If costs for medical treatment, hospital treatment or medication occur, then the policyholder must first cover some of these costs. This first contribution is known as the deductible rate.
Only if the costs exceed the agreed deductible rate, will the health insurance company contribute to further costs (minus the retention fee).
The deductible rate must only be paid once per calendar year.
In case of maternity there is no deductible rate (as long as there are no complications). The same applies to accidents (including accidents outside the workplace), if the employee is insured against accidents by his employer (accident insurance provided by employer).
Statutory deductible rate
For adults the standard or statutory deductible rate is CHF 300,
for children 0.
Optional deductible rate
Policyholders are entitled to increase the deductible rate, in order to profit from a discount in premium:
| Age Group |
Optional deductible rate |
Maximum discount |
| Children up to 18 years |
100 |
CHF 80 per annum |
|
200 |
CHF 160 per annum |
|
300 |
CHF 240 per annum |
|
400 |
CHF 320 per annum |
|
500 |
CHF 400 per annum |
|
600 |
CHF 480 per annum |
| Adults |
500 |
CHF 160 per annum |
|
1000 |
CHF 560 per annum |
|
1500 |
CHF 960 per annum |
|
2000 |
CHF 1360 per annum |
|
2500 |
CHF 1760 per annum |
The reduced premium will never be lower than 50 % of the basic premium (deductible rate 300/0, with accident). This also applies to alternative insurance models.
Example:
| Deductible rate |
Premium |
effective annual discount |
| Standard deductible rate 300 |
200.00 |
CHF 0 |
| Optional deductible rates 500 |
186.70 |
CHF 160 |
| 1000 |
153.30 |
CHF 560 |
| 1500 |
120.00 |
CHF 960 |
| 2000 |
100.00 |
CHF 1200 (50% rule) |
| 2500 |
100.00 |
CHF 1200 (50% rule) |
It is up to the individual health insurance company, whether or not they offer all levels of deductible rate. It is therefore possible that you will not find all new levels of deductible rate on offer from every insurance company.
Example:
Company A offers all levels of deductible rate (300, 500, 1000, 1500, 2000, 2500).
Company B only offers the basic rate (300) and two optional deductible rates (1000, 2500).
Changing the deductible rate
Lowering the deductible rate: It is possible to change to a lower deductible rate at the beginning of each calendar year. You must inform the health insurer in writing of your selected deductible rate by 30 November (receipt of the letter by the insurer).
Increasing the deductible rate: You can change to a higher deductible rate at the beginning of each calendar year. You must inform the health insurer in writing of your selected higher deductible rate by 31 December at the latest (keep in mind public holidays) or until the last work day in December.
|
|
|
