the Lamal of the border workers at (sometimes) so low a cost

the Lamal of the border workers at (sometimes) so low a cost

Since the abolition of French private insurance, cross-border workers have to choose between the French system and the so-called “cross-border” Lamal, whose rates have never been so low with certain insurers. Investigation.

It is well known that healthcare in Switzerland is expensive. However, for some cross-border workers, this amounts to a hundred euros each month. At Helsana (ex-Progrès), count 158 ​​francs per month, for an adult, with only 300 francs annual deductible. The equivalent for a Geneva resident with the same insurer? 554 francs.

But why is it so cheap? First of all – and this is the most important point – the Lamal Frontiers formulas are not like our health insurance. Under the free trade agreement, contributions are only shared between residents of the same country. For example, in the case of France-Voisine, the contributions are divided between cross-border workers and there are no exchanges with Swiss contributions.

framed by law

Border Lamals are not subject to a solidarity fund. When in a Swiss insurance the profiles are too young, the insurance must pay back part of its contributions to support another insurance which has older profiles in its ranks. For cross-border contributions, this is not the case. “This promotes competition,” notes the director of Geneva health insurance, Patrick Mazzaferri.

If the differences between the Lamal “Swiss” are small, in the radius of their border cousins, it’s a roller coaster. Count 269 francs at Provita, one of the cheapest, against 1,395 at CSS, which has only about thirty policyholders in its ranks.

In addition to this “advantage”, cross-border commuters are workers. “These are generally healthy people, who cost less to the community,” says Patrick Mazzaferri. Finally, the Lamal for cross-border workers paradoxically opens a gateway to the French health system. Each insured person can apply for his vital card. Advantage? Costs are reduced in all areas. A consultation with a family doctor costs only €25. Insurers and cross-border workers come out on top.

One in five cross-border commuters

However, these figures must be qualified. According to the CPAM of Haute-Savoie, approximately 20% of cross-border workers are affiliated with Lamal. A figure confirmed on the Geneva side. “The French often prefer to stay on social security,” adds Patrick Mazzaferri. A choice that does not allow him to come for treatment in Switzerland.

The gap between border and Swiss premiums is annoying. However, “There should be an appropriate legal basis, taking into account the fact that insured persons from border cantons should not benefit from the more advantageous processing costs for border residents in their country of residence”, we are told at Helsana. The federal chambers are thinking about putting in addition a solidarity fund for the border sickness funds.

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