The short answer
In Switzerland, your health insurance deductible — called the franchise — is the amount you pay out of pocket each calendar year before your mandatory basic insurance (KVG) starts contributing. Adults choose a franchise between CHF 300 and CHF 2,500; children between CHF 0 and CHF 600. A higher franchise lowers your monthly premium but increases your maximum yearly cost. After the franchise is used up, you still pay a 10% coinsurance (up to CHF 700 per adult, CHF 350 per child) on further treatment during the same year.
Key takeaways
- The franchise is a yearly out-of-pocket amount, reset every 1 January.
- Adults: CHF 300, 500, 1,000, 1,500, 2,000 or 2,500. Children (under 18): CHF 0, 100, 200, 300, 400, 500 or 600.
- A higher franchise = lower premium, but more risk if you need care.
- On top of the franchise, you pay a 10% coinsurance, capped at CHF 700 per adult and CHF 350 per child per year.
- Maternity care (from week 13 of pregnancy through 8 weeks post-birth) is exempt from franchise and coinsurance.
- You can change your franchise once a year, with written notice by 30 November, effective 1 January.
What is the Swiss franchise?
The franchise (German Franchise, French franchise, Italian franchigia) is the fixed annual amount you pay yourself for medical treatment covered by mandatory basic health insurance under the Federal Health Insurance Act (KVG). Every insurer offers the same legally defined options; the difference between insurers is the premium attached to each level, not the coverage.
Once you reach the franchise in a given calendar year, the insurer begins paying, and you contribute a 10% share of further costs (the Selbstbehalt) up to a fixed annual cap. From 1 January the counter resets to zero.
How much can you choose?
The Federal Office of Public Health (FOPH/BAG) sets the permitted franchise levels. They have not changed for many years and are identical across all Swiss insurers.
Franchise options
Age group | Available franchise (CHF) |
|---|---|
Adults (from 1 January of the year you turn 19) | 300 · 500 · 1,000 · 1,500 · 2,000 · 2,500 |
Children (0–18) | 0 · 100 · 200 · 300 · 400 · 500 · 600 |
Choosing a franchise above the minimum earns a premium discount set by law. Insurers cannot exceed the maximum statutory discount, which is why the savings between insurers on higher franchises are similar.
Franchise vs coinsurance (Selbstbehalt): what is the difference?
Many families confuse the two. The franchise is a fixed amount you pay first. The coinsurance is a percentage you pay after the franchise, on every further bill in the same year, until you reach the annual cap. In Switzerland, this 10% contribution is officially called the Selbstbehalt.
Franchise | Coinsurance (Selbstbehalt) | |
|---|---|---|
Type | Fixed CHF amount | 10% of costs |
Adult range | CHF 300–2,500 | Capped at CHF 700 / year |
Child range | CHF 0–600 | Capped at CHF 350 / year |
When it applies | First, until reached | After the franchise, same year |
Resets | 1 January | 1 January |
Your maximum out-of-pocket for KVG treatment in one year is therefore the franchise plus the coinsurance cap. For an adult on the standard CHF 300 franchise, that is CHF 1,000; on the CHF 2,500 franchise, CHF 3,200.
A worked example
Assume an adult with a CHF 1,000 franchise incurs CHF 4,500 in covered treatment in one year:
- First CHF 1,000 → paid by the insured (franchise).
- Next CHF 3,500 → the insured pays 10% = CHF 350 (coinsurance, below the CHF 700 cap).
- Insurer covers the remaining CHF 3,150.
Total paid by the insured: CHF 1,350, plus monthly premiums.
Which franchise should you choose?
The right franchise depends on how much care you expect to use in the coming year and how much risk you can absorb if something unexpected happens. As a rule of thumb, the higher franchise only pays off if your yearly treatment costs stay well below the break-even point.
Rough break-even guide
Choosing … | Only saves money if yearly costs are below approximately |
|---|---|
CHF 2,500 instead of CHF 300 | CHF 1,700–2,000 in expected costs |
CHF 1,500 instead of CHF 300 | CHF 1,000–1,300 in expected costs |
CHF 500 instead of CHF 300 | CHF 350–450 in expected costs |
The exact break-even depends on the discount your insurer applies to each level. Ask your insurer for the annual premium at each franchise before deciding.
A simple decision framework
- Rarely visit a doctor, healthy, stable income: CHF 2,500 is often the most efficient choice.
- Occasional GP visits, no chronic condition: CHF 1,500 or CHF 2,000 usually strike a good balance.
- Chronic condition, planned surgery, therapy, pregnancy planned: CHF 300 is almost always the best choice, because you are highly likely to exceed the low franchise.
- Children: CHF 0 is common. Higher franchises only make sense if the child is genuinely healthy and rarely needs a paediatrician.
Special situations
Pregnancy and maternity
From the 13th week of pregnancy until 8 weeks after birth, statutory maternity care is exempt from franchise and coinsurance. Illness unrelated to the pregnancy is still subject to both. If you are planning a pregnancy, a low franchise for the mother is usually the better choice, because unrelated illness and the newborn's first months of care are covered under normal KVG rules.
Newborns
A newborn is insured from day one and can be enrolled retroactively during the first three months. You can choose the child's franchise at enrolment; for the first year, CHF 0 is a natural default. Learn more in our guide to Swiss baby insurance.
Moving to Switzerland
You must take out basic insurance within three months of arrival, backdated to the date you took up residence. Cover starts on that date and you pay premiums for the intervening months. You choose your franchise at enrolment. Our insurance guide for international families explains the full sign-up process.
Accidents
If you work at least 8 hours per week for a Swiss employer, accident cover (UVG) is provided by your employer and you can — and should — remove accident cover from your KVG policy to lower your premium. The franchise then only applies to illness.
How and when to change your franchise
You can change your franchise once a year. The written change request must reach your insurer by 30 November, and the new franchise applies from 1 January. Increasing your franchise is generally accepted without conditions; lowering it can, in practice, only be done at the annual switch and requires that your insurer accepts the change.
Switching insurer for basic insurance follows the same 30 November deadline. Because coverage under KVG is legally identical, the only real differences between insurers are premium, service and the supplementary (VVG) products they offer. See basic vs supplementary insurance for the full distinction.
Common mistakes and misconceptions
- "A higher franchise means less coverage." No. Coverage is identical at every franchise level — only your out-of-pocket share changes.
- "I can lower my franchise anytime." Only at the annual change window, with notice by 30 November.
- "Supplementary insurance uses the same franchise." No. Supplementary (VVG) products have their own conditions independent of the KVG franchise.
- "Prevention is not covered until I hit the franchise." Certain statutory preventive services (for example, defined cancer screenings) are exempt from the franchise by law.
- "My franchise resets on my birthday." It resets every 1 January, regardless of when you signed up.
What this means for your family
For a healthy adult expecting few visits, the highest franchise is often the cheapest choice over a full year. For anyone with a chronic condition, a planned procedure or a pregnancy in view, the lowest franchise almost always wins. For children, CHF 0 is a sensible default unless the child is genuinely low-risk. Reviewing the franchise once a year — alongside insurer, model (family doctor, HMO, telmed) and supplementary cover — is one of the most reliable ways to keep premiums under control without sacrificing care.
Before you decide: a short checklist
- Estimate your realistic yearly medical costs for the coming year.
- Request the premium at each franchise level from your current insurer.
- Check whether your employer already covers accident insurance (UVG).
- Consider planned events: surgery, therapy, pregnancy, dental treatment.
- Confirm any change is submitted in writing before 30 November.
Frequently asked questions
What is the standard Swiss franchise?
The default for adults is CHF 300, which is the lowest permitted level. Children are typically enrolled with CHF 0.
Does the franchise apply to my monthly premium?
No. Premiums are paid in addition to the franchise. The franchise applies only to treatment costs.
What happens if I do not use any care in a year?
You pay no franchise and no coinsurance, only your monthly premiums. Unused franchise does not roll over to the next year.
Can I choose a different franchise for each family member?
Yes. Every insured person has their own franchise, chosen independently.
Is medication counted towards the franchise?
Yes. Prescription medicines covered by KVG count towards both the franchise and the coinsurance.
Do I pay a franchise for a hospital stay?
Yes, plus a daily contribution to accommodation costs of CHF 15 per day for adults (children and young adults in education up to 25 are exempt from the daily contribution).
Are preventive check-ups free?
Only specific statutory preventive services are exempt from the franchise. General check-ups usually count towards it.
Official Swiss sources
- Federal Office of Public Health (BAG): Cost sharing under mandatory health insurance.
- ch.ch (Federal portal): Health insurance premiums and deductibles.
- Federal Health Insurance Act (KVG), Art. 64: Fedlex — official text.
- FOPH regulation on cost sharing (KVV Art. 103–105): Federal ordinance on health insurance.
This article provides general information about Swiss mandatory health insurance and does not replace personalised insurance, legal, financial, tax or medical advice. Rules can change and individual circumstances vary.