2027 LAMal premiums for cross-border workers: what each insurer costs depending on your country of residence, and how to switch before 30 November with no gap in cover

By the end of October at the latest, your Swiss health insurer sent you your 2027 premium. In Switzerland, the FOPH announced an average increase of 5%. For a cross-border worker, that figure means almost nothing: their premium depends not on the canton where they work but on the country where they live, and the gap between two insurers for the same basic insurance far exceeds the year's increase. This guide sets out the 2027 premiums published by the Federal Office of Public Health for France, Germany, Italy and Austria, explains why they have moved so little, and describes how to switch insurer before 30 November without losing a single day of cover.

It is aimed at cross-border workers who chose Swiss health insurance, and at the family members insured with them. If you are still weighing up LAMal against the insurance of your country of residence, start with our guide on choosing between LAMal and cover in your country of residence.

1. How much does LAMal cost a cross-border worker in 2027, by country?

For an employed adult, the median 2027 premium is 489.30 francs a month in France, 500.10 francs in Germany, 434.20 francs in Italy and 447.40 francs in Austria. But from one insurer to another, the same cover costs up to nearly five times as much in Germany, and four times as much in France.

Insured persons living in a European Union state do not pay the premiums of their canton of work: each insurer sets a premium specific to each country, based on the costs in that country, as the FOPH explains in its EU/EFTA/UK premium overview 2027, published on 22 October 2026 (art. 61 para. 4 of the Federal Act on Health Insurance, LAMal). The table summarises that document for the four countries most cross-border workers come from.

Monthly 2027 premiums in Swiss francs for an adult aged 26 and over, 300-franc deductible, without accident cover. Source: FOPH, EU/EFTA/UK premium overview 2027; median calculated by ibani across all the insurers active in each country.

In France, choosing the cheapest insurer rather than one at the median level makes a difference of around 3,360 francs a year for a single adult; compared with the most expensive, the gap exceeds 7,300 francs. The content of basic insurance, on the other hand, is the same everywhere: it is set by law. Our guide to CSG-CRDS and health contributions for cross-border workers sets out, insurer by insurer, the scale for people living in France. For the other countries, the list by insurer is in the FOPH document.

For young adults aged 19 to 25, the 2027 median is 484.50 francs in France, 400.10 francs in Germany, 349.25 francs in Italy and 429.20 francs in Austria; for a child, with no deductible: 153.50 francs in France, 125.60 in Germany, 116.00 in Italy and 139.70 in Austria.

2. Why has your premium not followed the Swiss increase?

Because in 2027, most insurers left their premium for European Union residents unchanged. The cheapest insurer in each country, however, raised its premium.

In Switzerland, the FOPH announced on 29 September 2026 a 5.0% increase in the average premium, to 412 francs a month, and of 4.9% for an adult, to 487.60 francs. For cross-border workers, comparing the FOPH's 2026 and 2027 overviews gives a very different picture:

Adult, 300-franc deductible, without accident cover, francs a month. In each country, the cheapest insurer in 2026 remained the cheapest in 2027.

In other words, the increase depends entirely on your insurer. If you are insured with the cheapest insurer in your country, your premium has risen by 4.6% to 10%, but it remains the cheapest for an adult: just check that it is also the cheapest for the other members of your household (section 3). If your premium stayed stable with an insurer at or above the median level, the stability is misleading: the gap with the cheapest insurer exceeds 1,400 francs a year per adult. And in France, two insurers raised their premium by 9.5% and 18.6%: if you are with one of them, your October letter shows it.

3. Single, couple or family: the cheapest insurer is not always the same

Each insurer sets its premiums for adults, young adults and children separately. The ranking therefore changes with the make-up of your household.

Take a typical household: an employed cross-border worker, a spouse without gainful employment and two children, all insured with the same insurer (the employee without accident cover, the other three with it). In 2027, the annual premium ranges as follows:

Francs a year, FOPH 2027 premiums, ibani calculation; two children under 19, with no deductible.

Two examples show that the ranking for adults is not enough. In Germany, the cheapest insurer for this household is not the one that is cheapest for a single adult. In France, the cheapest insurer for a young adult aged 19 to 25 (178.30 francs) is not the cheapest for an adult (209.30 francs). So do the calculation for your actual household, member by member, using the FOPH document.

If your income is modest, a premium reduction may also apply: for cross-border workers and their families, according to the FOPH, it is a matter for the canton where you work (art. 65a LAMal).

4. Until when can you switch insurer?

For 1 January, your termination notice must be received by your insurer by 30 November at the latest. For 1 July, by 31 March at the latest.

Both dates come from article 7 of LAMal:

• On 31 December: when the new premium is announced, the insured person can switch insurer for the end of the month before it takes effect, giving one month's notice (para. 2). The insurer must announce the new premium at least two months in advance and remind policyholders of their right to switch. In practice, the termination letter must be received by 30 November: posted on the 29th and delivered on 2 December, it arrives too late. Send it by registered post, leaving yourself several days' margin.
• On 30 June: the insured person can also switch insurer for the end of a calendar half-year, giving three months' notice (para. 1), so with a termination notice received by 31 March at the latest. For insured persons living in Switzerland who have an optional deductible, the ordinance limits switching insurer to the end of the year (art. 94 para. 2 OAMal). Cross-border workers are not affected: optional deductibles and alternative insurance models are not open to them (art. 101a OAMal), so the June date remains open to them.

Switching insurer must not be confused with switching system. The right of option between LAMal and the insurance of your country of residence is in principle irrevocable; switching insurer within LAMal does not affect it. The rare situations that reopen the right of option are described in our guide on changing health insurance as a cross-border worker (LAMal vs CMU/GKV/SSN).

5. How to switch with no gap in cover, S1 included

Join the new insurer first, terminate with the old one next, then check that your registration with the health insurance institution of your country of residence follows.

1. Choose an insurer active in your country. Not every Swiss insurer offers contracts to residents of the European Union: according to the FOPH, about a third of them do, and some only in a few countries. Those that do must accept you, with no health questionnaire and no age condition: insurers are required to accept, within the limits of their territorial area of activity, anyone who is required to take out insurance (art. 5 let. i of the Federal Act on the Supervision of Social Health Insurance, LSAMal).
2. Apply to join the new insurer for 1 January, stating your country of residence, your cross-border worker status and the suspension of accident risk if you are entitled to it.
3. Terminate with the old insurer, by registered post, so that it receives the letter by 30 November at the latest.
4. Let the law ensure continuity. Your old membership only ends once the new insurer has confirmed to the old one that it is covering you without interruption; if it fails to do so, it must compensate the loss, in particular the difference in premium (art. 7 para. 5 LAMal). You are therefore never left without basic insurance.
5. Have your registration in your country of residence carried over. The S1 form registers you with the health insurance institution of your country of residence (the CPAM in France, for example) on behalf of your Swiss insurer; the Common Institution under the Health Insurance Act (LAMal/KVG) points out that it is presented to the institution of the place of residence. With a new insurer, the registration has to be redone in its name, and insurers can send it themselves electronically. Ask for it as soon as your membership is confirmed and check that it has been recorded before 1 January, so that you are not refused cover for treatment at the start of the year. Our guide to what LAMal covers in France, Germany and Italy with the S1 form explains what this registration covers.
6. Your supplementary insurance policies are separate. The old insurer cannot force you to terminate a supplementary policy taken out with it, nor terminate it because you are leaving for basic insurance (art. 7 paras. 7 and 8 LAMal). If you want to terminate it too, its general terms and conditions set the notice periods.

The deductible remains 300 francs with the new insurer, since it is the only one open to cross-border workers. A proposal to raise the minimum deductible from 300 to 400 francs was put out for consultation on 13 March 2026; it requires an amendment to LAMal, and no date of entry into force has been set: nothing changes for 2027.

Finally, the premium is paid in Swiss francs or in euros, at the insurer's choice, and the insurer may also collect it quarterly (art. 92a of the Health Insurance Ordinance, OAMal). The ordinance does not set a conversion rate: if your insurer invoices in euros, ask it which rate it applies.

6. What is being prepared for 2028

From 2028, cross-border workers are expected to be brought into the risk equalisation between insurers, which would push their premiums up. The principle has been voted; the ordinance implementing it has not yet been adopted.

Risk equalisation requires insurers that mainly cover people in good health to pay a levy to those that cover more people who are ill. Insured persons resident abroad are currently excluded from it. On 14 June 2024, Parliament decided to include them, and on 3 September 2025 the Federal Council put out for consultation the amendment to the risk equalisation ordinance, with entry into force planned for the start of 2028, at the same time as the uniform financing of benefits.

According to the FOPH, around 200,000 insured persons are concerned, most of them cross-border workers living in France or Germany. Only the benefits they received in Switzerland would be taken into account. The office expects premiums for these insured persons to trend upwards; in return, insured persons in cantons with many cross-border workers, Geneva and Basel-City in particular, would see their premiums fall slightly. In Ticino, the revision would have no tangible consequence, since most cross-border workers there are insured in Italy.

As at 13 November 2026, the version of the ordinance published on Fedlex is still the one dated 1 January 2025, and no decision to adopt it has been announced: the size of the increase has not been quantified. The 2028 premiums will be published by the FOPH in autumn 2027. That is when, and not before, the comparison in this guide will need to be redone.

7. Key takeaways

For a cross-border worker insured in Switzerland, the LAMal premium is set by insurer and by country of residence, not by canton. In 2027, the median has barely moved, but the gap between the cheapest insurer and one at the median level remains 1,400 to 3,400 francs a year per adult, depending on the country. An insurer active in your country must accept you, the law guarantees continuity of cover, and switching insurer does not affect your right of option.

Three steps: compare your 2027 premium with the FOPH scale for your country and for each member of your household; send your termination notice so that it is received by 30 November at the latest, or by 31 March for a switch on 1 July; check that the new insurer has carried over your registration with the health insurance institution of your country of residence.

8. Frequently asked questions