LAMal vs CMU: which scheme to choose for Swiss cross-border workers?

Choosing between LAMal (Swiss health insurance) and CMU (French PUMa) is crucial for any cross-border worker. The two schemes differ in cost, healthcare coverage in Switzerland and France, as well as in their administrative procedures. This clear and practical guide helps you compare and select the best option for your personal and family situation.

Understanding the right of option

When you start working in Switzerland or move from France, you have 3 months to exercise your right of option. If you don’t act, you’ll be affiliated by default. This choice is binding for the long term: except for specific events (unemployment with French benefits followed by resumption in Switzerland, switch to 100% Swiss retirement, etc.), it is difficult to reverse.

Two possible options

• LAMal cross-border: coverage under the Swiss system, easy access to healthcare in Switzerland, options for care in France via supplementary insurance.
• CMU: attached to the French system, reimbursements based on French tariffs, easier access to care in France.

Costs: how to compare?

LAMal is often per adult premium (independent of income), while CMU is based on the household’s reference taxable income. To decide, estimate your full annual cost (contribution + possible supplementary insurance) and factor in your healthcare consumption. Couples with two earners, families, and higher incomes don’t always reach the same result.

Coverage and access to healthcare

With LAMal, access to care in Switzerland is direct, useful for emergencies or Swiss specialists. With CMU, you are mainly treated in France, with the carte Vitale and a broad network. Depending on where you live, your usual doctor and your needs (maternity, chronic condition, ophthalmology, dental), one scheme may be more practical than the other.

Practical tools for cross-border workers

• CMU vs LAMal
• Swiss net salary
• Borrowing capacity
• Transport cost
• Cross-border teleworking
• Administrative deadlines calendar

Family, maternity and children

Check the coverage for children and spouse. Under LAMal, each person is insured with their own premium; under CMU, the contribution depends on the household’s income. Also compare maternity, dental, and optical cover through supplementary policies adapted to your chosen scheme.

Procedures and documents

Keep your work contract, proof of residence, option forms, and affiliation certificates. With LAMal, you receive a Swiss insured card; with CMU, your French carte Vitale is activated. Respect deadlines to avoid reimbursement delays.

When to prefer LAMal or CMU?

• LAMal: you mainly consult in Switzerland, want fast access to Swiss specialists, have high or stable income, or need premium predictability.
• CMU: you mainly receive care in France, have low to moderate income, prefer the French care pathway and the carte Vitale.

Key points before validating

• Simulate the total annual cost for your household.
• Check access to care near you (Switzerland/France).
• Choose supplementary health insurance suitable for your scheme.
• Exercise your right of option within 3 months and keep evidence.

Conclusion

The “best” scheme depends on your profile: usual place of care, income, family composition, and risk tolerance. Use the tools above, compare LAMal and CMU point by point, then validate your right of option promptly. Need help? A specialized broker can secure your procedures and optimize your coverage.