Cross-Border Health Insurance: LAMal or CMU, What Impact on Your Housing Budget?
The choice that impacts your budget by 200 to 500 CHF per month
When you become a cross-border worker, there's one decision everyone underestimates: health insurance. LAMal (Swiss insurance) or CMU-PUMa (French coverage)? This isn't an administrative question — it's a first-order financial question. Depending on your profile, the gap can reach 500 CHF per month. And that amount directly affects your housing budget.
LAMal: how it works for cross-border workers
LAMal (Federal Health Insurance Act) is Switzerland's mandatory health insurance. As a cross-border worker, you can access it through your G permit status.
The principle
You choose a Swiss insurer (Helsana, CSS, Swica, Groupe Mutuel, etc.), an annual deductible (300 to 2,500 CHF — the amount you pay before insurance kicks in), and you pay a monthly premium. The premium varies by age, canton, and chosen deductible.
Concrete costs in 2026
For a cross-border worker aged 25-35 working in Geneva, the LAMal premium is between 250 and 450 CHF per month with a 2,500 CHF deductible (the most economical). With a 300 CHF deductible (maximum coverage), expect 380-550 CHF/month.
Beyond the premium, there's the co-payment: you pay 10% of remaining medical costs after the deductible, up to a maximum of 700 CHF per year. LAMal covers care in both Switzerland AND France (with the European health insurance card).
Key advantage
LAMal is fixed: your premium doesn't depend on your salary. Whether you earn 4,000 or 12,000 CHF, you pay the same amount. This is a considerable advantage for high earners.
CMU-PUMa: the French coverage
The alternative is to exercise your "right of option" within 3 months of starting work in Switzerland, to be covered by the French system (CMU-PUMa, Universal Health Protection).
The principle
You're affiliated with the French CPAM and contribute proportionally to your reference tax income. You access the French and European healthcare network normally.
Concrete costs in 2026
The CMU-PUMa contribution is 8% of your reference tax income (after allowances). Concretely, for a gross salary of 70,000 CHF/year (about 5,800 CHF/month gross), the reference tax income in France is approximately 50,000 €, giving a contribution of about 4,000 €/year, or 333 €/month (~350 CHF).
For a gross salary of 100,000 CHF/year, the contribution rises to about 500-550 €/month (~530-580 CHF). For a salary of 50,000 CHF/year, it's about 200 €/month (~210 CHF).
Key advantage
For modest salaries (below 65,000 CHF gross/year), CMU is often cheaper than LAMal. And you don't have to pay a deductible upfront.
Comparison table by salary
| Annual gross salary | LAMal premium (2500 deductible) | CMU-PUMa contribution | Monthly gap | Recommended option |
|---|---|---|---|---|
| 50,000 CHF | ~300 CHF | ~210 CHF | 90 CHF | CMU |
| 65,000 CHF | ~320 CHF | ~300 CHF | 20 CHF | Equivalent |
| 80,000 CHF | ~350 CHF | ~400 CHF | -50 CHF | LAMal |
| 100,000 CHF | ~380 CHF | ~530 CHF | -150 CHF | LAMal |
| 120,000 CHF | ~400 CHF | ~650 CHF | -250 CHF | LAMal |
The tipping point is around 65,000-70,000 CHF gross annually. Below that, CMU is generally more advantageous. Above, LAMal becomes progressively more interesting because its premium is fixed while CMU increases with salary.
Direct impact on your housing budget
This is where it gets concrete. Let's take three cross-border profiles.
Profile 1 — Junior at 55,000 CHF gross/year (~4,200 CHF net/month). With LAMal (300 CHF/month), 3,900 CHF remains for everything else. With CMU (230 CHF/month), 3,970 CHF remains. The 70 CHF/month difference is modest. Recommended housing budget (30%): ~1,200 CHF. Coliving at 1,380 CHF is tight with both options.
Profile 2 — Manager at 85,000 CHF gross/year (~6,200 CHF net/month). With LAMal (350 CHF), 5,850 CHF remains. With CMU (420 CHF), 5,780 CHF remains. LAMal saves 70 CHF/month. Housing budget: ~1,750-1,860 CHF. Coliving at 1,380 CHF is very comfortable.
Profile 3 — Senior manager at 120,000 CHF gross/year (~8,500 CHF net/month). With LAMal (400 CHF), 8,100 CHF remains. With CMU (650 CHF), 7,850 CHF remains. LAMal saves 250 CHF/month, or 3,000 CHF/year. At this level, the insurance choice significantly frees or constrains the housing budget.
Traps to absolutely avoid
The right of option is practically irreversible. You have 3 months after your Swiss contract starts to choose. If you do nothing, you're automatically enrolled in LAMal. If you choose CMU, you cannot easily switch back to LAMal (except for situation changes like contract termination).
LAMal premium increases are a real concern. Each year, premiums increase by 5-10%. What's advantageous today may not be in 3 years. CMU only increases if your salary increases — which is generally a good sign.
Coverage isn't identical. LAMal offers direct access to Swiss doctors without needing a referring physician. CMU requires coordinated care (referring doctor in France). If you live in France but regularly consult in Switzerland, LAMal may be more practical.
Supplementary insurance is quasi-mandatory in both cases. Count 30-80 €/month extra for coverage of specialist surcharges, dental, and optical care.
How to optimize the insurance + housing combo
Here's our recommended approach by profile.
If you earn less than 60,000 CHF gross, choose CMU and use the monthly savings for slightly better housing or to build a safety cushion. Coliving at 1,380 CHF represents about 33% of your net — above the 30% rule, but justified by the fact that everything is included (no hidden charges).
If you earn between 60,000 and 80,000 CHF gross, both options are financially equivalent. Choose based on your medical habits: frequent consultations in Switzerland → LAMal; medical follow-up in France → CMU. Coliving at 1,380 CHF represents 23-27% of your net — very comfortable.
If you earn more than 80,000 CHF gross, LAMal is almost always more advantageous. The 100-300 CHF/month saving vs CMU is significant. At this salary level, coliving is a comfort and community choice, not a constrained one — you're there because the service is excellent, not because you can't afford better.
The best advice we can give you
Do this calculation BEFORE arriving. Many cross-border workers discover the health insurance question after signing their lease and regret not optimizing earlier. The CMU/LAMal choice impacts your monthly budget by 100-300 CHF — equivalent to the gap between basic flatsharing and premium coliving.
Consult a cross-border insurance broker (several exist in Annemasse and Saint-Julien) for a personalized simulation. It's free and can save you thousands of francs per year.
Looking for housing that simplifies everything else in your budget? Check our all-inclusive pricing or apply directly.
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