Six federal Franchise tiers under Art. 64 KVG — 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.
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Franchise (deductible) is set by federal law — Art. 64 KVG fixes the six adult tiers (CHF 300, 500, 1,000, 1,500, 2,000, 2,500) plus 10% coinsurance up to a CHF 700/year cap. Children's tiers (under 18) are 0, 100, 200, 300, 400, 500, 600 with a CHF 350/year coinsurance cap. The federally-regulated discount steps mean your premium falls predictably as the Franchise rises — but not linearly. The optimal 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. The math is simple but most people misjudge their own usage band.
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 (
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.
Federally-regulated monthly discounts vs the CHF 300 baseline: CHF 500 = -CHF 14/month, CHF 1,000 = -CHF 47/month, CHF 1,500 = -CHF 80/month, CHF 2,000 = -CHF 113/month, CHF 2,500 = -CHF 147/month. The discounts are uniform across Switzerland — the same insurer-by-canton premium gets reduced by the same step.
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 calculator on the section hub at /health-insurance/#franchise-calculator. Enter your canton, age, model, and projected annual cost; it runs all six tiers and highlights the optimum.
Rare-care (
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.
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.
Trap 01
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
Households pick CHF 300 'for safety' even with rare care usage. The CHF 1,764/year discount 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
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
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).
Canonical four-traps reference: the four traps deep-dive.
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 of annual exposure vs CHF 1,764 premium discount. Net cost of holding the high tier: ~CHF 966/year. Recommendation: switch high-care adult to CHF 300, keep low-care adult at CHF 2,500. Combined annual saving: ~CHF 1,300. The mismatched-band mistake is one of the most common cases we see.
Aggregated from real client patterns. Names anonymised; figures illustrative.
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. Most reviews end with a single Franchise change saving CHF 500–1,500/year — a smaller change than switching insurer but no underwriting risk.
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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.
CHF 2,500 makes sense for rare-care households. For regular-care, the math goes negative.
If your usage genuinely lands under CHF 1,000/year, the high-tier discount outweighs the worst-case exposure substantially.
Annual review against last year's actual spend is the discipline. Major life events shift the band.
Family-Franchise cap (Art. 64 §4 KVG) interacts with children's tiers. Model children separately.
Franchise is one lever; insurance model (Standard/Hausarzt/HMO/Telmed) is a separate lever. They compound; don't substitute one for the other.
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. Most reviews fix a mismatched-band Franchise — savings CHF 500–1,500/year, no underwriting risk.
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