If costs for medical treatment by a doctor, hospital treatment or medication occur, the policyholder must contribute to these costs. The contribution includes a previously agreed amount, the so-called deductible rate, as well an additional retention fee of 10 percent.
The deductible rate must only be paid once per calendar year and is at least CHF for adults.
In case ofmaternity 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/her employer (covered according to accident insurance laws).
Statutory deductible rate
For adults, the normal or statutory deductible rate is CHF 300, for children CHF 0.
Optional deductible rate
Policyholders are entitled to increase the deductible rate in order to benefit from a reduction in premium:
| Age group | Optional deductible rate | Maximum reduction |
|---|
| Children up to 18 years |
100 |
CHF 70 per year |
|
200 |
CHF 140 per year |
|
300 |
CHF 210 per year |
|
400 |
CHF 280 per year |
|
500 |
CHF 350 per year |
|
600 |
CHF 420 per year |
| Adults |
500 |
CHF 140 per year |
|
1000 |
CHF 490 per year |
|
1500 |
CHF 840 per year |
|
2,000 |
CHF 1,190 per year |
|
2,500 |
CHF 1,540 per year |
In any case, the reduced premium may not be smaller 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 reduction |
|---|
| Basic deductible rate 300 |
200.00 |
CHF 0 |
| Optional deductible rates500 |
186.70 |
CHF 160 |
| 1,000 |
153.30 |
CHF 560 |
| 1,500 |
120.00 |
CHF 960 |
| 2,000 |
100.00 |
CHF 1,200 (50% rule) |
| 2,500 |
100.00 |
CHF 1,200 (50% rule) |
It is up to the individual health insurance company whether or not the offer all levels of deductible rates. It is therefore possible that you will not find all new deductible rate levels on offer from every insurance company.
Example:
Company A offers all levels of deductible rates (300, 500, 1,000, 1,500, 2,000, 2,500).
Company B only offers the basic deductible rate (300) and two optional deductible rates (1,000, 2,500) an.
Changing the deductible rate
Decreasing 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 insurance company in writing of you selected lower deductible rate by 30th November or by the last working day in November (receipt of the letter by the insurance company).
Increasing the deductible rate: It is possible to change to a higher deductible rate at the beginning of each calendar year. You must inform the health insurance company in writing of your selected higher deductible rate by 31st December (take holidays into consideration) or by the last working day in December (receipt of the letter by the insurance company). |
