If you are moving to Switzerland from London, Chicago, Mumbai or Singapore, one choice on your insurance form surprises almost everyone: the deductible. In Swiss, it is called the franchise in French and Franchise in German. This guide walks you through what it is, how the levels work, and how the insurance model changes the picture, so you arrive knowing what the form is asking.
What a deductible means in Swiss basic insurance
Basic health insurance (LAMal in French, KVG in German) is compulsory for people who live in Switzerland. Every basic plan covers the same core treatments. What differs between plans is the price and the way you access care.
The deductible is the amount of medical costs you pay yourself each calendar year before the insurer starts reimbursing. After that, you also pay a share of each bill, called the co-payment (quote-part or Selbstbehalt). The deductible and the co-payment are two separate things, and forms often show them side by side.
If you come from a country with a private plan, the idea may feel familiar. If you come from the UK, where the NHS does not ask for this, it will feel new. For the full picture of the system, see how Swiss health insurance works and LAMal basics.
The levels available
The ordinary deductible for an adult is CHF 300 per year (FOPH). Children have no ordinary deductible. Adults may choose a higher optional deductible of CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 or CHF 2,500 per year, in exchange for a discount on the monthly premium (FOPH).
The logic is simple. A higher deductible means a lower monthly premium, but a bigger bill if you need care. A lower deductible means a higher premium, but less to pay when you visit a doctor. The right balance depends on how often you expect to use care and how comfortable you are holding a reserve of savings. A specialist can look at your own situation through the request at the bottom of this page.
How the choice works, step by step
The order matters. Many newcomers pick a deductible while still abroad and later discover that the model or the canton changes the premium. Looking at the three elements together avoids that surprise.
Insurance models in plain English
Besides the deductible, Swiss insurers offer different ways of accessing care. These are called models, and they change the premium too. In broad terms:
- Standard model: you may see any approved doctor directly.
- Family doctor model: a chosen family doctor is your first stop, and referrals go through that doctor.
- Health network or HMO model: you go first to a particular group practice or network.
- Telemedicine model: you phone or video call a service before seeing anyone in person.
Alternative models usually come with a lower premium in exchange for less freedom of choice. Details differ by insurer and by region, so the exact rules are shown on each offer. The best place to confirm them is the insurer's own documents, and a specialist can walk you through them.
You can read more on cost in what health insurance costs.
Thinking it through: three fictional examples
These examples are invented and only show how people reason.
A couple from Toronto, both healthy, early thirties. They rarely see a doctor, so they look hard at higher optional deductibles. Their question is whether they could cover the full deductible from savings in a bad year.
A family of four arriving from Dubai, with two school-age children. Children carry no ordinary deductible, so the parents' choice is about the adults only. They also check how a family doctor model would work near their new home.
A single professional moving from Seoul, taking regular medication. Because care is predictable, a lower deductible may fit better. The model matters as much as the level.
None of these is advice for you. They show which questions come up.
Pitfalls worth knowing about
- Choosing only on price. The cheapest premium can come with the highest deductible and the strictest model.
- Forgetting the co-payment. The deductible is only part of what you pay out of pocket.
- Ignoring pregnancy plans. Expected care in the coming year changes the maths. See maternity care in Switzerland.
- Assuming extras are included. Basic insurance does not cover everything. Look at supplementary insurance separately.
- Overlooking accidents. Accident cover is often handled through an employer. See accident insurance.
- Setting and forgetting. Your needs change, and so can the best level.
What to prepare from abroad
- List the members of your household and their ages
- Note any regular treatment or medication
- Decide how much of a medical bill you could cover from savings
- Ask your employer how accident insurance will be arranged
- Keep copies of vaccination and medical records
- Check the planned address, since premiums depend on the region
Our relocation calendar places this step among the other tasks, and health insurance for newcomers covers the first weeks on the ground. If you are still early in planning, the start here guide is a good anchor.
Frequently asked questions
What is a deductible in Swiss health insurance?
It is the amount of medical costs you pay yourself each calendar year before the insurer begins to reimburse. After that, a co-payment applies to the rest of your bills.
What is the standard deductible for an adult?
The ordinary deductible is CHF 300 per year for an adult (FOPH). It applies unless a higher optional level has been chosen.
Do children pay a deductible?
No. Children have no ordinary deductible under basic insurance, which is why family choices focus on the adults.
Which optional deductible levels exist for adults?
Adults can choose CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 or CHF 2,500 per year (FOPH). Each level lowers the monthly premium.
Does a higher deductible always save money?
Not always. The discount helps in a year with little care, but a year with heavy use can cost more overall. It is a trade-off, not a rule.
Is the deductible the same as the co-payment?
No. The deductible is paid first. The co-payment is a share of each bill that applies afterwards. Both count toward your out-of-pocket costs.
Can I change my deductible later?
Generally yes, but changes follow insurer and legal deadlines, and moves toward a lower deductible are often more restricted than moves toward a higher one. Ask your insurer for the exact rules.
When does the deductible reset?
It is counted per calendar year, so it starts again at the beginning of each year.
Does the deductible apply to all treatments?
Not to every item. Some services, such as certain preventive care and maternity-related care, are treated differently. Check the policy wording or ask the insurer.
What is the difference between basic and supplementary insurance?
Basic insurance is compulsory and covers a defined set of treatments. Supplementary insurance is optional and covers extras. Read more in our supplementary insurance guide.
Does my choice of deductible change my coverage?
No. The covered treatments stay the same. Only the amount you pay first and the monthly premium change.
What is a family doctor model?
It is an insurance model where a chosen family doctor is your first point of contact and arranges referrals. It usually comes with a lower premium.
What is a telemedicine model?
You contact a telephone or video service before seeing a doctor in person. It usually lowers the premium, and you accept the service as your first stop.
What is an HMO model?
You receive care through a specific group practice or network. Rules and premiums depend on the insurer and region.
Can I keep my home-country insurance instead?
Basic Swiss insurance is compulsory for residents, with limited exceptions decided by the authorities. A home plan is not a stand-in. A specialist can explain whether an exception could apply.
Does the premium depend on where I live?
Yes. Premiums vary by region and by insurer, which is why the address matters when you compare.
How do I know which deductible fits my family?
It depends on expected care, savings, and comfort with risk. A specialist can look at your household through the request at the bottom of this page.
What if I am pregnant or planning a baby?
Expected care changes how people think about the deductible. See pregnancy and birth in Switzerland and parental leave for the wider picture.
Is accident cover part of the deductible choice?
Accident insurance is a separate system, often arranged through an employer. Ask your employer how it is set up.
Do I get a certificate showing my deductible?
Yes. The policy documents state the deductible and the model. Check them as soon as they arrive.
Where can I get official information?
The Federal Office of Public Health (FOPH) publishes the optional deductible levels, and ch.ch gives a public overview of premiums. Both are listed below.