By Frontaliere Ticino Editorial Team
Legal framework and scope
The Italian SSN contribution is established by Law 213/2023, Article 1(237–239), and the decree of 14 November 2025. It covers the statutory categories, including existing cross-border workers under Article 9 who opted for Italian healthcare, and dependent family members. It is not a Swiss tax limited to new workers.
Amounts and regional implementation
The statutory range is 3–6% of Swiss net salary, with a progressive family contribution and limits of EUR 30–200 per month worked, which may double for omitted payment or reporting. The competent region or autonomous province sets the annual contribution: check its implementing measure for the 2026 amount and deadline rather than automatically applying 6%.
Status in Lombardy and Piedmont at 31 October 2026
Lombardy: the Region announced it chose the 3% minimum: EUR 120 on EUR 4,000 net a month. On 23 April 2026 it set the goal of starting by September; on 1 July 2026 it confirmed the 3%, without a start date. We found no published regional measure with a deadline and payment method.
Piedmont: we found no regional measure applying the contribution. Agenda item no. 260, tabled in the Regional Council on 9 June 2025, states that Piedmont had not yet applied it and asks the regional government to confirm this: it is an act by councillors, not a decision of the regional government.
Articles on this topic (in Italian)
- Tensioni tra Italia e Ticino sulla tassa salute
- La Lombardia annuncia il contributo entro settembre
- Lo scontro tra Lombardia e Ticino
- Il contributo e gli stipendi sanitari
Existing workers and right of option
Existing cross-border workers are not excluded: the law expressly refers to Article 9(1) workers who exercised the SSN option. Healthcare coverage, individual circumstances and territorial measures must be checked; a G permit or hiring date alone is insufficient.
Paying the contribution
The decree of 14 November 2025 provides for annual payments by the persons concerned directly to the region or Autonomous Province of Bolzano through the payment channels under Article 5 of Italy's Digital Administration Code. It does not provide for Swiss payroll withholding or transfers via the Swiss Confederation.
Tax documentation
Do not automatically claim it as a credit for Swiss taxes: this contribution funds Italian healthcare. Check the tax instructions applicable to your circumstances with a tax adviser and retain the payment receipt and the competent authority's notice.
SSN contribution and LAMal
No. LAMal concerns Swiss health insurance; the Italian contribution depends on statutory categories and conditions. Not every new cross-border worker automatically owes both: the right of option and individual healthcare status must be checked.
Legal source: decree of 14 November 2025
Frequently asked questions
- What is the cross-border health contribution?
- The Italian SSN contribution is established by Law 213/2023, Article 1(237–239), and the decree of 14 November 2025. It covers the statutory categories, including existing cross-border workers under Article 9 who opted for Italian healthcare, and dependent family members. It is not a Swiss tax limited to new workers.
- How much is the 2026 cross-border health contribution?
- The statutory range is 3–6% of Swiss net salary, with a progressive family contribution and limits of EUR 30–200 per month worked, which may double for omitted payment or reporting. The competent region or autonomous province sets the annual contribution: check its implementing measure for the 2026 amount and deadline rather than automatically applying 6%.
- Do old cross-border workers have to pay the health contribution?
- Existing cross-border workers are not excluded: the law expressly refers to Article 9(1) workers who exercised the SSN option. Healthcare coverage, individual circumstances and territorial measures must be checked; a G permit or hiring date alone is insufficient.
- Who actually collects the cross-border health contribution?
- The decree of 14 November 2025 provides for annual payments by the persons concerned directly to the region or Autonomous Province of Bolzano through the payment channels under Article 5 of Italy's Digital Administration Code. It does not provide for Swiss payroll withholding or transfers via the Swiss Confederation.
- Is the health contribution tax-deductible?
- Do not automatically claim it as a credit for Swiss taxes: this contribution funds Italian healthcare. Check the tax instructions applicable to your circumstances with a tax adviser and retain the payment receipt and the competent authority's notice.