Choosing the Right Deductible in Switzerland
Find the optimal balance between monthly premiums and out-of-pocket costs with our step-by-step guide to selecting your ideal franchise.
Understanding the Swiss Deductible System
In Switzerland, the deductible (franchise) is a key component of the health insurance system that directly impacts both your monthly premiums and out-of-pocket expenses. It's the amount you must pay for healthcare services each year before your insurance begins to cover costs.
Choosing the right deductible requires balancing immediate monthly savings against potential healthcare costs. While a higher deductible means lower monthly premiums, it also means you'll pay more out-of-pocket if you need medical care.
Key Facts About Swiss Deductibles
CHF 300, 500, 1000, 1500, 2000, or 2500
Deductibles reset every January 1st
Must request changes by November 30th
Comparing Deductible Options
See how different deductible levels affect your premiums and potential savings.
| Deductible Level | Premium Reduction* | Annual Premium Savings* | Best For |
|---|---|---|---|
| CHF 300 (Standard) | Base rate | None (reference) | People with frequent healthcare needs or chronic conditions |
| CHF 500 | Approx. 5-8% | CHF 150-240 | People who visit doctors several times a year |
| CHF 1,000 | Approx. 10-15% | CHF 300-450 | People with occasional healthcare needs |
| CHF 1,500 | Approx. 15-20% | CHF 450-600 | Generally healthy people with rare doctor visits |
| CHF 2,000 | Approx. 20-30% | CHF 600-900 | Very healthy people with strong financial reserves |
| CHF 2,500 | Approx. 30-40% | CHF 900-1,200 | Rarely ill people with significant savings and high risk tolerance |
The Breakeven Calculation
To determine if a higher deductible makes financial sense, you need to calculate your breakeven point:
Annual Premium Savings + Current Deductible > New Higher Deductible
For example, if increasing your deductible from CHF 300 to CHF 2,500 saves you CHF 1,000 in annual premiums, your calculation would be: CHF 1,000 + CHF 300 = CHF 1,300, which is less than CHF 2,500. In this case, you would need to have healthcare costs below CHF 1,300 to benefit from the higher deductible.
Choosing Your Ideal Deductible: Step-by-Step
Follow these seven steps to select the deductible level that best matches your healthcare needs and financial situation.
Understand the Swiss deductible system
Learn about the available deductible levels in Switzerland (CHF 300, 500, 1000, 1500, 2000, 2500) and how they affect your monthly premiums and out-of-pocket costs.
The Swiss Deductible System Explained:
- Annual Reset: Your deductible resets every January 1st, regardless of when you reached it in the previous year.
- Co-Payment: After reaching your deductible, you still pay 10% of costs up to an annual maximum of CHF 700 for adults or CHF 350 for children.
- Children's Deductibles: For those under 18, different deductible options and rates apply, with a standard deductible of only CHF 0 and maximum of CHF 600.
- Excluded Services: Some services bypass the deductible entirely, including maternity care, certain preventive services, and some accident-related treatments.
Calculate your expected annual healthcare usage
Estimate your yearly healthcare costs based on your medical history, planned treatments, regular medications, and typical doctor visits.
Determine your breakeven point
Calculate the point at which a higher deductible saves you money, based on premium differences between deductible levels and your expected healthcare costs.
Breakeven Calculation Example:
Let's say you're considering increasing your deductible from CHF 300 to CHF 2,500:
| Factor | Amount |
|---|---|
| Annual premium with CHF 300 deductible | CHF 4,800 (CHF 400/month) |
| Annual premium with CHF 2,500 deductible | CHF 3,600 (CHF 300/month) |
| Annual premium savings | CHF 1,200 |
| Additional out-of-pocket maximum | CHF 2,200 (CHF 2,500 - CHF 300) |
| Breakeven healthcare expenses | CHF 1,500 |
In this example, if your annual healthcare expenses are below CHF 1,500, the higher deductible makes financial sense. If they exceed CHF 1,500, the lower deductible is more cost-effective.
Consider your financial situation
Assess your ability to pay the full deductible amount out-of-pocket at once if needed, and your comfort level with financial risk.
Evaluate special circumstances
Factor in planned procedures, pregnancy, chronic conditions, or other special situations that might affect your healthcare needs in the coming year.
Special Circumstances to Consider:
- Pregnancy: If you're planning to become pregnant, consider a lower deductible since maternity-related costs are exempt from the deductible and co-payment once pregnancy is confirmed.
- Planned Procedures: If you have a scheduled surgery or other expensive treatment, calculate whether the lower deductible plus premium cost would be less than a higher deductible plus premium.
- Chronic Conditions: For ongoing treatments requiring regular care, a lower deductible is typically more cost-effective since you're likely to exceed it early in the year.
- Family Planning: When choosing deductibles for children, remember they generally have lower healthcare costs but may need more preventive care.
Make your decision and apply
Select the appropriate deductible level when signing up for a new insurance plan or request a change with your current provider during the allowed period.
Reassess annually
Review your choice each year before the November 30 deadline based on changes in your health status, financial situation, or premium rates.
Need Help Selecting the Right Deductible?
Our insurance experts can review your healthcare needs and financial situation to recommend the optimal deductible level for your circumstances.
No obligation, just expert guidance for your Swiss insurance needs.
Deductible Decision Tool
Use this simplified guide to help determine which deductible level might be right for your situation.
Which Deductible Might Be Right For You?
Low Deductible (CHF 300-500) May Be Best If:
- You visit doctors frequently (more than 4-5 times per year)
- You have a chronic condition requiring regular treatment
- You take multiple prescription medications regularly
- You have planned medical procedures in the coming year
- You prefer predictable monthly costs over potentially high one-time expenses
Medium Deductible (CHF 1,000-1,500) May Be Best If:
- You visit doctors occasionally (2-3 times per year)
- You take some medications but not on a continuous basis
- You have some savings to cover potential out-of-pocket costs
- You're looking for a balance between monthly premiums and potential out-of-pocket expenses
High Deductible (CHF 2,000-2,500) May Be Best If:
- You rarely visit doctors (0-1 times per year)
- You don't take any prescription medications regularly
- You have substantial savings to cover potential out-of-pocket costs
- You're comfortable with financial risk and prioritize lower monthly premiums
- You're generally healthy with no anticipated medical procedures
Important Note: This is a general guide only. Your specific healthcare needs, financial situation, and risk tolerance should all be carefully considered when making this decision.
Frequently Asked Questions
What is a deductible (franchise) in Swiss health insurance?
A deductible (franchise in French/German) is the amount you pay out-of-pocket each year for healthcare services before your insurance begins to cover costs. In Switzerland, basic health insurance offers deductible options ranging from CHF 300 to CHF 2,500. The higher your deductible, the lower your monthly premiums, but the more you'll pay before insurance coverage kicks in.
How much can I save with a higher deductible?
The premium reduction depends on the deductible level chosen. Generally, each step up in deductible level reduces your monthly premium. For example, increasing from the standard CHF 300 deductible to the maximum CHF 2,500 deductible can save approximately 30-40% on monthly premiums, resulting in annual savings of CHF 1,000-1,500 for an average adult, though this varies by insurer and canton.
When can I change my deductible?
You can change your deductible for the following calendar year by notifying your insurance provider by November 30. Some insurers may allow you to increase your deductible mid-year, but decreasing it is only possible at the beginning of a new calendar year.
Is a high deductible always better if I'm healthy?
Not necessarily. While healthy individuals often benefit from higher deductibles, you should consider your financial reserves, risk tolerance, and potential for unexpected health issues. Remember that a CHF 2,500 deductible means you might need to pay this amount in full before receiving insurance benefits. Unexpected health issues can happen even to healthy people.
Do deductibles apply to all healthcare services?
Most medical services are subject to the deductible, including doctor visits, hospital stays, and medications. However, some preventive services are exempt, such as mammograms for breast cancer screening, certain prenatal care services, and some vaccinations. Additionally, maternity-related services are not subject to the deductible once pregnancy is confirmed.
Have more questions about choosing the right deductible?
Related Insurance Guides
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How to Change Insurance Models
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Finding the Best Health Insurance
Compare providers and plans to find the perfect coverage for your specific needs.
How to Apply for Premium Subsidies
Learn if you qualify for premium reductions and how to apply in your canton.
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