Published on 17/07/2026 · Sources last reviewed: 21/09/2026 · Our method

LAMal or CMU: decide on the 2026 figures, not on a forum thread

If you live in France and work in Switzerland, you have three months after starting your job to choose your health insurance — and that choice is in principle final for as long as you remain a cross-border worker. It is the heaviest financial decision of your status, so here is how it actually adds up.

The two systems, one sentence each

LAMal (Switzerland): a FIXED premium per insured person

Every insured person pays their own premium, whatever their income. Official 2026 average: 465.30 CHF a month per adult (+4.1% on 2025 for adults; +4.4% average rise across all age groups), around 122 CHF per child — varying by canton, insurer and deductible.

Cross-border CMU (France): a PERCENTAGE of income

A contribution of 8% calculated on your reference tax income from two years ago, after an abatement of 25% of the French social security ceiling — and dependants (a spouse with no income, children) are covered at no extra cost.

The honest logic of the choice

Modest income and/or a family → the CMU often wins: the percentage stays low and the family is included.
High salary and single → LAMal becomes competitive: the premium is fixed while 8% of your reference income climbs.
Watch your reference income: it includes ALL your income (rental, investments…), not just your Swiss salary — many people underestimate their future CMU.
2026 changed the picture: LAMal rose by 4.4% on average. If you did your sums with 2024 figures, do them again.

Orders of magnitude: single person on 90,000 CHF gross — CMU ≈ 8% × (reference income − about €11,800); LAMal ≈ 5,600 CHF a year. Depending on the situation the tipping point sits around 75,000–95,000 CHF of salary for a single person — but YOUR case depends on your deductible, your canton, your family and your real reference income: calculate, do not copy.

The documented traps

The choice is made through the right-of-option form within three months — no form means automatic affiliation to LAMal;
Going back is close to impossible: the 2016 agreement makes the choice irrevocable, except on four events — taking up work in Switzerland, resuming work in Switzerland after unemployment, moving your home to France, retiring. A change of employer with no unemployment in between, a marriage or a birth do not reopen it;
The CMU has to be declared every year (URSSAF/CNTFS) — forgetting is expensive;
On cross-border LAMal you are treated on both sides of the border without formalities — your Swiss insurer issues the S1 form for France. The French option does not rule it out: necessary care in Switzerland on the European Health Insurance Card, planned care with prior authorisation (S2). The difference is ease, not possibility.

Want the numbers straight away? The free LAMal/CMU comparator applies these rules to your salary in ten seconds.

Frequently asked questions

How long do I have to choose, and what if I do nothing? You have three months from the day you start work, using the right-of-option form. Doing nothing is itself a decision: with no form, you are affiliated to LAMal by default. And the choice is final and irrevocable: the 2016 France–Switzerland agreement only reopens it on four events — taking up work in Switzerland, resuming work in Switzerland after a period of unemployment, moving your home to France, or retiring. Marriage, a birth or a change of employer with no unemployment in between are not enough.

Is the CMU contribution really calculated on my Swiss salary? Not exactly, and this is where people underestimate the bill. The 8% is calculated on your reference tax income from two years ago, after an abatement of 25% of the French social security ceiling. That reference income includes ALL your income — rental income, investments — not only your Swiss salary.

At what salary does LAMal become cheaper than the CMU? There is no single answer, and anyone quoting one figure is guessing. For a single person the tipping point sits somewhere around 75,000 to 95,000 CHF, but it moves with your deductible, your canton, your family situation and your real reference income. A family with one income often keeps the CMU much longer, because dependants are covered at no extra cost. Run your own numbers rather than copying someone else's.

Compare LAMal and CMU on YOUR numbers. Relokea's Decision Engine runs both options with your salary, family and canton inside a full scenario — tax and disposable income included — on up-to-date 2026 scales.

Compare my scenarios

Official sources

FOPH — 2026 health insurance premiums (+4.4%) (accessed on 16/07/2026)
URSSAF — contribution of Swiss cross-border workers (accessed on 16/07/2026)
France–Switzerland agreement of 7 July 2016 — the right of option is final and irrevocable, only four triggering events (art. 2) (accessed on 21/09/2026)
CLEISS — France–Switzerland right of option: default affiliation, care in Switzerland under the French option (accessed on 21/09/2026)

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