Since the abolition of French private insurance, frontiersmen have to choose between the French system and Lamal dites ‘frontier’, not that the tariffs have never been accompanied by certain insurers. Investigation.
It is well known that treatment in Switzerland is expensive. Yet, for some border guards, it costs a hundred euros a month. At Helsana (ex-Progrès), count 158 francs a month for an adult, with only 300 francs a year. The equivalent for a Genevan resident with the same insurer? 554 francs.
But why is it so cheap? First of all – and this is the most important point – Lamal frontier formulas are not like our health insurance. Under the free trade agreement, contributions are distributed only among residents of the same country. For example, in the case of neighboring France, contributions are distributed across borders and there is no exchange with Swiss contributions.
Framed by law
Les Lamal frontalières are not subject to a solidarity fund. When the profiles are too young in a Swiss insurance policy, the insurance must pay back part of its contributions to support another insurance company that has older profiles in its ranks. This is not the case for cross-border contributions. “It promotes competition,” said Patrick Mazzaferri, director of health insurance in Geneva.
If the differences between the “Swiss” Lamals are small, within the radius of their border cousins, it is the roller coasters. Count 269 francs at Provita, one of the cheapest, compared to 1,395 at CSS, which has only about 30 policyholders in its ranks.
In addition to this “advantage”, border guards are workers. “These are generally healthy people who cost the community less,” said Patrick Mazzaferri. Finally, the Lamal des frontaliers paradoxically opens a gateway to the French health system. Each insurer can claim their vital card. Advantage? Costs are low in all areas. A consultation with a family doctor costs only € 25. Insurers and frontiersmen emerge victorious.
One in five border guards
However, these figures need to be nuanced. According to the CPAM of Haute-Savoie, about 20% of border guards are affiliated with Lamal. A figure confirmed on the Geneva side. “The French often prefer to stay with social security,” added Patrick Mazzaferri. A choice that does not allow him to come to Switzerland for treatment.
The gap between border and Swiss premiums is staggering. However, “an appropriate legal basis would be needed, taking into account the fact that insured persons in the border townships should not benefit from the more favorable treatment costs of border guards in their country of residence,” we explained at Helsana. The federal chambers are considering adding a solidarity fund for border health insurance funds.