Basics
Cross-border workers, definition and G permit
Cross-border workers are employees who live in a country neighbouring Switzerland and work in Switzerland. They return to their place of residence at least once a week and hold a G permit (cross-border commuter permit). The insurance obligation in Switzerland starts on the first working day.
Germany
Largest group of cross-border workers. Right of choice: KVG, GKV or private cover.
France
Second-largest group (mainly Geneva, Vaud, Jura). Option: LAMal or CMU.
Italy & Austria
Ticino and eastern Switzerland. Option: KVG or the national system.
Key decision
The right of choice, the decisive fork in the road
In principle you are subject to Swiss KVG insurance as a cross-border worker. However, Switzerland has special agreements with Germany, France, Italy and Austria. You can apply to be exempted from the Swiss insurance obligation and stay insured in your country of residence.
- 1
Start of work in Switzerland
The 3-month deadline starts on your first working day.
- 2
Make your decision
KVG (Switzerland) or cover in your country of residence (GKV/CMU/private).
- 3
File the exemption request
With the cantonal authority if you choose cover in your country of residence.
CAUTION: The decision is irrevocable!
You can exercise your right of choice only once. If you miss the 3-month deadline, you are automatically assigned to the KVG.
Exceptions, a new right of choice is possible in case of:
- Marriage or the birth of a child
- Return to work after a period of unemployment
- Change of country of residence
Source: FOPH (Federal Office of Public Health).
Comparison
KVG vs GKV vs private cover, the big comparison
Three insurance models side by side, with all the criteria that matter for cross-border workers.
| Criterion | KVG (Switzerland) | GKV (Germany) | PKV (private) |
|---|---|---|---|
| Premium | From CHF 228/month | 14.6% + supplementary contribution on pay | From about €400/month |
| Calculation | Uniform, based on age | Income-based (up to €5'812.50/month) | Age, health, benefits |
| Cost at average pay | CHF 228–353/month | €900–1'174/month | €400–800/month |
| Family cover | ❌ Each member separately | ✅ Spouse + children free | ❌ Each member separately |
| Treatment in Switzerland | ✅ Yes | ❌ Emergencies only | ✅ Depends on tariff |
| Treatment in country of residence | ✅ With E106/S1 | ✅ Yes | ✅ Yes |
| Deductible/out-of-pocket share | CHF 300–2'500 + 10% share | None (covered benefit) | Depends on tariff |
| If you lose your job | → must switch | → stays insured | → stays insured |
| Ideal for | Singles, high earners | Families, middle incomes | High earners, self-employed |
KVG insurer comparison
The cheapest KVG insurers for cross-border workers in 2026
The KVG premium is independent of income, only age counts. Because the statutory basic insurance benefits are identical at every insurer, comparing pays off particularly well. In 2026 cross-border premiums are even around 1.7% lower than the year before.
Adults from 26, without accident cover.
| Health insurer | Monthly premium 2026 | Comparison |
|---|---|---|
 Sympany euroline | CHF 227.90 | Cheapest |
 SWICA | CHF 241.80 | +6% |
 Groupe Mutuel | CHF 265.00 | +16% |
 CSS | CHF 298.00 | +31% |
 Helsana | CHF 352.50 | +55% |
Young adults (19–25)
Sympany euroline: CHF 164.10/month, well below all competitors.
🇩🇪 Germany
Cross-border workers from Germany, KVG, GKV or private?
German cross-border workers have the most options: Swiss KVG, German statutory insurance (GKV) or private health insurance (PKV).
KVG (Switzerland)
- From CHF 228/month, independent of income
- Treatment in CH and DE (with form E106/S1)
- In Germany: no out-of-pocket share, no deductible
- Best option from a gross salary above CHF 5'500/month
GKV (Germany)
- 14.6% + supplementary contribution on gross pay (up to the ceiling of €5'812.50)
- Free family cover for spouse and children
- Family with 2 children: GKV usually far cheaper than 4× KVG
- Drawback: very expensive at high salaries (up to €1'174/month)
PKV (private)
- From about €400/month, good tariffs
- Freely selectable benefits (chief physician, single room)
- Drawback: dearer with age, hard to return to the GKV
- No family tariff, each person separately
Worked example, single
Gross salary CHF 7'000/month
- KVG (Sympany)CHF 228/month ✅
- GKVabout €950/month ❌
- PKVabout €450/month
Worked example, family
2 adults + 2 children, CHF 7'000/month
- KVG (4×)CHF 912/month ❌
- GKVabout €950/month ✅
- PKV (4×)about €900/month
Family insured free of charge in the GKV.
🇫🇷 France
Frontaliers, LAMal or CMU?
French cross-border workers (frontaliers) choose between LAMal (the Swiss KVG) and CMU/PUMa (the French social system). The cost calculation differs fundamentally.
Swiss basic insurance
- Fixed premium CHF 200–450/month per person
- Treatment possible in CH and FR
- Independent of income
- Each person insured separately
French social system
- Calculation 2026: (reference tax income − €11'775) × 8%
- Example: €50'000 income → €3'058/year (€255/month)
- Dependants covered at no extra cost
- Treatment mainly in France
Worked example, single
Gross salary CHF 6'000/month (~€60'000/year reference)
- LAMalCHF 350/month
- CMU€322/month ✅
CMU calculation: (€60'000 − €11'775) × 8% = €3'858/year.
Worked example, family
Same salary, family with 2 children
- LAMal (4×)CHF 16'800/year
- CMU€3'858/year ✅
Dependants insured free, the CMU is massively cheaper for families.
🇮🇹 🇦🇹
Cross-border workers from Italy and Austria
Italy (Ticino, Graubünden)
- Option: KVG or SSN (Servizio Sanitario Nazionale)
- SSN: funded through taxes, state health system
- The KVG is often advantageous thanks to treatment in Switzerland (closer to work)
- Deadline: 3 months after starting work
Austria (eastern Switzerland, Vorarlberg)
- Option: KVG or ÖGK (Österreichische Gesundheitskasse)
- ÖGK: compulsory insurance via the employer in the country of residence
- Similar considerations as with the German GKV
- Family cover possible with the ÖGK
Form S1 (formerly E106)
How treatment in both countries works
If you choose the KVG, you receive form S1. With it you register with a helper insurer in your country of residence and can see a doctor in both countries.
- 1
Take out KVG insurance
You receive a Swiss insurance card.
- 2
Request form S1
From your Swiss insurer, it will be sent to you.
- 3
Register with a helper insurer
In your country of residence (for example AOK in Germany), you receive a second insurance card.
- 4
Two cards, two countries
One card for Switzerland, one for your country of residence. Free choice of doctor.
Advantages with S1
- Free choice of doctor in both countries
- In Germany: NO out-of-pocket share and NO deductible
- Contributions only to the Swiss insurer, the helper insurer is free of charge
- European Health Insurance Card (EHIC) included
Which insurance suits you?
We check free of charge which option (KVG, GKV, PKV, CMU) is best for your situation.
Cross-border families
Cross-border workers with a family, which insurance?
For families the choice matters especially, because KVG and private cover charge per person, while the GKV and CMU offer free family cover. More in the families guide.
Family with 2 adults + 2 children.
| Option | Cost per month | Family cover |
|---|---|---|
| KVG (4 × Sympany) | CHF 912/month | Each person separately |
| GKV (Germany) | about €950/month | Family free |
| CMU (France) | about €320/month | Family free |
| PKV (4 people) | about €900+/month | Each person separately |
Avoid
The 5 most common mistakes as a cross-border worker
Mistake 1
Missing the 3-month deadline
Automatic assignment to the KVG, the right of choice is gone.
Mistake 2
Choosing the GKV as a single
Extremely expensive with a high Swiss salary (up to €1'174/month).
Mistake 3
Choosing the KVG as a family
4 individual premiums instead of free family cover.
Mistake 4
Not requesting form E106/S1
Without S1 there is no regular treatment in your country of residence through the KVG.
Mistake 5
Forgetting supplementary insurance
The KVG is basic insurance only. Dental care, glasses and alternative medicine are not covered.
FAQ
Frequently asked questions on cross-border health insurance
The best health insurance as a cross-border worker?
There is no one-size-fits-all answer. For singles with a good salary the Swiss KVG (for example Sympany euroline from CHF 227.90) is usually unbeatably cheap. For families with one earner the GKV or CMU in the country of residence is often worthwhile thanks to free family cover. Important: the decision is irrevocable, so review your situation carefully within the 3-month deadline.