Choosing a health insurance plan in Switzerland isn’t just about finding the lowest monthly premium. It’s about understanding how the system actually works — and how much you’ll really pay if you need medical care.

For many people, the terms franchise (deductible) and Selbstbehalt (co-payment) are confusing. You might be wondering what they mean, how they affect your budget, and which option makes the most sense for you or your family. If that’s you — you’re not alone.

This guide walks you through the essentials with simple explanations, real-life examples, and a few tips to help you make a better-informed decision — without the stress.

Franchise (Deductible)

This is the amount you have to pay each year out of your own pocket before your insurance starts covering costs. You choose your deductible — it can be as low as CHF 300 or as high as CHF 2’500 (for adults):

• Lower franchise = higher monthly premium, but you pay less when you get care.
• Higher franchise = lower premium, but you’ll need to cover more upfront if you fall ill.

Selbstbehalt (Co-payment)

Once you’ve reached your franchise, the insurance steps in — but you still pay 10% of any additional costs, up to a maximum of CHF 700/year (CHF 350 for children).

Your Maximum Out-of-Pocket Cost (Annually)

Your total annual risk is the franchise plus the CHF 700 cap on co-payments.
For example:
CHF 2’500 (deductible) + CHF 700 (co-payment) = CHF 3’200

That’s the worst-case yearly cost if you need extensive care.

• “Low deductible is always safer”
  Not necessarily. If you rarely go to the doctor, you’re likely overpaying for something you don’t use.
• “If I choose a high deductible, I won’t be covered”
  Not true. You’re still insured — but you’ll need to budget for care costs before coverage kicks in.
• “I pay 10% for everything all year”
  No — the 10% co-payment only kicks in after you’ve reached your deductible, and it’s capped.
• “Children don’t need a deductible”
  Actually, you can choose a deductible for children, and it might make financial sense depending on how often they see a doctor.
• “The Middle Ground is the Safe Choice.”
  Most people choose a middle deductible — like CHF 1’000 or CHF 1’500 — thinking it’s a safe balance between premium cost and risk. But in practice, the middle often does neither well: you pay more in premiums than you save, and still carry meaningful out-of-pocket risk.
  Statistically, very few people actually reach the level of medical expenses where the middle makes financial sense. Unless you have moderate but consistent healthcare needs, you may end up overpaying — without realizing it.
  ➤ The high deductible (CHF 2’500) often saves money if you’re healthy. The low deductible (CHF 300) may make sense if you have ongoing high costs. The middle? It often just feels “safe” — but isn’t efficient.

Person	Profile	Franchise	Monthly Premium	If Sick (Est.)	Total Annual Cost
A	28, healthy, sees doctor 1–2x/year	CHF 2’500	CHF 200	CHF 3’000	CHF 5’400
B	Parent, child needs regular care	CHF 300	CHF 380	CHF 1’000	CHF 5’560
C	Freelancer, moderate usage	CHF 1’500	CHF 290	CHF 2’000	CHF 5’480

Based on simplified Zurich averages. These aren’t perfect — but they give you a feel for how costs play out.

• You can change your deductible once a year, usually by giving notice before November 30 for changes starting January 1.
• Choosing a higher franchise can lower your premium significantly — but only if you can afford to cover medical costs upfront.
• For families: you can set different deductibles for each family member.
• Consider putting a small amount aside monthly (e.g. CHF 100) into a “health buffer” if you opt for a high deductible.
• Use Priminfo.ch, the official federal comparison site: DE, FR and IT.
  (Note: The site is only available in Switzerland’s official languages.)

• Health insurance premiums are partially tax-deductible in most cantons.
• This applies even if you choose a high franchise — and it can help lower your tax burden.
• Look for this when filing under “Versicherungsprämien / Primes d’assurance”.

Balancing premium savings with tax impact is part of smart household budgeting.

Choosing the right deductible isn’t about picking the “cheapest” or the “safest.” It’s about what fits your life right now — your health habits, your risk tolerance, and your financial comfort zone.

If you’re healthy and rarely need care, a higher deductible could save you hundreds per year. If you want peace of mind with fewer surprise bills, a lower franchise might be worth the higher premium.

Whatever you choose, understanding these mechanics is a major step toward taking control of both your healthcare and your finances.

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