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Changing cross-border health insurance

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Switch back to LAMal

The right of option, which allows a cross-border worker to choose to take out health insurance in France, is irreversible. This is stated in the regulations.

However, there are changes in the situation that allow a return to LAMal.

Conditions for switching back to LAMal

Career change

Certain professional changes are sufficient grounds for renew the right of option:

  • Starting a paid activity in Switzerland after having worked in another country
  • Retirement
  • To lose one’s job in Switzerland, to have a period of paid unemployment in France and to return to work in Switzerland


The duration of the period of unemployment is not decisive. What is decisive is the fact that you receive benefits from the ‘Pôle Emploi’ (unemployment office). This will make you a ‘new’ cross-border worker who can then choose his or her insurance system again.

Change of main residence

Changing one’s main residence from France to Switzerland allows one to renew the right to option. This is the ‘last resort’ condition for cross-border workers who were unable to benefit from the previous conditions.

This condition is not difficult to meet for Swiss citizens who have kept family ties in the Confederation. It is more difficult for foreigners. They will have to obtain a ‘resident’ permit B or L and rental accommodation in Switzerland.

Steps to switch back to LAMal

You are or will be in one of the aforementioned cases? Would you like to plan ahead and opt for the Swiss LAMal scheme today? What are the steps that will enable you to do so?

The procedures of the Cantonal Health Insurance Authority must be followed to the letter. Be particularly careful about the deadlines, the form and the requirements for a transition to LAMal.

Communicating with the Health Insurance Authority

The cantonal health insurance office in your place of work can be contacted by telephone, but the official channel is still by post.

Your request to cancel your previous choice of health insurance must therefore be sent by post. Supporting documents must be enclosed.

These letters should focus on the required information. Do not jumble up the conditions for a transition to LAMal. It is better to clearly present one and only one condition for switching to LAMal than to mix a number of them.

Plan your steps

The steps for a successful transition to LAMal take 3 months. In order to be planned as well as possible, they should be started one month before the expected date of your change of status:

    • Month M-1: one month before your change of situation, compare the offers of the different Swiss health insurance companies and calculate your insurance premiums
    • Month M: Just after your change of situation, send your letter of cancellation of your previous choice of option to the cantonal health insurance office (you have 3 months maximum to do this, but we advise you to do it within the month)
    • Month M+1: you receive the first response from the cantonal health insurance office and a request for additional information: maximum delay 1 month
    • Month M+2: completion of your new health insurance contract with the Swiss insurer, termination of your current contract and follow up reply from the health office authority (SAM ‘Service de l’assurance-maladie’) maximum delay 1 month.


Compare offers from Swiss insurance providers

To compare offers successfully, you need to define your needs (location of care, type of care, deductible, coverage, etc.) and then compare equivalent offers.

You should ask a cross-border worker health insurance professional to help you make sense of the offers. He or she will provide you with quotes for solutions tailored to your needs.

Cancel your previous choice of health insurance

Send a letter to the Health Insurance Department requesting the cancellation of your choice of option. Indicate precisely what ‘significant change in situation’ leads you to make your request.

Complete your file and inform the cantonal health insurance service.

If the answer from the cantonal health insurance office is positive, you can proceed with your application. Confirm your choice with the Swiss health insurance fund you have chosen. It will ask you for proof (including the agreement of the cantonal service) before issuing you with an insurance attestation.

Send the new insurance attestation to the cantonal office enclosing the final documents in your file.

You should cancel your current contract only after the Swiss cover has been confirmed.

Inform your private cross-border worker insurance company of the change in your situation and the document from the cantonal health insurance service indicating your transfer to the Swiss system. Don’t hesitate to ask for information, as the termination may be immediate or may take several months, depending on your insurance company.

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