Do you live in France and are starting work in Switzerland as a cross-border worker? The Swiss cross-border worker’s right of option allows you, subject to conditions, to choose between Swiss and French health insurance. You have 3 months from the start of your professional activity in Switzerland to exercise this option. If you do not indicate your preference for the French system by the end of this period, you will be automatically affiliated in Switzerland.
Prepare a starting-point note for your discussion
Before comparing the options, gather the key details of your situation in a note that is easy to review. Include your employment start date, your place of residence, your canton of employment and any other activities you may have. For each household member, note their employment status and current coverage. This will give you a clear basis for explaining your plans to the people you speak with.
- Keep the contact details of your CPAM and the relevant cantonal authority handy.
- Write down the points that still need confirmation, particularly if you also work in France.
- Set aside time to compare the answers you receive with your actual situation.
This note is an aid to preparing for your discussion. Ask the relevant organisations directly which documents you need to provide for your application.
Check your situation before choosing
The right of option applies in particular to EU and Swiss nationals who work in Switzerland and live in France. According to Cleiss, a cross-border worker returns to their country of residence every day or at least once a week.
If you also work in France, check with your CPAM whether you meet the conditions for the right of option. Depending on the extent or nature of your activities, your country of affiliation may be France rather than Switzerland.
CMU or LAMal: what are the implications for your healthcare?
If you choose Swiss health insurance
Your healthcare in Switzerland is covered by your Swiss insurance fund under Swiss regulations and rates. For healthcare in France, your Swiss insurer must issue you with an S1 document to present to the CPAM where you live. Coverage in France is then provided by the French system on behalf of the Swiss system.
If you choose French health insurance
You are covered by the French system in return for a contribution. In Switzerland, medically necessary care may be covered under the same conditions as for people insured in Switzerland upon presentation of your European Health Insurance Card. Coverage may also include non-urgent outpatient care and planned care, with the latter subject to prior authorisation formalised by an S2 document.
To prepare for your choice, you can estimate your French contribution using the Urssaf simulator.
Compare using a framework suited to your daily life
Prepare practical questions: where would you usually like to receive care? Do you already have a doctor on each side of the border? What appointments do you need to arrange soon? For each answer, distinguish between the country where care is provided, the organisation to contact and the procedure to check. If an example presented online seems close to your situation, compare its assumptions with those of your household before using it.
For your budget, note available estimates separately from information you still need to obtain. Keep the date, source and assumptions for each estimate. You can then compare consistent scenarios and ask for an explanation when an amount or condition seems difficult to understand.
Steps to take within 3 months
The form indicated by Cleiss is called “Choice of health insurance system” and is being updated. Depending on your situation, complete parts 1, 2 and 4 or 1, 3 and 4, then tick the system you have chosen in part 5.
If you choose the Swiss system, provide your CPAM with a certificate or a copy of the S1 from your Swiss insurer and have it complete part 6 of the form. If you choose the French system, also have the CPAM where you live complete part 6. Also request an exemption from the Swiss system.
Then submit the form within 3 months to the relevant cantonal authority in your canton of employment. Prepare for these steps early enough to allow for the visit to the CPAM.
Keep a simple record of the formalities
Create a single folder for correspondence related to your right of option. Keep the form you used, the documents you submitted and the answers you received in it. For each submission, note the date, the recipient and the next action to take. Request confirmation of receipt when needed for your records and keep the available supporting documents.
If a response is delayed or an instruction seems ambiguous, contact the organisation concerned, explaining your situation and the current stage of the process. Ask a specific question: which document is still required, who must complete it and to whom should it be sent? Then review your file in light of the answer you receive.
A choice to prepare for carefully
The right of option is irrevocable. Certain changes in circumstances nevertheless allow you to reconsider your decision, particularly a return to work in Switzerland after a period of unemployment, a move to France or retirement under the Swiss system alone.
Marriage, divorce, a birth or a death in the family are not considered changes in circumstances that allow you to reconsider this choice. The same applies to a change of professional activity without a period of unemployment between the two activities.
Your family members who live in France and do not work or do not receive a pension or annuity under the Swiss system alone do not have their own right of option: their health coverage depends on your choice.
Points to clarify before finishing
Review your starting-point note and check that your questions have been answered. Has your work situation been described correctly? Are the procedures for your healthcare in France and Switzerland clear? Have you identified the contacts for each household member? Keep any outstanding questions in your file so you can address them in your next discussion.
After clarifying your base health insurance, you can compare your supplementary health cover for cross-border workers. Prepare your healthcare priorities and take time to read the benefits offered. For the rules governing the right of option and the formalities, consult the official Cleiss FAQ on cross-border workers.
This guide provides general information, not personalised advice. To check your situation and the applicable formalities, contact your CPAM and the relevant cantonal authority.
