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InsuranceHealth insuranceGlossaryDeductible

Deductible (franchise)

  • What is the deductible ("franchise")?
  • What annual deductibles are available for adults and children?
  • Which deductible is best?
  • When and how can I change my deductible?
  • Summary

What is the deductible ("franchise")?

The deductible (or excess) together with the coinsurance percentage form the out-of-pocket expenses policyholders must pay for the benefits covered by health insurance (e.g. treatment by a doctor or in hospital and the cost of medicine). Any healthcare costs incurred up to the amount of the deductible (2,500 francs maximum) must be paid by the policyholders themselves. A coinsurance percentage of 10% must be paid towards any costs incurred in excess of the deductible. The health insurer covers the remaining cost using the premiums it receives.

What annual deductibles are available for adults and children?

Policyholders are free to choose their deductible each year. Increasing it gives them a discount on their premiums.

Deductible for adults

Optional deductible for adults (from 18 years of age)Maximum discount on annual premium
CHF 300No discount
CHF 500CHF 140
CHF 1,000CHF 490
CHF 1,500CHF 840
CHF 2,000CHF 1,190
CHF 2,500CHF 1,540

Deductible for children and babies

Optional deductible for children (up to 18 years of age)Maximum discount on annual premium
CHF 0No discount
CHF 100CHF 70
CHF 200CHF 140
CHF 300CHF 210
CHF 400CHF 280
CHF 500CHF 350
CHF 600CHF 420

The health insurers themselves decide which deductibles to offer, so not all deductibles are offered by all health insurers.

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Which deductible is best?

You are free to choose the deductible yourself. Generally speaking, a deductible of 2,500 francs is suitable for people who never need medical treatment. People who regularly require medical treatment should consider the 300-franc deductible.

When and how can I change my deductible?

Reducing the deductible

It is possible to switch to a lower deductible with effect from the beginning of the calendar year. Your health insurer must receive notice of the lower deductible in writing by the last working day in November.

Increasing the deductible

You can request a higher deductible with effect from the beginning of the calendar year. Your health insurer must receive notice of the higher deductible in writing by the last working day in December.

Summary

  • The deductible is a minimum of 300 francs for adults and 0 francs for children.
  • You only pay the deductible once per calendar year when you claim on the insurance.
  • If you switch health insurer in the middle of the year, your new insurer will take into account any deductible and coinsurance already paid.
  • Pregnant women do not have to pay any out-of-pocket expenses from the 13th week of pregnancy until eight weeks after the birth.
  • It is possible to switch to a lower or higher deductible with effect from the beginning of the calendar year.
  • Policyholders are free to choose a higher deductible in order to lower their premiums. This is only worth it for people with low healthcare costs.
  • Example calculation of out-of-pocket expenses
  • Out-of-pocket expenses can be different in supplemental insurance.

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