Frontalier CMU: Functioning, Cover and Cost

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90 days. It is the deadline that Swiss authorities grant you to choose between being affiliated with the Swiss health insurance LAMal or the CMU (French health insurance). 

As it is final, your choice will be full of consequences. 

I wrote a series of articles about LAMal and Frontalier CMU. The goal is for you to have all of the necessary information available in order to quickly take the best decision possible. 

You will find below 10 points explaining what the CMU is and how it works and here you will find the form that needs to be filled:

What is the CMU?

CMU Is the abbreviation for universal healthcare. It is the French health insurance system to which you can subscribe as a frontalier to benefit from a certain level of care in Switzerland and in France. 

What is a right of option?

The right of option refers to the three months periods, starting from your first day of work, during which you can choose to subscribe to the CMU or the LAMal.

Time line showing the deadline for the right of option, i.e. to choose between the KVG and the CMU for a cross-border commuter

You enjoy this right during 90 days. Not a single one more. in case you do not answer, the Swiss authorities will decide for you.

You will be signed up at the LAMal with a Swiss private insurance of their choice. 

The insurance will apply delay penalties. 

You can choose but you have to choose quickly. 

Can I go back on my choice and change health systems?

Between the CMU and the LAMal, you not only have to choose quickly, but you also have to choose well. Your decision is final. Non revokable. No turning back possible. 

Well… there are however two exceptions: 

  • You live in France and move to Switzerland. If you are affiliated to the CMU, the law requires that you subscribe to the LAMal. The opposite is not possible.
  • You receive unemployment benefits. You have 90 days, starting from your first day of unemployment, to choose between the CMU and the LAMal, regardless of your previous affiliation. 

Is my partner covered by my insurance?

If you subscribe to the CMU, your partner is considered as a beneficiary. They enjoy the same protection as you do. 

If your partner also works in Switzerland, they can however subscribe to the LAMal if they want to. 

Are my children covered by my insurance? 

If one of the parents is covered by the CMU, the children are also covered by the CMU without any additional contribution. 

However, if both parents are covered by the LAMal, then your children will also have to subscribe to the LAMal. The Swiss insurance will require an additional premium per child (less costly than that of the adults). 

When I am covered by the CMU, what happens in case I require care? 

You can choose between getting treated in France or in Switzerland. In each case, to get the maximal refund, you will have to choose a general practitioner to serve as first contact person.

Is it best to get treated in Switzerland or in France? The answer depends on the situation.

In non urgent medical situations

France determined a fixed rate for each type of medical service. The full list is available on the website Ameli :

Your right to reimbursement is based on this price list.

Imagine that your visit to the doctor costs you €25. If the fixed price mentioned on the website Ameli.fr is €25, you are entitled to the maximum reimbursement: 70% of the bill. 

Be careful: the CMU does not take into account the price differences between France and Switzerland. The bill from a medical visit in Switzerland will greatly exceed the 25€. But you will be reimbursed 70% of the 25 euros fixed by the French authorities. 

The rest will come out of your pocket. 

The CMU cover is shorts in case of non-urgent health problems. 

If your condition requires specific medical knowledge or equipment that is not available in Switzerland yet, you can ask for a derogation in order to get treated at the Primary Sickness Insurance Fund (CPAM). 

Urgent medical situation

In case you have an urgent health problem, it is simpler: the CMU covers the costs, whether you are in Switzerland or in France. Phew!

What happens in case of unemployment?

If you lose your job, you are no longer covered by the CMU or by the LAMal, but rather by the French social security system. 

What happens in case of termination of employment contracts?

In this case as well, if you live in France but no longer work in Switzerland, you will not be covered by the CMU or the LAMal anymore. 

Compared to those of the LAMal, what are the advantages of the CMU?

Here is a comparative table which sums up the main characteristics of being insured with the LAMal on the left and with the CMU on the right: 

Table summarizing the main differences between the LAMal and the CMU

In short, being affiliated to the CMU is advantageous in case of a modest salary and if you intend to keep receiving care in France.

Pay attention, the calculation of your CMU contributions is based on an 8% rate, which might increase in the coming years. In Switzerland, contributions are not based on a rate. They are stable and even tend to decrease. 

How much does the CMU cost?

It is just like taxes: the more you make, the more you pay.

If you want to know the exact amount of your (potential) future CMU premiums, I prepared an article explaining in a simple and easy way how to calculate it

Do you still have questions about the Frontalier CMU? Please feel free to ask them in the chat box at the bottom right this page. One of our experts will answer you as soon as possible. 

This was Noé, the FBK Conseils mascot would spend its life making yours easier.

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