Swiss health insurance deductible math is easier than most people think. Remember four numbers—monthly premium, franchise (CHF 300 or 2’500), 10 % co-pay capped at CHF 700, and CHF 15/day hospital fee—and you can forecast every basic-insurance bill before it lands.
This post breaks that formula down, shows when each cost kicks in, and walks you through a real hospital invoice so you see the mechanics in action. Stick around to the end for quick savings hacks—and a no-fluff FAQ that kills the most common myths.
Swiss Health Insurance Deductible Guide – Contents
1. The 4-Step Cost Formula
Think of Swiss basic insurance like a video game with four “levels” of cost sharing. You clear one level before the next starts:
- Monthly Premium – your non-negotiable membership fee. Adults in 2025 pay anywhere from CHF 250 to CHF 550, depending on canton, age band, model, and, yes, the franchise you choose.
- Franchise / Deductible – the first CHF 300 – 2’500 you pay for covered care each calendar year.
- 10 % Co-Pay – after the franchise, you split costs 90/10 with the insurer until your share hits CHF 700 (CHF 350 for kids). Then the meter stops.
- Hospital Fee – CHF 15 per inpatient day, designed to cover food & utilities you’d pay at home. Children, students ≤ 25, and moms-to-be pay zero.
2. Franchise Levels: CHF 300 vs 2’500
You theoretically have six choices (CHF 300 | 500 | 1’000 | 1’500 | 2’000 | 2’500). In practice, 95 % of smart Swiss households lock in one of two extremes. Why?
- CHF 300 – cheapest if you expect more than CHF 1’800 in medical bills (chronic meds, specialist care, often visits to the doctor).
- CHF 2’500 – cheapest if you expect less than CHF 1’800 in medical bills ; premiums drop ± 25 %.
| Option | Best For | Premium Effect* |
|---|---|---|
| CHF 300 | Routine care, prescriptions, planned birth | Baseline |
| CHF 2’500 | Rare doctor visits, cash buffer ready | ≈ 25 % cheaper |
*Exact % varies by canton and insurer, but higher franchise = lower premium—always.
3. One Real-Life Hospital Bill (CHF 2’600)
Maria, age 31, lives in Zurich, standard model, CHF 300 franchise. No prior claims in 2025. She spends three nights in hospital after a health problem.
| Cost Item | Paid by Maria (CHF) | Total Out-of-Pocket |
|---|---|---|
| Hospital fee (CHF 15 × 3 nights†) | 45.00 | 45.00 |
| Franchise | 300.00 | 345.00 |
| 10 % Co-Pay on remaining 2’255 | 225.50 | 570.50 |
†Checkout morning counts as half a day, so only three billable nights.
4. Five Proven Savings Levers
- Switch to HMO or Telmed: 10–20 % off for accepting a gatekeeper first call.
- Raise the franchise smartly: healthy < CHF 1 800/year → go 2 500.
- Pay annually: many insurers knock off 1–2 % for a single upfront payment.
- Skip accident cover: most Swiss employers already insure occupational & leisure accidents.
- Apply for subsidies: 1 in 4 residents qualifies—see BAG official table.
Need current premiums? Compare all providers free on our Swiss health insurance calculator.
5. FAQs – Swiss Health Insurance Deductible
Does my deductible reset each January?
Yes, every 1 January your franchise counter returns to zero.
Can I change the franchise mid-year?
No. Any change you request takes effect the next 1 January.
Does the 10 % co-pay apply to drugs?
Yes, for covered medications, but only after you reach the franchise and until the CHF 700 cap.
Bottom line: Your worst-case annual hit is franchise + CHF 700 co-pay + CHF 15/day hospital. Follow the rule—if your yearly care runs under CHF 1 800, the CHF 2 500 franchise makes the Swiss health insurance deductible work for you; otherwise stick with CHF 300.
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