Cross-Border Workers France–Switzerland: Healthcare, Taxes & Social Rights in 2025

A cross-border worker lives in France but works in Switzerland, returning home at least once per week. This unique status gives access to special healthcare, tax, and pension systems—but you must choose your health regime within 3 months.

For comprehensive information about healthcare systems in Europe, see our expat healthcare guide.

Since 2014, cross-border workers must choose between two regimes:

| Option | Coverage | Avg. Cost 2025 | Pros | Cons |

|--------|-----------|---------------|------|------|

| LAMal (Switzerland) | Swiss system | 400–450 CHF/month | Full Swiss access, fast reimbursement | Expensive for families |

| CPAM (France) | French system | 8% of income (max ~300€/mo) | Family coverage, Carte Vitale | Slower refunds, limited Swiss care |

Choose within 3 months—otherwise you're automatically in LAMal.

> Expat advice: Compare LAMal/CMU quotes before signing. Official simulator: service-public.fr – travail frontalier Suisse.

Learn more about European health insurance options in our EHIC guide.

Your Swiss employer automatically deducts:

- AVS (Old-age insurance) ≈ 5.3%

- AI/APG (Disability/income loss) ≈ 1.45%

- AC (Unemployment insurance) ≈ 1.1%

- LPP (Occupational pension) ≈ 7–10% depending on age

These contributions don't cover health or French family benefits: those remain your responsibility via CPAM or LAMal + URSSAF (specific contribution).

> Budget tip: set aside 10% of net salary for French social charges and potential taxes.

| Employment canton | Where to pay tax? | Specifics |

|-----------------|------------------|----------------|

| Geneva | In Switzerland (withholding tax) | You also declare in France to avoid double taxation (tax credit). |

| Vaud, Valais, Neuchâtel | In France | Annual declaration + tax advance. |

| Basel, Bern, Zurich | In France | Same logic. |

> Advice: Verify forms 2047 + 2042-C each spring. Even if main tax is paid in Switzerland, French declaration remains mandatory.

For more on tax compliance, explore our VAT and tax guide.

- If you choose LAMal, you can attach spouse and children (with reduced premiums).

- Under CPAM, family coverage is automatic by default (free for children).

- Students in France can keep CEAM (European Health Insurance Card).

Good reflex: Update your Carte Vitale or request European LAMal card. In an emergency, this is the document you'll be asked for at the hospital.

- With LAMal: Reimbursements via Swiss insurer (Helsana, Atupri, CSS, etc.), often in Swiss francs. For care in France, provide E106 form to CPAM.

- With CPAM: Standard reimbursements to French account, Carte Vitale required.

> Tip: Download the *Ameli* app or your Swiss insurer's app to track reimbursements in real-time.

Cross-border workers often have a dual system:

- In Switzerland, the first 3 days are sometimes unpaid.

- Beyond that, income loss insurance takes over (if subscribed).

- In France, if you depend on CPAM, daily allowances are calculated on declared French taxable income.

> Key: Verify your employer subscribed to income loss insurance (mandatory for 80% of companies).

Your years worked in Switzerland count toward your French retirement via form U1/U2. Each country pays its share according to years contributed.

> Example: 12 years in Switzerland + 20 years in France = 2 pensions, cumulative.

> Check info-retraite.fr and the Swiss Compensation Fund (AVS Geneva).

- Create a FranceConnect account + Ameli account + online LAMal account. Centralize everything.

- Save your forms (E106, 2047, 3916-BIS, etc.) in secure cloud.

- Set calendar reminder for annual LAMal/CPAM attestation before March.

- Check your cantonal tax scales each December: they change slightly every year.

For more about managing cross-border work, see our remote work compliance guide.

Claire lives in Annemasse and works in finance in Geneva. She chose LAMal in 2023. Her premium is 405 CHF/month, but she gets care in Switzerland without advancing costs. In France, she uses her E106 for occasional consultations. In 2025, she plans to keep the same regime—because despite the cost, comfort is superior and waiting times shorter.

- Swiss employer attestation

- LAMal or CPAM choice within 3 months

- E106 form (if LAMal)

- Declaration 2047 & 2042-C

- Cantonal tax certificate

- Income loss insurance verification

- Digital copy of AVS/LPP statements