Deductible

What is the deductible?

The deductible is the first part of your healthcare costs that you pay out of your own pocket in a calendar year. In Swiss German and French it is called the Franchise. Only once the bills for a year exceed the deductible you have chosen does your health insurer start to contribute. Together with the retention fee, the deductible is part of the statutory co-payment in basic health insurance.

The term comes from French. It means a fixed annual amount from which the insurer is exempt. Every adult in Switzerland has a deductible. You choose the amount yourself within the levels set by the Federal Council in the Health Insurance Ordinance (KVV). These levels are the same at every health insurer.

For adults aged 26 and over and for young adults aged 19 to 25, the standard deductible is CHF 300. Instead of this minimum deductible you can choose an optional deductible of CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 or CHF 2,500. No standard deductible is charged for children up to 18; parents can, however, choose an optional deductible of CHF 100, 200, 300, 400, 500 or 600 for them.

The deductible applies only to basic health insurance under the Health Insurance Act (KVG/LAMal). Supplementary insurance policies have their own excess arrangements, set out in the contract, which have nothing to do with the statutory deductible. A bill for the single-room supplement in hospital, or for glasses paid by your supplementary insurance, therefore does not count towards your deductible.

How it works

Every bill covered by basic health insurance is first counted towards your deductible. This applies both to bills you submit yourself and to those that your doctor’s practice, pharmacy or hospital sends directly to the insurer. As long as the total for the calendar year stays below the deductible, you pay everything yourself. As soon as the total exceeds the deductible, the insurer covers the rest, minus the 10% retention fee.

The retention fee is capped: adults pay at most CHF 700 a year, children at most CHF 350. Together with the deductible, this gives your maximum personal contribution. With a CHF 300 deductible that is at most CHF 1,000 a year, with CHF 2,500 at most CHF 3,200. Basic health insurance will not cost you more than this in a year, however high the bills are. The only addition is the hospital contribution of CHF 15 per day, which adults pay for inpatient stays. Children, young adults in education and women around childbirth are exempt from it.

The count starts again on 1 January. What matters is the date of treatment, not the date of the invoice. A treatment on 28 December therefore counts towards the previous year’s deductible, even if the bill only arrives in February. If you change insurer during the year, for example because you move, the new insurer takes into account the deductible you have already paid.

If several children in one family are insured with the same insurer, a family cap applies: without an optional deductible, all the children together pay no more in co-payments than one adult. With optional deductibles, the children’s combined co-payment may not exceed twice the maximum amount per child.

Some benefits are exempt from the deductible. For maternity, the insurer may not charge any co-payment from the 13th week of pregnancy until eight weeks after the birth. The Federal Council can also exempt certain preventive measures from national or cantonal programmes from the deductible.

Why choose a higher deductible?

Because the insurer gives you a discount on your premium in return. The law limits this discount: per year it may not exceed 70% of the additional risk you take on with the higher deductible. The additional risk is the difference from the standard deductible. At CHF 2,500 this is CHF 2,200, so the discount may be at most CHF 1,540 a year. You can see the actual discount at your insurer in the premium calculator, which shows the official premiums of all insurers for every deductible, as published by the Federal Office of Public Health (FOPH).

Legal basis

The deductible is governed by Art. 64 of the Federal Health Insurance Act (KVG). Under Art. 64 para. 2 KVG, the co-payment consists of a fixed annual amount (deductible) and 10% of the costs exceeding the deductible (retention fee). Art. 64 para. 3 KVG leaves it to the Federal Council to set the deductible and a maximum amount for the retention fee. Art. 64 para. 4 KVG states that no deductible is charged for children and that several children of one family insured with the same insurer together pay no more than the amounts for one adult. Art. 64 para. 7 KVG excludes co-payments for maternity from the 13th week of pregnancy, and Art. 64 para. 8 KVG prohibits insuring the co-payment.

The amounts are set out in the Health Insurance Ordinance (KVV). Art. 103 para. 1 KVV sets the standard deductible at CHF 300 per calendar year, and Art. 103 para. 2 KVV sets the maximum retention fee at CHF 700 for adults and CHF 350 for children. Under Art. 103 para. 3 KVV the date of treatment is decisive, and under para. 4 a new insurer credits the deductible already paid in the same year. Art. 93 KVV lists the optional deductibles, Art. 94 KVV governs changes (a higher deductible only from the start of the year, a lower deductible with the notice periods under Art. 7 KVG at the end of the year), and Art. 95 para. 2bis KVV limits the premium reduction to 70% of the risk taken on. The hospital contribution of CHF 15 per day is governed by Art. 104 KVV. You can find the texts on fedlex.admin.ch, linked under “Sources”.

Example: same costs, two deductibles

Anna is 34 and lives in the city of Zurich. She compares the standard deductible of CHF 300 with the highest deductible of CHF 2,500. In 2026 the median monthly premium across all 128 offers for her age group is CHF 580.00 with a CHF 300 deductible and CHF 453.90 with a CHF 2,500 deductible (premiums 2026, municipality of Zurich, region 1, adults, with accident cover; source FOPH). That is a difference of CHF 126.10 a month or CHF 1,513.20 a year.

The table shows what Anna pays in total for different levels of healthcare costs per year: annual premium plus deductible plus 10% retention fee (at most CHF 700). The annual premium is CHF 6,960.00 with a CHF 300 deductible and CHF 5,446.80 with a CHF 2,500 deductible.

Costs in the year	Own share CHF 300	Total CHF 300	Own share CHF 2,500	Total CHF 2,500
CHF 0	CHF 0	CHF 6,960.00	CHF 0	CHF 5,446.80
CHF 1,000	CHF 370	CHF 7,330.00	CHF 1,000	CHF 6,446.80
CHF 2,000	CHF 470	CHF 7,430.00	CHF 2,000	CHF 7,446.80
CHF 3,000	CHF 570	CHF 7,530.00	CHF 2,550	CHF 7,996.80
CHF 10,000	CHF 1,000	CHF 7,960.00	CHF 3,200	CHF 8,646.80

The calculation shows the basic pattern: the higher your expected costs, the more likely a low deductible pays off. With very low costs, the high deductible wins. Exactly where the break-even point lies depends on the premium difference at your own insurer, not on the median. The deductible calculator works out this point using your actual premiums.

What this means for you

Choose your deductible based on your expected costs, not on the lowest premium. Three questions help:

1. How high were your costs over the last two to three years? The statements of benefits from your insurer show the total. If it is well below the break-even point in the example, there is a strong case for a high deductible.
2. Do you regularly need medicines or therapy? Ongoing treatment almost certainly leads to costs above the deductible. In that case CHF 300 is usually cheaper.
3. Can you afford the maximum amount? With a CHF 2,500 deductible, a bad year can leave you paying up to CHF 3,200 yourself. Set this amount aside if you choose the high deductible.

Keep the deadlines in mind. If you want to switch to a lower deductible for next year, for example because an operation is planned, your notice must reach the insurer by 30 November; in 2026 that day falls on a Monday. You can still choose a higher deductible up to 31 December. All dates related to switching are listed under deadlines. You can also choose a new deductible when you switch insurer; the switching centre explains how.

For children the calculation is similar, but with smaller amounts. The optional deductible of CHF 600 mainly pays off for children who rarely see a doctor. If a child needs regular therapy, the option without a deductible is often cheaper. Dental treatment and braces are usually not covered by basic health insurance at all.

Common mistakes

• Looking only at the premium. The lowest monthly premium almost always comes with the highest deductible. If you then have an expensive year, you end up paying more. Always calculate with the premium plus the possible co-payment.
• Thinking the deductible applies to supplementary insurance. The deductible applies only to basic health insurance. Supplementary insurance has its own rules in the contract.
• Reporting the change too late. If you plan an operation in the new year and only ask for a lower deductible in December, you are too late: the deadline is 30 November.
• Not submitting bills. You should send your insurer bills below the deductible too. Only then do they count towards the deductible, and the insurer pays as soon as the total is exceeded.
• Forgetting the retention fee. After the deductible, not everything is free: you pay 10% of further costs yourself, up to a maximum of CHF 700.

We explain how we build our examples and calculators under How we calculate.