To prepare for healthcare between your country of work and country of residence, start by identifying the health insurance system to which you are affiliated. The documents and coverage conditions differ depending on this choice and where you receive care.
This guide provides general information: for your personal case, contact your health insurance fund or insurer before receiving care.
A reminder for organising your documents
Keep this reminder in mind when preparing your file: healthcare country work residence. Note your affiliation, the country where you will receive care and the corresponding document. Present these details to your contact and ask them to confirm the appropriate process. Then keep the guidance you receive with your documents.
Check your affiliation before preparing documents
The right of option allows, among others, EU and Swiss nationals who work in Switzerland and reside in France to choose French health insurance rather than Swiss health insurance.
For a cross-border worker, the option period is three months from the start of professional activity in Switzerland or the transfer of residence to France.
Working in both France and Switzerland requires verification with the CPAM: depending on the extent or nature of the activity, the state of affiliation may be France.
Swiss affiliation: the S1 for healthcare in France
If you choose the Swiss system, care provided in Switzerland is covered by your Swiss health insurance fund under Swiss regulations and tariffs.
For healthcare in France, your insurer must issue you with the portable S1 document, which you must present to the CPAM in your place of residence.
This document enables care in France to be covered by the French scheme on behalf of the Swiss scheme.
Before an appointment, check with your insurer or your CPAM that the procedures relevant to your situation have been completed.
French affiliation: distinguishing healthcare in Switzerland
If you choose French health insurance, you are covered by the French system in return for a contribution.
For medically necessary care in Switzerland, the European Health Insurance Card, or CEAM, provides coverage under the same conditions as those applicable to people insured in Switzerland.
Coverage may also apply to non-urgent outpatient care and planned care, subject, for the latter, to prior authorisation formalised by an S2 document.
Planned care here means care arranged in advance that is the main reason for travelling to Switzerland.
Before receiving planned care, ask your health insurance fund about prior authorisation and the S2 document.
Prepare your documents without confusing the processes
- For Swiss affiliation and healthcare in France, identify your S1 and the CPAM for your place of residence.
- For French affiliation and medically necessary care in Switzerland, prepare your CEAM.
- For planned care in Switzerland with French affiliation, check the prior authorisation and the S2 document.
For practical details about reimbursement and the documents to submit for your situation, ask the organisation covering the care.
Also prepare for each family member's situation
Cleiss states that, for family members residing in France who do not work or do not receive a pension or annuity from the Swiss scheme alone, health coverage depends on the option chosen by the cross-border worker.
To prepare a family file, tell the competent organisation about each person's situation: work, residence and any pension. Ask which document must be presented for each person, then check the practical details before gathering the supporting documents for cross-border reimbursement.
Distinguish a stay in another country
For a temporary stay in a third member state, distinct from the country of residence and the country of work, Cleiss recommends requesting a CEAM from the health insurance organisation in the state of work.
Include the destination of your stay in your questions. Before leaving, specify where you are insured and the type of care you anticipate, then ask your organisation about the procedures that apply to this situation.
