Franchise — Your Annual Deductible

What is the franchise?

The franchise (also called the deductible or Selbstbeteiligung) is the amount you pay entirely out of your own pocket each calendar year before your health insurance contributes anything. It is set annually, resets on 1 January, and you choose the level when you sign up or by 30 November for the following year.

The logic: the higher the franchise you accept, the lower your monthly premium, because you are taking on more of the initial financial risk yourself. Swiss law sets the allowed levels — insurers cannot offer different amounts.

Franchise levels for adults (26+)

• CHF 300 — minimum, highest monthly premium
• CHF 500
• CHF 1,000
• CHF 1,500
• CHF 2,000
• CHF 2,500 — maximum, lowest monthly premium

The premium reduction from the lowest to the highest franchise typically amounts to CHF 60–120 per month — so CHF 720–1,440 per year. The exact figure depends on your canton, age group, and insurer.

Franchise levels for young adults (19–25)

Young adults between 19 and 25 have the same six franchise levels available. Their premiums are lower than adults, so the absolute savings from a high franchise are somewhat smaller — but still significant.

Franchise levels for children (0–18)

Children have their own scale:

• CHF 0 — no deductible (child pays nothing out of pocket)
• CHF 100
• CHF 200
• CHF 300
• CHF 400
• CHF 500
• CHF 600 — maximum

Most families choose CHF 0 for children. Pediatric care is frequent enough that the premium savings from a higher child franchise rarely offset the out-of-pocket costs.

How the franchise works across the year

Say you have chosen a franchise of CHF 1,000:

• February — GP visit: CHF 180 bill. You pay CHF 180. Running total: CHF 180 paid.
• April — blood test + follow-up: CHF 240 bill. You pay CHF 240. Running total: CHF 420.
• July — physiotherapy (10 sessions): CHF 800 bill. You pay CHF 580 (to reach the CHF 1,000 threshold). Your insurer pays CHF 220. Franchise exhausted.
• September — specialist visit: CHF 350 bill. You pay 10% = CHF 35 (Selbstbehalt). Your insurer pays CHF 315.

On 1 January next year, your franchise counter returns to zero. You start again from CHF 0.

The break-even calculation

The break-even point is the medical spending level at which the premium savings from a high franchise exactly equal the extra out-of-pocket costs. If you spend less than this amount on healthcare in a year, the high franchise wins. If you spend more, the low franchise wins.

As a rough guide: if your annual medical costs (excluding premiums) regularly exceed your franchise level, choose a lower franchise. If you are generally healthy and your annual costs are below your franchise, a high franchise is almost always more economical.

Changing your franchise

• Lowering your franchise: You can lower your franchise at any time during the year — useful if your health situation changes unexpectedly. Write to your insurer and specify the effective date.
• Raising your franchise: You can only raise it effective 1 January. The deadline to notify your insurer is 30 November of the current year. Miss the deadline and you stay at the same level for another full year.

Franchise and the insurance models

The franchise applies equally across all insurance models. However, combining a high franchise with an alternative model (HMO, Telmed, Hausarzt) provides double savings — lower premiums from the model and lower premiums from the franchise. This is the most common strategy used by healthy young adults in Switzerland. Read more in Insurance Models.

Franchise and specific treatments

A few costs are exempt from the franchise entirely and are covered by insurance from the first franc:

• Maternity care (prenatal, birth, postnatal)
• Certain preventive screenings (mammography, colorectal cancer)
• Annual general check-up (Vorsorgeuntersuchung) for people over 35

For all other covered treatments, the franchise applies first.