Cross-border workers in Switzerland

Do you live in France and work in Switzerland or receive a Swiss pension? As a cross-border worker in Switzerland, you must contribute to health insurance in order to receive sickness benefits and be entitled to reimbursement of your health care.
To do this, you need to choose between :

  • Swiss health insurance (LAMal) ;
  • French health insurance managed by Cpam (caisse primaire d’assurance maladie) in your place of residence.

The first step : choose your health insurance scheme

You need to choose between these two insurance schemes by exercising what is called the « droit d’option » (right of option). You need to choose your health insurance scheme within 3 months of starting your job in Switzerland or moving to France. After that date, you are obliged to join the Swiss health insurance scheme.

If you want to join the French health insurance scheme, fill in the « Choix du système d'assurance maladie » form and send it directly to the Cpam (caisse primaire d’assurance maladie) of your place of residence, together with the justifying documents required.

As soon as your Cpam has informed Urssaf of your membership, your Urssaf health insurance account will be created with a number starting with 828 or 438. You will be informed by mail, and you will be able to proceed with your first steps.

Get off to a right footing by creating your online space on urssaf.fr. This is where you will manage all your administrative steps : declare your income, pay your contribution, obtain a payment certificate or communicate with an advisor via a messaging service.

 

- Your health insurance contribution

To benefit from French health insurance, you must pay a health insurance contribution to Urssaf.

- Calculating your health insurance contribution

This contribution is calculated on the basis of all your income received in the penultimate year, after deduction of a flat-rate allowance. The contribution rate is then applied to this base (8 % in 2022).
For example : your 2023 contribution is calculated on your 2021 income that appears on your 2022 tax notice.
If you started your activity or terminated your employment contract in Switzerland during the year, the amount of the health contribution is proportional to the number of days worked in Switzerland.
Do you want to estimate the amount of your contribution? A simulator is available.

- Paying your health insurance contribution

Urssaf sends the payment schedule of your health contribution by mail.
It can be paid monthly or quarterly. By default, payment deadlines are quarterly (set on the last working day of the calendar quarter – for example, the contribution of the 1st quarter is due on 31/03). You can make the change from your online space.

You can choose from the following payment methods :

  • by direct debit (quarterly or monthly), by joining from your online space ;
  • by credit card from your online space ;
  • by bank transfer using the Urssaf RIB (bank details) accessible on your online space ;
  • by cheque payable to Urssaf, to be sent to the postal address of your Urssaf (see below the « points of contact » section).

The second step : declare your income

To calculate your first health insurance contribution, you must declare your income to Urssaf within 20 days of your affiliation. This declaration is made from your online space.

You will subsequently declare your income annually to update the calculation of your health insurance contribution the following year.
For example, as of September 2022, you need to declare your 2021 income featured on your 2022 tax notice.

You must declare :

  • net salaries and pensions (linked to your individual fiscal income) ;
  • other income received by the tax household, i.e. : declared income from movable capital, declared expenses from movable capital, taxable income from movable capital, net life annuity for valuable consideration, net property income, capital gains from the sale of securities or property, declared deficit on previous movable capital ;
  • your reference fiscal income for the year in question.

Important : if you do not declare your income, your health insurance contribution will be calculated on a flat-rate basis (automatic taxation).

Your points of contact

If you opt for the French health insurance scheme, you will have two points of contact :

The Cpam of the « département » of your residence for questions relating to affiliation, any change of situation, coverage and refunding of your health care :

  • ameli.fr ;
  • 36 46 (free service + cost of call) Monday to Friday 8.30 am to 5 pm. From abroad, dial +33 184 90 36 46 (free service + cost of call).

Urssaf, department for cross-border workers in Switzerland for questions related to the calculation and payment of your health insurance contribution or any procedure regarding the declaration of income or change of situation (moving, end of activity in Switzerland...).

  • 0 806 807 713 from Monday to Friday between 9am and 5pm (free service + cost of call)
  • By mail, depending on your place of residence :
    • If your Urssaf account number starts with 438 :
      Urssaf Franche-Comté
      TSA 41037
      69833 Saint-Priest cedex 9
    • If your Urssaf account number starts with 828 :
      Urssaf Rhône-Alpes
      TSA 50002
      38046 Grenoble

Cpam :

Caisse primaire d’assurance maladie. La Cpam est l'organisme de base qui assure le service des prestations d’assurance maladie, maternité, invalidité et décès, accidents du travail et maladies professionnelles. Elle effectue l'immatriculation des assurés sociaux relevant de sa compétence, le contrôle administratif des malades, la mise en œuvre d'une action sanitaire et sociale.

Urssaf :

Les Urssaf collectent et répartissent les cotisations et contributions sociales qui financent l’ensemble du système de Sécurité sociale (financement du système de santé, des aides au logement ou la garde d’enfants, des pensions de retraite…). Les Urssaf accompagnent également les entreprises en difficultés financières, et participent à la lutte contre la fraude et l'évasion sociale.