Information sourced from the Swiss Federal Office of Public Health (FOPH / bag.admin.ch). Amounts and rules in force for the 2026 calendar year. Last verified: April 2026.
1. What is the deductible?
The deductible (in French: franchise) is the fixed annual amount you pay yourself before your health insurer starts reimbursing your medical costs. It resets every 1st January.
In practice: if you choose a 1,000 CHF deductible and incur 800 CHF of care in a year, your insurer reimburses nothing. Once you exceed 1,000 CHF, the insurer covers 90% of additional costs — you pay the remaining 10% as co-payment.
2. Available amounts
| Deductible | Monthly premium | Max. annual risk* |
|---|---|---|
| 300 CHF (standard) | Highest (reference) | 1,000 CHF |
| 500 CHF | Reduced | 1,200 CHF |
| 1,000 CHF | Reduced | 1,700 CHF |
| 1,500 CHF | Reduced | 2,200 CHF |
| 2,000 CHF | Reduced | 2,700 CHF |
| 2,500 CHF (maximum) | Lowest | 3,200 CHF |
*Maximum annual risk = deductible + maximum co-payment of 700 CHF.
Children are exempt from the standard deductible (0 CHF). Optional deductibles for children are: 100, 200, 300, 400, 500 and 600 CHF. The maximum co-payment is capped at 350 CHF per child per year.
3. The golden rule: calculating the break-even point
Choosing a high deductible is only worthwhile if the premium savings exceed the additional medical costs you’ll bear. The calculation is simple:
300 CHF deductible — premium 400 CHF/month
4,800 CHF/year
2,500 CHF deductible — premium 340 CHF/month
4,080 CHF/year
In this example, if your annual medical costs are below 2,500 CHF, you save by choosing the high deductible. If you regularly reach or exceed this amount, the standard deductible becomes more advantageous.
As a general rule, the optimal deductible for an adult is the highest one (2,500 CHF) when expected gross benefits are below 1,500–2,000 CHF per year.
4. Which deductible fits which profile?
| Profile | Recommended deductible | Reason |
|---|---|---|
| Good health, few consultations | 2,500 CHF | Maximum premium savings |
| Fair health, a few consultations per year | 1,000–1,500 CHF | Good risk / savings balance |
| Regular follow-up, chronic treatment, frequent medication | 300 CHF | Maximum financial protection |
| Pregnant woman or planning pregnancy | 300 CHF | Maternity is exempt from deductible |
| Child in good health | Optional deductible if savings verified | Lower premium, low risk |
5. What the deductible does not cover: the exceptions
Some situations fall outside the usual deductible mechanism. Knowing them prevents overestimating your future costs.
Maternity-related services (check-ups, ultrasounds, delivery, obstetric care, childbirth preparation classes) are exempt from both the deductible and the co-payment. From the 13th week of pregnancy until 8 weeks after delivery, no cost-sharing is required — including for illnesses unrelated to pregnancy.
Certain preventive measures explicitly listed by law (recommended vaccinations, approved screenings) are also exempt from cost-sharing.
Cost-sharing paid in those countries does not count towards your Swiss deductible or co-payment. These are two separate systems.
6. Deadlines and procedure for changing your deductible
| Action | Deadline |
|---|---|
| Switch to a lower deductible | Written notice to the insurer by 30 November, effective 1st January |
| Switch to a higher deductible | Only possible on 1st January; inform the insurer by mid-December at the latest |
| Change during the year | Not possible, except when switching insurer |
7. Good to know
If your doctor prescribes an original drug while a cheaper generic exists without medical justification, the co-payment rises to 40% instead of 10%. To avoid this surcharge, ask your doctor to prescribe the active ingredient rather than the brand name.
A 15 CHF daily contribution for hospital stays is added to the deductible and co-payment. It is not capped over time. Exempted categories:
children up to age 18;
young adults in training up to age 25;
women for maternity-related services.
An optional deductible can be combined with an alternative model (family doctor, HMO, Telmed). However, the legal minimum premium — 50% of the standard ordinary premium for your age group and region — must always be respected, even with the maximum deductible.
The discount granted by the insurer for a high deductible cannot exceed 70% of the additional risk borne by the insured. The premium reduction therefore never fully compensates the increased financial risk — you always carry part of the risk.
This guide is provided for information purposes. For any specific personal situation, consult your health insurer or the FOPH directly. The amounts and rules cited are in force for the 2026 calendar year. Sources: FOPH (bag.admin.ch) — Health insurance: Premiums and cost-sharing, Optional deductibles, Cost-sharing for persons insured in Switzerland.