Every insured person must contribute towards their treatment costs via their deductible, excess and hospital contribution. This “cost contribution” is the same at every health insurer. You can change your deductible on an annual basis.
Deductible
Your deductible is the fixed contribution that you must make towards your treatment costs each calendar year. If, for example, you select a deductible of CHF 300, you must pay the first CHF 300 of treatment costs each calendar year. In calculating the contribution for each calendar year, the date of treatment (and not the invoice date) is used.
As a policyholder, you can choose from the following deductibles:
Adults | Children |
---|---|
CHF 300 | CHF 0 (ohne Jahresfranchise) |
CHF 500 | CHF 200 |
CHF 1'000 | CHF 400 |
CHF 1'500 | CHF 600 |
CHF 2'000 | |
CHF 2'500 |
How to choose the right deductible for you.
So how do you decide the right deductible for you? Take into account the treatment costs you would expect to incur over the next year as well as your financial flexibility. If you anticipate lower costs, then it is preferable to choose a high deductible – and vice versa.
The best way to estimate your future treatment costs is to take a look at the tax statements from your health insurer. These list the treatment costs from the prior year. If you choose a high deductible of CHF 2,500, you should be aware of the financial risk involved. In the worst-case scenario, you would have to pay CHF 3,200 out of your own pocket: CHF 2,500 deductible plus CHF 700 excess per year. If you have a high deductible, it is a good idea to put this amount aside in a savings account.
How to change your deductible
You can increase or decrease your deductible as of the start of a calendar year (1 January). You must notify your health insurer of a change to a lower
deductible by 30 November and a change to a higher deductible by 31 December. You can do this via e-mail or online in the deductible calculator.
If you choose a low deductible, you pay less towards your treatment costs. In return, your monthly insurance premiums are higher, however. By contrast, if you opt for a higher deductible, you must contribute more towards your treatment costs, but your insurance premiums are a lot less.
Excess
An excess is due as soon as the deductible you have selected is used up for a calendar year. From this point on, you pay 10% of your treatment costs up to a maximum of CHF 700 (children: CHF 350) per calendar year. This excess applies irrespective of your chosen deductible.
For certain medication, health insurers may charge an excess of 20%.
Hospital contribution
The hospital contribution is an excess that is paid by inpatients. It amounts to CHF 15 per day in hospital. Children up to 18 years of age and adults in education up to the age of 25 do not pay a hospital contribution.
Overview of cost contributions
Deductible | Fixed amount of costs, possible to select between CHF 300 and CHF 2,500 |
---|---|
Excess | 10% of the costs in excess of the deductible must also be covered by the insured person. Annual maximum amount: CHF 700 for adults, CHF 350 for children |
Hospital contribution | CHF 15 per day (from 18 / 25 years of age) |
No cost contribution is due for statutory maternity benefits. Furthermore, women past their 13th week of pregnancy and up to eight weeks after the birth no longer have to contribute towards the costs of general benefits and care services in the case of illness.
More information on benefits related to pregnancy and maternity
Frequently asked questions
This is possible, as your compulsory basic insurance premium depends on the premium region in which you live. You can use the premium calculator to calculate your new premium.
A potential increase after moving house is not classed as an extraordinary premium adjustment, which means you cannot terminate your basic or supplementary insurance.
Splitting a joint policy into individual policies (e.g. if a family separates) has no impact on premium levels. It is only a change of residential address that can result in a new premium region and in turn, lead to a change of premium level.
If families want their adult children to start paying their own health insurance premiums, we need written confirmation from a family member (father, mother or child) with information about the new address, bank/post office account and any changes to insurance cover required.