Guide to the LAMal health system: obligation and choice (cross-border guide)

Context

In a nutshell

• The New Frontier Agreement was signed on 23 December 2020 and entered into force on 1 January 2024.
• Border crossers who were already border crossers before 17 July 2023 have an exemption of CHF 7,500, while new border crossers have an exemption of CHF10,000.
• The Italy-Switzerland Double Taxation Convention was signed on 9 December 1976.
• LAMal health insurance is mandatory for all Swiss and border citizens.

Guide to the LAMal health system: obligation and choice

The Italy-Switzerland Double Taxation Convention, signed on 9 December 1976, provides for an exemption regime for employees' income and for self-employment income. The Convention also establishes the rules for determining residence and source of income.

LAMal health insurance is mandatory for all Swiss and border citizens, starting from 1 January 2024. Border crossers who were already border crossers before 17 July 2023 have an exemption of CHF 7,500, while new border crossers have an exemption of CHF10,000. This means that border workers who have already lived in Switzerland for more than 90 days in the course of a year can benefit from an exemption on the first CHF 7,500 of their healthcare expenses, while new border workers can benefit from an exemption of CHF10,000.

LAMal is a health insurance scheme that covers health expenses for all Swiss citizens and

Operational details

Key facts

• What: Swiss health system LAMal
• When: 2024-2033, transitional period for border crossers
• Where: Canton of St. Gallen and Switzerland
• Who: Frontier workers and Swiss citizens
• Amount: CHF 7,500 (exemption) and CHF10,000 (deductible)

The Swiss health system LAMal has been introduced to ensure fair and accessible health coverage for all Swiss and border citizens. Starting from 2024, the transitional period for border crossings has been established until 2033, during which Swiss and border crossers will be able to access health services with a deductible of CHF 10,000 or with a free membership up to CHF7,500.

Obligation to join

From 2024, membership in the LAMal health system becomes mandatory for all Swiss and border citizens. Those who do not register by the established date will have to pay a penalty. Border workers who do not have a permanent residence in Switzerland can choose to join the LAMal health system for a limited period, for example during their summer holidays in Switzerland.

Choosing the type of membership

Swiss and border citizens can choose between two types of membership: free membership or deductible. Free membership is reserved for those who have a low or middle income and cannot afford to pay the deductible. The deductible is CHF 7,500 for free membership and CHF10,000 for the deductible.

Concrete examples

For example, a Swiss citizen who

Useful tools to protect your net income

To reduce FX leakage, compare CHF-EUR exchange options and banks for cross-border workers.

Key points

Guide to the LAMal health system: obligation and choice

Action

• For border crossers who have already been such before 17 July 2023, it is important to check the exemption of CHF 7,500.
• For new frontier workers, it is necessary to check the excess of CHF 10,000.
• For both cases, it is important to consult your health insurance contract and check the coverages and costs.
• In addition, it is important to note that reimbursement of healthcare expenses is only possible for expenses incurred in Switzerland.
• Finally, it is important to check your health coverage and any exclusions or limitations before undertaking any activity.

Concrete examples

• A border worker resident in Italy who has been in Switzerland for work for 5 days is entitled to an allowance of CHF 1,500 for health expenses.
• A Swiss citizen who goes to the hospital in Geneva for a surgical operation can claim reimbursement of healthcare expenses up to CHF 20,000.
• A border worker residing in France who has been in Switzerland for a week's holiday can claim reimbursement of healthcare expenses up to CHF 5,000.

Regulations

• The Federal Act of 8 October 1992 on the health system (LSA) states that every person residing in Switzerland for more than 90 days must have adequate health coverage.
• The Federal Law of 22 March 2006 on Occupational Diseases (LMP) stipulates that workers staying in

Evaluating a Ticino job offer? Simulate your net payslip: enter gross salary, marital status and municipality for a detailed breakdown.