How to choose your Swiss health insurance Franchise (deductible).
Six federal Franchise tiers under Art. 93 KVV — CHF 300, 500, 1,000, 1,500, 2,000, 2,500 (adults). Plus 10% coinsurance on costs above the Franchise, capped at CHF 700/year. The right tier depends on your actual annual care usage, not your appetite for risk.
Updated
45 minutes with Robert. Free.
In English · With or
We'll send you a short intake form so we understand your needs before we speak.
Your details
You're booked
Check your email for a calendar invite and a video call link.
In brief
The optimal Franchise (deductible) tier depends on your actual yearly medical costs: rare-care households should hold the highest tier (CHF 2,500) for maximum premium discount; regular-care households often net negative on high-Franchise tiers once coinsurance + Franchise stack against the smaller premium discount.
- Adult tiers
- Set by federal law — Art. 93 KVV fixes six: CHF 300, 500, 1,000, 1,500, 2,000, 2,500.
- Coinsurance
- 10% of costs above the Franchise, capped at CHF 700/year.
- Children (under 18)
- Separate tiers of CHF 0, 100, 200, 300, 400, 500, 600, with a CHF 350/year coinsurance cap.
- Premium discount
- Capped by federal law at 70% of the extra risk — up to CHF 1,540/year at CHF 2,500 vs CHF 300.
The math is simple but most people misjudge their own usage band.
One year, one bill — who pays what.
You fall ill, see a doctor, get some tests. The bills add up to CHF 2,000. You pay the first CHF 300 — your Franchise — then 10% of the rest, capped at CHF 700 a year. Your insurer pays the remainder: this year you pay CHF 470.
Pregnancy is the exception: check-ups and the birth come with no Franchise and no 10%.
The Swiss deductible tiers, in one table.
Adult tiers under Art. 93 KVV, with the federally capped premium discount (insurers may reduce the premium by at most 70% of the extra risk you take on) and the worst-case yearly exposure including the 10% coinsurance cap of CHF 700.
| Franchise (adult) | Max. premium discount / year | Worst case out of pocket / year | Tends to fit |
|---|---|---|---|
| CHF 300 | — (baseline) | CHF 1,000 | Regular care, chronic treatment, planned pregnancy |
| CHF 500 | up to CHF 140 | CHF 1,200 | Rarely optimal — discount too small for the added risk |
| CHF 1,000 | up to CHF 490 | CHF 1,700 | Mid-usage households (the in-between tiers rarely win) |
| CHF 1,500 | up to CHF 840 | CHF 2,200 | Mid-usage households |
| CHF 2,000 | up to CHF 1,190 | CHF 2,700 | Rarely optimal — CHF 2,500 usually beats it |
| CHF 2,500 | up to CHF 1,540 | CHF 3,200 | Healthy, rare-care adults with a cash buffer |
| Max. premium discountFranchise10% coinsurance, capped at CHF 700 | |||
Children (under 18): tiers CHF 0–600, coinsurance capped at CHF 350/year. The optimal adult choice is almost always CHF 300 or CHF 2,500 — the middle tiers price the risk poorly.
Video · 2:48 Swiss health insurance deductible: CHF 300 or 2,500?
Video page, chapters and transcript
Chapters
- 0:00The bill after the doctor
- 0:14The short answer
- 0:30Deductible, then 10%
- 0:51The choices
- 1:10Healthy or not: the break-even
- 1:39Families: the CHF 1,000 cap
- 2:01Pregnancy is different
- 2:16What to do now
- 2:29Your first Swiss insurance review
Read the transcript
0:00 The bill after the doctor
Which deductible should you choose for Swiss health insurance: CHF 300, or 2,500? And why did you get a bill after seeing a doctor?
0:14 The short answer
The short answer: it depends on your actual yearly medical costs, not on your appetite for risk. Under CHF 1,000 a year, 2,500 usually wins. Over 3,000, usually 300.
0:30 Deductible, then 10%
Here is where the bill comes from. Your bills for the year add up to CHF 2,000. First, you pay your deductible: 300. Above it, 10%: 170. Your insurer pays the rest. You pay 470.
0:51 The choices
The 10% stops at CHF 700 a year. There are six deductibles, from 300 to 2,500. A higher one lowers your premium, but the law caps the discount: at most CHF 1,540 a year.
1:10 Healthy or not: the break-even
A trap we catch every week: the highest deductible, taken for its discount. In our worked example, an adult in Bern spends about CHF 4,800 a year on physiotherapy and medication. On 2,500, even after the largest discount, that year costs CHF 1,190. On 300, CHF 750: at least CHF 440 less.
1:39 Families: the CHF 1,000 cap
Children are different. Three or more children at the same insurer, on the default deductible of zero, pay at most CHF 1,000 a year together. Split them across insurers, and that cap is gone. Raise each child's deductible to 600, and it rises to about 1,900.
2:01 Pregnancy is different
One exception: pregnancy. Check-ups and the birth come with no deductible and no 10%. And from week 13 until eight weeks after the birth, everything medically necessary is covered in full.
2:16 What to do now
So add up last year's medical bills, and pick the level that fits. You can change it every year: tell your insurer by 30 November, for 1 January.
2:29 Your first Swiss insurance review
If you'd like someone to read your own contracts with you, book your first Swiss insurance review. It's free, 45 minutes, in English, with Robert or Nicole. The link is in the description.
Franchise selection — step by step.
-
Estimate your annual medical-cost reality
What did you actually spend on healthcare last year? Add up: GP visits, specialist consultations, prescription medications, dental (if separately tracked), planned procedures. For most households the figure lands in one of three bands: rare (under CHF 1,000/year), moderate (CHF 1,000–3,000), regular (over CHF 3,000). Your band determines the optimal Franchise tier.
Tip Include only basic-insurance-relevant care — supplementary-only spend (osteopathy, alternative therapies via EMR/ASCA) is separate. The Franchise applies only to KVG-covered care.
-
Apply the federal discount steps
Federal law caps the premium discount vs the CHF 300 baseline at 70% of the extra risk you take on (Art. 95 KVV). Maximum monthly discounts: CHF 500 = up to −CHF 12/month, CHF 1,000 = up to −CHF 41/month, CHF 1,500 = up to −CHF 70/month, CHF 2,000 = up to −CHF 99/month, CHF 2,500 = up to −CHF 128/month (CHF 140 / 490 / 840 / 1,190 / 1,540 a year). The cap is federal; each insurer sets its own discount at or below it, so check your insurer's figure for your canton.
-
Calculate the break-even cost level
For each Franchise tier, calculate: (annual premium discount vs CHF 300) minus (extra Franchise + 10% coinsurance up to CHF 700 cap). The break-even cost level is where the saving equals the extra exposure. Above that cost level, the high tier nets negative; below, it nets positive.
Tip Use the Franchise calculator on the health insurance hub. Enter your canton, age, model, and projected annual cost; it runs all six tiers and highlights the optimum.
-
Pick the tier matching your usage band
Rare-care (under CHF 1,000/yr): CHF 2,500 tier nets best — maximum discount, low coinsurance exposure. Moderate-care (CHF 1,000–3,000): typically CHF 1,000–1,500 tier. Regular-care (over CHF 3,000): usually CHF 300 tier — the high-tier discounts don't compensate for the larger Franchise + capped coinsurance stack. Don't pick the highest-discount tier reflexively; the math punishes mismatched bands.
-
Review annually as your usage band shifts
Major life events shift the band: pregnancy, chronic-condition diagnosis, ageing into more frequent care, leaving a high-care year. Franchise can be changed at the annual cycle (effective 1 January, notify by 30 November under Art. 7 KVG). Most households should review the band annually rather than setting once and forgetting.
-
Layer the Franchise with model + IPV + insurer
Franchise is one of the four basic-insurance levers. The full architecture also covers: insurance model (Standard / Hausarzt / HMO / Telmed — typically 10–18% premium reduction off Standard), IPV subsidy if eligible (Art. 65 KVG, see IPV guide), and insurer choice (federal benefits identical under Art. 25 KVG; differences in claim-handling and supplementary range). Optimising all four together typically saves CHF 100–300/month vs the default architecture.
What we catch every week.
Trap 01
The highest-Franchise reflex
Households pick CHF 2,500 because it has the biggest discount, without checking actual usage. For regular-care households the math goes negative — Franchise + coinsurance often exceeds the premium saving by CHF 500–1,500/year.
Trap 02
The lowest-Franchise reflex
Households pick CHF 300 'for safety' even with rare care usage. The discount of up to CHF 1,540/year on the highest tier vs the CHF 300 tier outweighs the worst-case Franchise + coinsurance exposure for rare users by a wide margin.
Trap 03
The set-and-forget failure
Households pick a Franchise at registration and never revisit. Pregnancy, chronic diagnosis, lifestyle change shift the band; the Franchise should follow. The annual cycle is for this.
Trap 04
The family-cap miss
Children have separate Franchise tiers (0–600) with a CHF 350/year coinsurance cap. Family planning the household Franchise without modelling the children's tier separately misses material savings on family-cap interaction (Art. 64 §4 KVG).
These four are specific to this topic. The four we check in every review — from the age-curve trap to the 3-month deadline — are in the four traps deep-dive.
A real-pattern case.
Anonymised pattern
A household in Bern with two adults, one in regular physiotherapy + medication for a chronic back condition, the other low-care. Both held the CHF 2,500 Franchise inherited from prior advice. Annual medical spend: ~CHF 4,800 for the high-care adult, ~CHF 600 for the low-care adult.
The math: for the high-care adult, CHF 2,500 Franchise + CHF 230 coinsurance (10% of CHF 2,300 above) = CHF 2,730 out of pocket, against a premium discount of at most CHF 1,540 — net CHF 1,190. At CHF 300 the same year costs CHF 300 + CHF 450 coinsurance = CHF 750. Net cost of holding the high tier: at least ~CHF 440/year.
Recommendation: switch high-care adult to CHF 300, keep low-care adult at CHF 2,500. Annual saving: at least ~CHF 440. The mismatched-band mistake is one of the most common cases we see.
Aggregated from real client patterns. Names anonymised; figures illustrative.
- Medical spend
- ~CHF 4,800
At the CHF 2,500 Franchise
- Franchise
- CHF 2,500
- Coinsurance, 10% of CHF 2,300
- CHF 230
- Out of pocket
- CHF 2,730
- Premium discount, at most
- −CHF 1,540
- Net
- CHF 1,190
At the CHF 300 Franchise
- Franchise
- CHF 300
- Coinsurance
- CHF 450
- Net
- CHF 750
Net cost of holding the high tier at least ~CHF 440/year.
Beyond this guide — the 45-minute review.
The 45-minute review with Robert runs the Franchise math against your actual prior-year medical spend, models the five-year cost path under different Franchise selections, and checks the family-Franchise cap for households with children.
In the worked example above, one Franchise change saves at least CHF 440 a year — a smaller change than switching insurer, and no underwriting risk.
Robert Kolar
Insurance advisor — health insurance specialist
20+ years in Swiss insurance. Reads the basic and supplementary contract for every review. The 45-minute review covers the four-lever framework applied to your address, age, household and existing coverage. German, English, Czech.
Common mistakes.
Picking the highest discount reflexively
CHF 2,500 makes sense for rare-care households. For regular-care, the math goes negative.
Picking CHF 300 'for safety'
If your usage genuinely lands under CHF 1,000/year, the high-tier discount outweighs the worst-case exposure substantially.
Set-and-forget
Annual review against last year's actual spend is the discipline. Major life events shift the band.
Ignoring children's separate tiers
Family-Franchise cap (Art. 64 §4 KVG) interacts with children's tiers. Model children separately.
Confusing Franchise with model
Franchise is one lever; insurance model (Standard/Hausarzt/HMO/Telmed) is a separate lever. They compound; don't substitute one for the other.
Frequently asked — choose your Franchise (deductible).
What is the Franchise in Swiss health insurance?
What's the best Franchise for Swiss health insurance?
Can I change my Franchise mid-year?
How much do I save by raising my Franchise?
What is the 10% coinsurance?
Should children have a Franchise?
Is the Franchise tax-deductible?
What if I exceed my Franchise mid-year?
Franchise selection, read properly.
We've been running Franchise math for expat households since 2017. The actual-usage band, the federal discount steps, the family-cap interaction, the model + Franchise stack. Free, 45 minutes, in English, with Robert. In the worked example above, fixing a mismatched Franchise saves at least CHF 440 a year — with no underwriting risk.
Book your first Swiss insurance review