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Italian Cross-Border Workers: Taxes, the 2020 Agreement and Health Insurance

Old and new cross-border workers, taxes in Switzerland and Italy, 25% remote work and health insurance: a practical guide. Fiorentino Law Firm, Naples.

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RFAvv. Renato Giuseppe Fiorentino·Published 17 October 2026·Updated 17 October 2026·6 min read

Updated on October 16, 2026

In 30 seconds

The 2020 Italy-Switzerland agreement entered into force on July 17, 2023, and applies from January 1, 2024. Anyone who becomes a cross-border worker (frontaliere) after that date pays tax in both Switzerland and Italy, with a tax credit. Those who already were one remain taxed only in Switzerland. For health insurance there is a right of option, to be exercised within three months of starting work.

This text is part of the guide Italians in Switzerland: Legal Guide.

Who is a cross-border worker

The new agreement looks at three elements. Tax residence in a municipality within 20 km of the border. Employment in the border zone of the other state. In principle, a daily return to one’s home.

The zones are Graubünden, Ticino and Valais for Switzerland, and Lombardy, Piedmont, Aosta Valley and the Province of Bolzano for Italy. The status is not lost if the return does not happen for work reasons, up to 45 days per calendar year. Above that limit, the status is lost for that year.

Old and new cross-border workers

  • Old cross-border workers: people who worked as cross-border workers between December 31, 2018 and July 17, 2023. They are taxed only in Switzerland, if the employer paid the withholding tax at source.
  • New cross-border workers: people who obtain the status after July 17, 2023. The Swiss withholding tax at source is 80% of the ordinary rate. Italy taxes the income and grants a credit for the tax paid in Switzerland.

Allowance and remote work

According to Circular 25/E of 2023 of the Italian Revenue Agency (Agenzia delle Entrate), from 2024 the Italian allowance for cross-border workers is 10,000 euros. Check with a tax adviser (commercialista) whether it has changed.

The protocol on working from home has been in force since February 9, 2026 and applies from January 1, 2024. Cross-border workers may work from home up to 25% of their working time, without changing the tax rules.

Health insurance

Cross-border workers who work in Switzerland are, as a rule, insured in Switzerland. For those who live in Italy there is a right of option: they can stay in the system of the country of residence. Anyone who does not want Swiss insurance must apply for exemption within three months of starting work, with the authority of the canton of work.

According to the Swiss Federal Office of Public Health, the “tacit” option is not valid. A formal application is needed.

The concrete steps

  1. Check your status. Check your municipality of residence, your start date and your days away from home.
  2. Keep the documents. Contract, payslips and withholding-tax certificates.
  3. Decide on insurance within three months. Ask the cantonal authority how to submit the exemption application.
  4. Note your remote-work days. They are needed to show that you stay within the 25% limit.
  5. Have a tax adviser do the calculations. The firm does not give tax advice: it handles the legal side of the documents.

Frequent case · A problem that happens often

A woman from Varese has worked for a company in Ticino since September 2023. She thinks she is an “old cross-border worker” because her colleagues are. She signed the contract after July 17, 2023, so she is a new cross-border worker. She did not apply for exemption from the Swiss health insurer (cassa malati) within three months. Now she wonders whether she can change her choice. First she needs to understand which status she has and what was done in time.

Frequent case described in general terms: names, places and details do not refer to real people or cases.

The best solution for you

Before starting work. The best path is to check your status: municipality of residence, start date, days away from home. It is usually worth doing right away, because the choice on health insurance has a three-month deadline.

After starting work. You check whether the exemption application was filed within three months with the cantonal authority. It is usually best to ask the cantonal authority how to file it. The “tacit” option is not valid.

If the office does not cooperate or the deadline has passed. It is better to gather the contract, payslips and withholding-tax certificates. With these documents you can assess what was done in time.

What to do right away

  1. Check your start date: after July 17, 2023 you are a new cross-border worker.
  2. Ask the cantonal authority how to submit the application for exemption from Swiss insurance.
  3. Note your remote-work days and keep your contract, payslips and certificates.

No path guarantees an outcome.

Learn more: Legal guides from Studio Legale Fiorentino.

How attorney Fiorentino can help you

  1. He can help you understand whether you are an old or a new cross-border worker, starting from your employment documents.
  2. He can check with you what was done within the three months for health insurance.
  3. He can handle the legal side of the documents; tax calculations stay with a tax adviser (commercialista).

Contact usWhatsAppCall 347 5264190

Frequently asked questions

How does one become an old cross-border worker?

You had to be a cross-border worker between December 31, 2018 and July 17, 2023, with withholding tax at source paid in Switzerland by the employer.

What happens if I work too many days from home?

Beyond the agreed threshold the tax rules may change. The threshold is 25% of working time, effective January 1, 2024.

Can I choose Italian insurance?

Those who have the right of option must exercise it with a formal application to the authority of the canton of work, within three months of starting the activity.

How many days can I stay away from home?

For work reasons, up to 45 days per calendar year, according to the Swiss fact sheet.

Who does the tax calculations?

A tax adviser (commercialista). The firm handles the legal and documentary aspects.

Official sources

Pages of institutional websites consulted on October 16, 2026.

Read also

The firm

The firm is based in Naples (Piazza Giovanni Bovio 22 and Via Monte di Dio 14) and works throughout Italy; the first meeting can be held by video call. To ask for a consultation: WhatsApp or phone 347 5264190.

Informational text, prepared with the help of artificial intelligence tools. It does not replace advice on a specific case.
Author: attorney Renato Giuseppe Fiorentino
Updated on October 16, 2026

Do you have a similar issue?

Every situation depends on the documents of the specific case. You can contact the firm from anywhere, remotely.

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