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.
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.