Cross-border

LAMal premiums 2027 for cross-border workers: compare and switch insurer before 30 November

October 2026·10 min read

Updated 20 October 2026 — rules in force for 2027.

At the end of September, Switzerland published its health insurance premiums for 2027: +5.0% on average. If you live in France and chose LAMal, that figure doesn't directly apply to you: your premiums follow a separate scale, calculated for people who live in France.

For 2027, that scale barely moves. But the gap between insurers is still huge, and you only have until 30 November to switch for 1 January. Here's what you need to know, and how to go about it.

Cross-border workers: a "France" scale, not a cantonal one

For insured persons living in a European Union country, Swiss law provides that premiums are calculated according to the country of residence. Each insurer therefore sets a premium specific to France, based on healthcare costs in France. The canton where you work plays no part, and neither does your salary. What makes your premium vary:

the insurer you choose
your age group (child up to 18, young adult aged 19 to 25, adult from 26)
whether accident cover is included

Another point: not every insurer covers people living in France. For 2027, the official list from the FOPH (the Swiss Federal Office of Public Health, OFSP in French) has 13.

2027 premiums for residents of France

Here are the 2027 monthly premiums for an adult (26 and over), without accident cover, taken from the FOPH's official EU/EFTA/UK premium overview ("France" pages), from cheapest to most expensive:

Helsana: CHF 209.30
SWICA: CHF 237.80
Mutuel Assurance Maladie: CHF 345.40
Assura: CHF 439.90
Vivao Sympany: CHF 461.30
Sanitas: CHF 474.90
Agrisano: CHF 489.30
ÖKK: CHF 597.10
Concordia: CHF 652.10
CSS: CHF 697.50
Aquilana: CHF 724.10
Visana: CHF 755.40
KPT: CHF 823.10

For an adult, the gap between the first and last insurer is more than CHF 600 a month — over CHF 7,000 a year — even though basic insurance benefits are set by law and identical from one insurer to the next. For young adults, the cheapest is SWICA (CHF 178.30), ahead of Helsana (CHF 188.40); for children, Helsana (CHF 48.10), ahead of SWICA (CHF 59.50).

Compared with 2026, 8 of the 13 insurers have not changed their adult premium. Helsana is up 4.7%, Visana 9.5% and Vivao Sympany 18.6%; SWICA is down 3.5% and Mutuel Assurance Maladie 1%. So the 5% "average" increase announced for Switzerland tells you nothing about your own situation: the letter from your insurer is what counts.

What about accident cover? The amounts above exclude accident cover. If you work at least 8 hours a week for the same Swiss employer, you are normally already insured against accidents through your employer's compulsory accident insurance (LAA). You can then ask your insurer to suspend the accident cover in your LAMal policy, with a certificate from your employer: check your contract so you don't pay twice.

The deadline: your cancellation must be received by 30 November

The rule comes from the Swiss Health Insurance Act (LAMal, art. 7) and applies to everyone insured under LAMal, cross-border workers included. Your insurer must notify you of your new premium at least two months in advance — in practice, before the end of October. You can then switch insurer for 1 January, with one month's notice.

In practice, your cancellation letter must reach your insurer by 30 November 2026 at the latest. What counts is the date it is received, not the date it is sent. The FOPH recommends sending the cancellation by registered mail before 15 November. From France, international registered mail takes several days: aim for early November instead, with proof of delivery (avis de réception).

Missed the date? Because residents of France necessarily have ordinary insurance (see below), the law also lets them switch insurer on 1 July, with three months' notice: the cancellation must then be received by 31 March at the latest.

Switching insurer, step by step

Read the letter from your insurer announcing your 2027 premium, and compare it with the FOPH's official overview.
Sign up with the new insurer. For basic insurance, an insurer must accept anyone, with no health questionnaire and whatever their age — provided, in your case, that it covers residents of France.
Cancel your basic insurance with your current insurer, in writing. The official Priminfo website offers template letters (in French) for cancelling and for signing up. Keep a copy and the proof of posting.
Wait for both confirmations. Your old cover only ends once the new insurer has confirmed to the old one that it insures you without interruption; the old insurer then writes to you with the end date. So there is no gap in cover on 1 January.
Don't forget the French side. Your cover in France relies on the S1 form issued by your Swiss insurer. Ask the new insurer how it issues the S1 in its own name and whether you need to send it to your CPAM yourself, so that your healthcare in France stays covered from January.
Do it for each person. LAMal is individual insurance: if your partner or children are also insured in Switzerland, check each person's premium and cancel for each person concerned.

Two things to watch. If you have unpaid premiums for which you received a reminder before 30 November, you can only switch if everything is paid before 31 December. And any Swiss supplementary insurance has its own deadlines: your old insurer cannot force you to cancel it at the same time as your basic insurance.

Deductible and insurance models: no lever for residents of France

In Switzerland, people are often advised to lower their premium by choosing a higher deductible (up to CHF 2,500) or a "family doctor", HMO or telemedicine model. These options are not available to people who live in the European Union: the Swiss Health Insurance Ordinance (OAMal, art. 101a) excludes them from these "special forms of insurance".

So you stay on ordinary insurance. For treatment received in Switzerland, that means a deductible (franchise) of CHF 300 a year for an adult, followed by a 10% co-payment, capped at CHF 700 a year. For treatment received in France, your CPAM reimburses you at French social security rates. The upshot: for a resident of France, the only real lever on your premium is the choice of insurer — and accident cover.

Switching insurer is not switching system

Be careful not to confuse two different steps:

Switching LAMal insurer: you stay in the Swiss system. You can do this every year, on the dates above.
Moving from LAMal to French health insurance (often called "CMU frontalier"): this is the right of option (droit d'option), exercised within 3 months of starting work in Switzerland. According to CLEISS (in French), this choice is permanent.

The right of option can only be exercised again in specific situations: a first job in Switzerland, returning to work in Switzerland after a job in another EU country or a period of unemployment in France, moving your residence to France, or retiring. Getting married, having a child or changing employer with no period of unemployment in between is not enough, and nor is a premium increase. However, if you were unemployed in France between two contracts (often the case for seasonal workers), the new contract reopens the choice.

And in 2028? An increase announced, with no official figure

In June 2024, the Swiss Parliament decided to include insured persons living abroad — around 200,000 people, mostly cross-border workers living in France or Germany — in "risk equalisation", the mechanism that rebalances costs between insurers. It is scheduled to take effect at the beginning of 2028.

Because cross-border workers are generally in good health, their insurers will have to pay contributions into this mechanism. The FOPH therefore expects premiums to tend to rise for insured persons living in countries with many cross-border workers, such as France. However, no official percentage has been published. Estimates in the order of +60 to 65% are circulating, even quoted in a question in the French Senate, but they do not come from the FOPH and should be treated with caution. 2028 premiums will only be known in autumn 2027.

What this means for you today: nothing for 2027, but one more reason to compare every autumn. And under the current rules, a premium increase does not allow you to revisit your right of option.

The most common mistakes

Posting your cancellation at the end of November from France — what counts is the date the insurer receives it
Cancelling without signing up elsewhere — without confirmation from a new insurer, you stay with the old one, at its price
Relying on the 5% average increase — that figure is for residents of Switzerland, not for you
Trying to raise your deductible or choose a family doctor model — these options are not available to residents of France
Paying twice for accident insurance — check whether your employer already covers you
Forgetting the CPAM — check with your new insurer and your CPAM that the S1 follows the switch
Confusing a change of insurer with the right of option — the first is possible every year, the second is permanent

Official sources

Getting support

Comparing premiums, writing the letters, following up the confirmations from both insurers and then the CPAM: none of it is complicated, but it all falls in November and leaves no room for delay.

I'm not an insurance broker, a tax specialist or a lawyer: I won't tell you which insurer to choose. But as an administrative assistant specialising in supporting cross-border workers, I can help you gather your letters, compare your premium with the official scale, prepare your cancellation and sign-up letters, and check that everything is in order on both the Swiss and the French side.

Is 30 November getting close? Book a free initial consultation — we'll prepare your change of insurer together.

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