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 systems differ in cost, coverage for care in Switzerland and France, and procedures. This clear and practical guide helps you compare and select the option best suited to your personal and family situation.

Understanding the right of option

When starting a job in Switzerland or moving from France, you have 3 months to exercise your right of option. If you do nothing, you will be automatically affiliated. This choice is binding over time: except for specific events (unemployment benefits in France followed by resuming work in Switzerland, full Swiss retirement, etc.), it is difficult to reverse.

Two possible options

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

Costs: how to compare?

LAMal is often per adult premium (independent of income), while CMU is indexed to the household’s reference taxable income. To decide, estimate your total annual cost (contribution + any supplementary) and include your healthcare usage. Dual-income couples, families, and high incomes do not always get the same result.

Coverage and access to care

With LAMal, access to care in Switzerland is direct, useful for emergencies or Swiss specialists. With CMU, you are primarily treated in France, with the carte Vitale and a wide network. Depending on where you live, your usual doctor, and your needs (maternity, chronic illness, ophthalmology, dental), one of the schemes may prove more practical.

Practical tools for cross-border workers

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

Family, maternity and children

Check how children and spouses are covered. In LAMal, each person is insured with their own premium; in CMU, the contribution depends on household income. Also compare maternity, dental, and optical coverage through complementary insurance adapted to your chosen scheme.

Procedures and documents

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

When to choose LAMal or CMU?

• LAMal: you mostly seek care in Switzerland, want quick access to Swiss specialists, have high or stable income, need predictable premiums.
• CMU: you mainly get care in France, have modest to average income, prefer the French care pathway and the carte Vitale.

Key points before confirming

• Simulate your total annual cost based on your household.
• Check access to care near you (Switzerland/France).
• Choose health supplements adapted to the chosen scheme.
• Exercise your right of option within 3 months and archive your proof.

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 quickly validate your right of option. Need help? A specialized broker can secure your procedures and optimize your coverage.