Newcomers to Switzerland meet two words that sound like the same thing: premium and deductible. The premium is what you pay each month. The Swiss health insurance deductible is what you pay yourself, each year, before your insurer starts paying for care. Choose it badly and you either overpay every month or face a nasty bill in a bad year. This article walks through the numbers the Federal Office of Public Health (FOPH) publishes, then shows how to choose your level.
What is a deductible in Swiss health insurance?
Basic cover (LAMal) works in three steps each calendar year:
- You pay the first part of your care costs yourself. This is the deductible (franchise in French, Franchise in German).
- Above the deductible, you pay 10% of the costs. This share is called the retention fee or co-payment.
- The 10% is capped: CHF 700 per year for adults and CHF 350 for children and adolescents under 18.
In hospital you also pay a contribution of CHF 15 per day. The standard deductible is CHF 300 for adults and CHF 0 for children. Adults can raise it up to CHF 2,500 in exchange for a lower premium. Insurers are not obliged to offer every step in between, so check the list on priminfo.ch.
Your yearly share of the costs is therefore made of the deductible and the capped co-payment, with the hospital contribution on top.
How much does a higher deductible save?
The FOPH sets a ceiling for the discount: the premium reduction for a higher deductible cannot exceed 70% of the additional risk you take on. The discount is not a free lunch. It is a bet that you will use less care than the amount you save.
The exact savings depend on your fund, canton and age, so there is no universal number. Use the comparison tool on priminfo.ch: enter your canton, birth year and deductible, then compare. Read the difference in annual premium between the CHF 300 and CHF 2,500 options and compare it with the extra risk you carry, which is the gap between the two deductibles.
How do the deductible and the co-payment add up over a year?
Think of three kinds of year, using the rules above. In a year with no care, you pay nothing beyond your premium, whatever your deductible. In a moderate year, you pay your care costs yourself up to the deductible, then 10% of what is above it. In a heavy year, you pay the deductible in full and the 10% co-payment stops at its cap, so your share stops growing. The hospital contribution of CHF 15 per day comes on top in every case. The FOPH's pages on premiums and co-payment set out the same rules, and priminfo.ch shows the premium for each deductible.
In a year with no care, the higher deductible costs you nothing and your lower premium is a pure gain. In a heavy year, you carry the whole gap between the two deductibles. If the annual premium saving exceeds the extra cost you expect, the higher deductible wins; if you expect regular visits, treatments or a pregnancy, the standard one is safer.
Not sure which deductible fits your profile? Moovy can help you structure the comparison, for example by listing what to enter on priminfo.ch and what to ask your fund, but it does not choose an insurer for you and does not know your future health costs.
How do you choose your Swiss health insurance deductible in three steps?
- Estimate your normal year. Look back at what you spent on doctors, pharmacy and treatment in the last two years, if you have the figures. If you have just arrived, think of regular visits, a chronic treatment, dental needs or a planned pregnancy.
- Work out the worst realistic year: the full deductible, plus the capped 10% co-payment (CHF 700 for adults), plus CHF 15 a day in hospital. Ask yourself whether you could pay that from savings within weeks.
- Compare the premium gap. On priminfo.ch, read the annual difference between the CHF 300 deductible and the one you consider. If the saving is small compared with the extra risk, stay with the lower deductible.
Repeat this every autumn, because the right deductible can change with your life. Your needs change, and so do premiums.
What if you change fund or arrive during the year?
Your deductible runs per calendar year and belongs to your policy with the fund. If you change fund at the end of the year, the new deductible applies from 1 January. If you arrive during the year, ask your insurer how the deductible applies for the first months, and start with a level you are comfortable with, not simply the cheapest one. See also cost of living in Switzerland to place health costs in your budget.
Who should choose which Swiss health insurance deductible?
There is no rule, only trade-offs. Some practical points:
- Young and healthy, with savings to cover a bad year: a higher deductible may make sense, as long as you could pay the full deductible and the capped co-payment without stress.
- Regular treatment, a pregnancy or a chronic condition: the standard deductible usually costs less overall.
- Families: children have a standard deductible of zero, so children and adults can have different choices; check what each member needs.
- Tight budget: a high deductible can turn an unexpected illness into a debt. Remember that a monthly premium is predictable and a deductible is not.
- Models with restricted choice of doctor (such as a family-doctor model) can also lower the premium; the FOPH advises reading the terms carefully.
When and how can you change your deductible?
A change of deductible takes effect only at the start of a calendar year. According to the FOPH's premium comparison site, priminfo.ch:
- To move to a lower deductible, you must tell your insurer in writing by the last working day of November (30 November in 2026).
- A higher deductible can only take effect on 1 January and for at least one year. The site recommends notifying your insurer in writing in good time, at the latest by mid-December.
In practice, taking on more risk is easier than reducing it, so decide before the autumn deadline rather than in December.
How do you change insurer?
Every year, insurers must tell their members the next year's premiums by 31 October. That gives you a month. Your cancellation must reach your current insurer by 30 November, and the postmark does not count. The FOPH recommends registered mail or A-Post Plus by mid-November and keeping the receipt.
- Sign up with the new insurer at the same time and do not wait for confirmation of your cancellation.
- The new insurer must confirm your enrolment in writing, to you and to your previous insurer.
- You cannot change if you still owe money to your current insurer on 31 December and had a reminder by 30 November.
- Mid-year changes at the end of June exist only for the standard model with a CHF 300 deductible, with notice received by 31 March.
If you have just arrived, your first choice is covered in health insurance in Switzerland: the three-month rule.
What does the average premium look like?
The FOPH announced that premiums for 2027 rise by 5.0% on average, to CHF 412 a month. Your own premium may be much higher or lower, because it depends on the fund, your canton, your age and your choices. Cantons grant premium reductions to people with modest means, so ask your cantonal office if your income is low.
What mistakes should you avoid?
- Choosing the lowest premium without calculating the worst case.
- Missing 30 November. The postmark does not count.
- Forgetting that you keep the CHF 700 co-payment on top of the deductible.
- Believing that all funds cover the same extras. Only basic cover is the same; supplementary insurance is a separate contract.
- Changing fund while you owe premiums. Unpaid premiums block the switch.