How much is the 2026 cross-border health contribution?

6% of the gross Swiss withholding tax: on a CHF 72,000 gross salary with 9% withholding it comes to around CHF 389/year (CHF 32/month); on CHF 90,000 with 10% withholding, about CHF 540/year (CHF 45/month).

Do old cross-border workers have to pay the health contribution?

No. Only 'new' cross-border workers hired after 17/07/2023 pay the contribution. Old workers hired before that date remain in the transitional regime until 2033 with no contribution due.

Who actually collects the cross-border health contribution?

The Swiss canton of employment withholds it at source. Switzerland then transfers it to the Confederation, which redistributes the amounts to the Italian border regions (Lombardy, Piedmont, Aosta Valley and Trentino-Alto Adige).

Is the health contribution tax-deductible?

Yes. The health contribution is included in the Italian foreign-tax credit. Declare it in Box CE of Redditi PF or Box G of the 730: it reduces the Italian IRPEF euro-for-euro.

Is the health contribution the same as LAMal?

No. LAMal is the Swiss compulsory private health insurance with monthly premiums of CHF 280-650 paid to a health fund. The health contribution is a 6% public levy withheld by the Swiss state. A new cross-border worker pays both in parallel.

Cross Border Health Contribution (cross-border guide)

Cross Border Health Contribution — free tools and expert guides for cross-border workers (frontalieri) between Switzerland and Italy. Compare salaries, tax, LAMal health insurance, pensions, and cost of living in Ticino. Updated 2026.

Last updated: August 2026

By Frontaliere Ticino Editorial Team

What is the cross-border health contribution?

The cross-border health contribution (known in Italian as tassa salute frontalieri) is a levy introduced by Article 9 of the Italy-Switzerland New Agreement that entered into force on 17 July 2023. It applies to so-called "new cross-border workers" — those who started working in Switzerland after that date — and funds the Italian National Health Service in the border regions (Lombardy, Piedmont, Aosta Valley and Trentino-Alto Adige).

2026 amount and calculation

The rate set by the Agreement is 6% of the gross withholding tax levied by the Swiss canton of employment. On a gross annual salary of CHF 72,000 with a 9% withholding tax, the health contribution amounts to around CHF 389 per year, or just over CHF 32 per month. The deduction appears on the Swiss payslip (Lohnabrechnung) under a line labelled Gesundheitsabgabe or "contributo salute frontalieri".

Who pays and who is exempt

Only new cross-border workers with a G permit hired after 17 July 2023 and residing in an Italian municipality within 20 km of the border are subject to the contribution. Exempt categories include old cross-border workers (hired before that date), B-permit holders, seasonal workers, and international officials.

It is crucial not to confuse the health contribution with the LAMal Swiss compulsory health insurance: LAMal is a private policy with a monthly premium of CHF 280-650 paid to a health fund, while the health contribution is a public levy withheld by the Swiss state. A new cross-border worker always pays the health contribution regardless of the LAMal vs SSN option.

Frequently asked questions

What is the cross-border health contribution?: It is a 6% levy on the Swiss gross withholding tax introduced by Article 9 of the Italy-Switzerland Agreement effective 17/07/2023. It funds the Italian National Health Service in the Italian border regions.
How much is the 2026 cross-border health contribution?: 6% of the gross Swiss withholding tax: on a CHF 72,000 gross salary with 9% withholding it comes to around CHF 389/year (CHF 32/month); on CHF 90,000 with 10% withholding, about CHF 540/year (CHF 45/month).
Do old cross-border workers have to pay the health contribution?: No. Only 'new' cross-border workers hired after 17/07/2023 pay the contribution. Old workers hired before that date remain in the transitional regime until 2033 with no contribution due.
Who actually collects the cross-border health contribution?: The Swiss canton of employment withholds it at source. Switzerland then transfers it to the Confederation, which redistributes the amounts to the Italian border regions (Lombardy, Piedmont, Aosta Valley and Trentino-Alto Adige).
Is the health contribution tax-deductible?: Yes. The health contribution is included in the Italian foreign-tax credit. Declare it in Box CE of Redditi PF or Box G of the 730: it reduces the Italian IRPEF euro-for-euro.