authority about sending the choice form.
Compare the consequences for your healthcare
If you choose Swiss health insurance, Cleiss states that your healthcare provided in Switzerland is covered by the Swiss insurance fund under Swiss regulations and tariffs. For healthcare in France, the Swiss insurer issues the S1 document to be presented to the CPAM.
If you choose French health insurance, a contribution is payable. Ameli states that its amount is calculated by Urssaf’s national centre for Swiss cross-border workers based on the reference taxable income shown on the tax assessment, after deduction of a fixed annual allowance.
Cleiss mentions an Urssaf calculator for estimating the health insurance contribution of Swiss cross-border workers. Use an estimate to prepare your questions, then have the competent authority confirm the calculation applicable to your situation.
With French health insurance, the European Health Insurance Card allows coverage of medically necessary care in Switzerland, among other things, under the conditions applicable to Swiss insured persons. Ameli states that this card can be requested from the health insurance fund, including through the ameli account.
Some planned care in Switzerland requires prior authorisation: check the procedures with your insurance fund before planning treatment. Ameli specifies that, if authorisation is granted, the fund sends the S2 form to be presented to the healthcare provider.
To compare the procedures, identify where you intend to receive care and ask your insurance fund about the documents and conditions for coverage. If you are affiliated with French health insurance, Ameli states that you can choose your primary care doctor in France or Switzerland; for a doctor in Switzerland, contact your insurance fund to learn about the procedures.
What about supplementary health insurance?
Ameli states that supplementary health insurance can be purchased to cover the portion of healthcare costs in France that remains payable by you. Consider this cover separately from your choice of base health insurance.
Preparing to speak with the authorities
Gather information about your pensions and healthcare needs, then ask the CPAM and the LAMal Joint Institution to confirm your situation and the formalities to complete. For questions about calculating contributions, Ameli refers you to Urssaf’s Swiss cross-border worker service.
This guide provides general information. The competent authorities are responsible for examining your individual case.