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If you live in France and choose Swiss health insurance, the S1 form for cross-border workers in Switzerland certifies your entitlement to healthcare cost coverage to the CPAM where you live.
The S1 is separate from the “Choice of health insurance system” form: both documents are involved in the process described by Assurance Maladie.
Which document should you request from the Swiss insurer?
The Swiss health insurer issues the portable S1 document, which certifies entitlement to healthcare cost coverage.
For your application to the CPAM where you live in France, Assurance Maladie says to submit a certificate or a copy of the S1.
The choice form, meanwhile, must be completed by you and then by the CPAM before it is sent to the competent Swiss authority.
How should you prepare for the process with the CPAM?
If you opt for Swiss health insurance, start by completing the “Choice of health insurance system” form.
Then submit the certificate or a copy of the S1 to the CPAM where you live in France and ask it to complete the choice form.
Finally, send the choice form to the competent Swiss authority: for a cross-border worker, this is the competent cantonal body in the canton where they work.
Assurance Maladie specifies a deadline of 3 months from the start of work in Switzerland to complete these steps.
When preparing your application, distinguish between the document certifying your entitlement and the choice form that must be completed: they are sent to different places in the process.
If you have any doubts about your insurance affiliation or your healthcare coverage, direct your question to the French health insurance system.
What healthcare is covered in France?
For care in France, health insurance entitles you and your dependants to coverage for care in the event of illness or maternity under the same conditions and at the same rates as other insured people.
You can take out supplementary health insurance to cover the portion of costs that remains your responsibility.
Workplace accidents, occupational illnesses, disability and loss of earnings related to illness or maternity are mandatorily covered by the Swiss social security system and are not covered by French health insurance.
It is therefore useful to distinguish coverage for care in the event of illness or maternity from situations that are mandatorily covered by the Swiss system.
Medical follow-up and practical steps
According to Assurance Maladie, designating a primary care doctor in France or Switzerland enables follow-up within the coordinated care pathway and better coverage of healthcare expenses.
If you choose a primary care doctor in Switzerland, contact your health insurance fund to find out about the procedures.
Assurance Maladie also states that certain medical procedures or treatments may require its prior approval, whether they are carried out in France, another European Union or European Economic Area country, or Switzerland.
To track your progress, the ameli account allows you, among other things, to download a certificate of entitlement, track your reimbursements and communicate by email with your health insurance fund.
Something to check before making your choice
The right of option allows you, under the conditions specified by Assurance Maladie, to choose between Swiss health insurance and French health insurance; once exercised, the option is irrevocable.
This right applies in particular to EU and Swiss nationals who work in Switzerland and live in France.
Assurance Maladie states that the option is exercised when starting a first job in Switzerland, returning to work in Switzerland after a period of unemployment, changing from worker to pensioner status or moving to France.
It specifies that the right of option may be exercised within 3 months of starting employment in Switzerland or taking up residence in France.
After this deadline, affiliation with Swiss health insurance is mandatory.
For any questions about affiliation or coverage of your healthcare costs, Assurance Maladie says you can call 36 46 at the cost of a call.
This information outlines the general steps; for your personal situation, contact your health insurance fund.