CMU (Glossary) (cross-border guide)
CMU (France) — Universal Health Coverage. French health insurance alternative to LAMal for French-Swiss cross-border workers.
By Frontaliere Ticino Editorial Team
In short
Example: CMU cost: ~8% of reference taxable income. For high incomes, it can be more expensive than LAMal.
On Italian documents the term reads «CMU (Francia)»: Couverture Maladie Universelle. Assicurazione sanitaria francese alternativa alla LAMal per frontalieri franco-svizzeri.
The same concept in the site's other languages: German «CMU (Frankreich)», French «CMU (France)».
The glossary provides clear, contextualised definitions of technical terms every cross-border worker encounters: fiscal acronyms (AVS, LPP, LAMal, IRPEF, INPS), administrative documents (CU, Modello 730, Lohnausweis, U1 Form), and legal concepts (fiscal domicile, permanent establishment, quasi-resident, concurrent taxation).
Each entry is written in accessible language and linked to the site's tools that use that concept. For example, from the definition of "withholding tax" you can access the payslip simulator directly, and from the "LPP" entry the pension calculator. This approach transforms the glossary from a simple dictionary into a practical navigation hub.
Understanding these terms is crucial for reading Swiss payslips, Italian tax declarations, official communications from the Ticino tax division, and letters from the Italian Revenue Agency. Bilingual terminology (Italian-German and Italian-French) also helps with direct communications to Swiss authorities.
The glossary also covers terminological differences between the Swiss and Italian systems: for example, "contributi sociali" in Italy corresponds to "Sozialabzüge" in Switzerland; "certificazione unica" (CU) is the Italian equivalent of the Swiss "Lohnausweis"; and "pensione di vecchiaia INPS" has its counterpart in the Swiss first-pillar AVS/AHV. These correspondences prevent confusion in cross-border documents.
Entries are regularly updated based on legislative changes, cantonal regulation amendments, and the most frequent questions from the cross-border worker community. Each term includes references to official regulatory sources (federal laws, bilateral agreements, AFC circulars) to enable independent further research.
Frequently asked questions
- Cos'è la CMU e quando si applica ai frontalieri?
- La CMU (Couverture Maladie Universelle, oggi PUMa — Protection Universelle Maladie) è il sistema sanitario pubblico francese. Si applica ai frontalieri residenti in Francia che lavorano in Svizzera e scelgono il diritto di opzione: invece di pagare la LAMal svizzera si iscrivono al sistema francese con un contributo proporzionale al reddito (circa 8% del reddito netto imponibile).
- La CMU riguarda anche i frontalieri italiani?
- No. La CMU è esclusivamente francese. I frontalieri italiani residenti in Italia hanno un'alternativa differente: il diritto di opzione verso il SSN (Servizio Sanitario Nazionale) italiano. La differenza con la Francia è che in Italia il SSN è finanziato tramite fiscalità generale e non richiede un contributo aggiuntivo dedicato.
- Is LAMal or the SSN better for an Italian cross-border worker?
- The right of option depends on citizenship and residence. Eligible workers choosing the SSN must formally request exemption from the competent authority in their canton of employment within three months of starting their contract; SSN registration alone is insufficient. The choice cannot be changed freely: check any new circumstances with the canton. During a temporary stay in Switzerland, people entitled to use the EHIC can receive medically necessary public healthcare, taking account of the treatment and length of stay, on the conditions and at the costs applicable to locally insured people. This is not limited to emergencies and is not necessarily free. The EHIC does not cover travel for planned treatment, private care or repatriation; planned treatment and care in the country of residence follow separate procedures to check beforehand with the ASL and insurer. Eligibility also depends on insurance affiliation and citizenship: do not assume every card can be used in Switzerland. LAMal-insured people resident in Italy receive form S1 from their insurer and register it with the competent Italian healthcare institution to access care under the rules of their country of residence. https://employment-social-affairs.ec.europa.eu/policies-and-activities/moving-working-europe/eu-social-security-coordination/european-health-insurance-card_en
- Come si attiva il diritto di opzione verso il SSN?
- I cittadini UE residenti in Italia che hanno diritto di opzione possono chiedere l’esenzione dalla LAMal all’autorità competente del Cantone di lavoro entro tre mesi dall’inizio dell’attività. La domanda deve essere formale: la sola iscrizione al SSN non basta. La scelta non si modifica liberamente. Per chi era assicurato LAMal, la nascita di un figlio può consentire un nuovo esercizio entro tre mesi, secondo la situazione familiare: verificare prima con il Cantone e l’ASL. Fonte: UFSP, https://www.bag.admin.ch/it/assicurazione-malattie-lavoratori-frontalieri-in-svizzera
- Can I receive care in Switzerland if I choose the SSN?
- During a temporary stay in Switzerland, people entitled to use the EHIC can receive medically necessary public healthcare, taking account of the treatment and length of stay, on the conditions and at the costs applicable to locally insured people. This is not limited to emergencies and is not necessarily free. The EHIC does not cover travel for planned treatment, private care or repatriation; planned treatment and care in the country of residence follow separate procedures to check beforehand with the ASL and insurer. Eligibility also depends on insurance affiliation and citizenship: do not assume every card can be used in Switzerland. https://employment-social-affairs.ec.europa.eu/policies-and-activities/moving-working-europe/eu-social-security-coordination/european-health-insurance-card_en