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Retention in basic health insurance

Application

The retention is the amount covered by the policyholder himself when claiming benefits, such as medical treatment, hospital treatment and medication. This amount cannot be chosen and is a percentage of the costs, whereas the deductible rate is a fixed amount, and is charged fully.

Calculation: 10% of medical costs minus deductible rate

Medical costs are for medical treatment, hospital treatment and medication. If the medical costs exceed the deductible rate, the policyholder covers the retention of 10% up to a maximum of CHF 700 (please note the exception for medication), i.e. the retention only applies once the deductible rate has been paid. (see Example calculations)

Retention for children and families

Retention for children is CHF 350. If more than 2 children of the same family are insured with the same health insurance, the total retention is limited to CHF 700 for all children.

Exception: medication

Since January 1 2006, the retention for original medication for which a generic product is available, has been raised from 10% to 20%. The retention for generic medication remains at 10%.

Exceptions:

  • A medical reason for not using the generic product.
  • If the price difference between the original and the generic product is under 20%, the retention stays at 10%.


Maternity

For maternity, no deductible rate or retention is charged, as long as there are no complications.

Example calculations

You can find examples for the sharing of costs here.

Accident coverage according to the UVG

Employees that work for the same employer for more than 8 hours per week are insured against accidents by their employer. Accident insurance according to the UVG is subject to neither a deductible rate nor retention.