The Swiss franchise is the fixed annual amount you pay yourself for healthcare before your basic health insurance (KVG) starts to contribute. Every adult resident chooses a franchise between CHF 300 and CHF 2,500 per calendar year. A lower franchise means higher monthly premiums but smaller out-of-pocket costs when you need care; a higher franchise reduces your premium but increases what you pay before the insurer contributes. The right level depends on how much healthcare you realistically expect to use in the year ahead.
Key takeaways
The franchise is the annual excess you pay yourself under basic health insurance (KVG) — separate from your monthly premium.
Adults can choose CHF 300, 500, 1,000, 1,500, 2,000 or 2,500 per calendar year. Children have their own scale from CHF 0 to CHF 600.
After the franchise, you still pay a 10% co-payment (retention) up to CHF 700 per year for adults (CHF 350 for children).
Maternity care from the 13th week of pregnancy is exempt from the franchise and the co-payment.
You can change your franchise once a year, in writing, by 30 November for the following year.
What is a franchise in Swiss health insurance?
Under the Swiss Federal Health Insurance Act (KVG), everyone living in Switzerland must hold basic health insurance. The franchise (Franchise, franchigia) is the annual amount of medical costs you pay yourself before your insurer begins to reimburse. It resets on 1 January every year.
The franchise applies to costs covered by basic insurance — GP visits, specialists, hospital treatment, prescribed medication, laboratory tests and similar services. It does not apply to costs outside basic cover (for example, most dental care) or to services paid under supplementary insurance (VVG/LCA).
Franchise, co-payment and premium — how they fit together
Three separate amounts shape what you pay for healthcare in Switzerland:
Monthly premium — paid to your insurer every month, regardless of whether you use care.
Franchise — the first tranche of annual treatment costs, which you pay yourself.
Co-payment (Selbstbehalt / retention) — after the franchise is used up, you still pay 10% of further costs, capped at CHF 700 per year for adults and CHF 350 for children.
Once you have reached both your franchise and the co-payment cap, basic insurance covers 100% of further eligible costs for the rest of the calendar year. Hospital stays add a small daily contribution of CHF 15 towards board and lodging for adults (children, students up to 25 in training and women during maternity are exempt).
Available franchise levels in 2025
Insured person | Available franchise levels (CHF per year) |
|---|---|
Adults (from age 19) | 300 · 500 · 1,000 · 1,500 · 2,000 · 2,500 |
Children (up to age 18) | 0 · 100 · 200 · 300 · 400 · 500 · 600 |
The standard (ordentliche) franchise is CHF 300 for adults and CHF 0 for children. Choosing a higher franchise entitles you to a premium discount set by the Federal Office of Public Health (FOPH/BAG); the maximum discount is capped and identical across insurers.
How to choose the right franchise
The decision is essentially a break-even calculation between the premium you save and the extra out-of-pocket costs you accept.
A simple rule of thumb
If you expect very few medical costs in the year, a higher franchise (CHF 2,500) usually costs less overall.
If you expect regular or significant costs — chronic condition, planned surgery, pregnancy, ongoing therapy — a lower franchise (CHF 300) is usually cheaper.
Middle franchises (CHF 500–1,500) rarely produce the best outcome; they tend to be a compromise rather than an optimum.
Worked example
Suppose the annual premium difference between a CHF 300 and a CHF 2,500 franchise is CHF 1,540 (an example figure — actual amounts vary by insurer, canton and age group).
With a CHF 2,500 franchise, you save CHF 1,540 in premiums but risk paying up to CHF 2,200 more in franchise (CHF 2,500 − CHF 300).
The higher franchise is financially better as long as your yearly treatment costs stay below roughly CHF 1,840 (CHF 300 + CHF 1,540).
Above that break-even point, the lower franchise becomes cheaper.
Always run the calculation with the actual premium figures for your canton, age band and insurer — the break-even point differs from person to person.
Franchise, pregnancy and children
Maternity benefits under KVG are treated differently. From the 13th week of pregnancy until eight weeks after birth, costs directly related to maternity — check-ups, delivery, postnatal care — are covered without franchise, co-payment or hospital contribution. Illnesses unrelated to pregnancy in the same period still count against the franchise.
For children, the family often benefits from choosing a franchise of CHF 0, because premiums for the lowest franchise are already heavily reduced by law and paediatric care can be unpredictable. A higher child franchise typically only makes sense when a child has consistently very low healthcare use over several years.
When and how to change your franchise
You can change your franchise level once per calendar year, effective 1 January.
The change request must reach your insurer in writing by 30 November of the current year.
Increasing the franchise is normally straightforward; decreasing it may require earlier notice depending on the insurer — always check your policy conditions.
Switching to a different insurer for basic insurance follows separate deadlines and rules.
For a full timeline of switching deadlines, see our guide on Swiss health insurance deadlines.
Expert Insight
A common misunderstanding is that a high franchise is always the “cheap” option. In reality, the franchise is a bet on how healthy you will be in the coming year. Life events that seem unlikely — a fall, a diagnosis, a pregnancy, a surgery recommended by a specialist — can turn a CHF 2,500 franchise into the most expensive choice overnight. A useful discipline is to keep the amount between your current franchise and CHF 2,500 available in savings; if you cannot, the high franchise is not really cheaper — it is riskier.
Common mistakes and misconceptions
Confusing franchise with premium. The premium is what you pay every month to be insured; the franchise is what you pay when you actually use care.
Assuming supplementary insurance covers the franchise. VVG/LCA supplementary policies cover extras such as private hospital rooms or alternative medicine — they do not pay your basic-insurance franchise.
Forgetting the 10% co-payment. Even after the franchise, you still pay 10% of further costs up to CHF 700 per year.
Choosing a high franchise without a financial buffer. If an unexpected treatment arises, the full amount is due to the insurer within the usual payment terms.
Not reviewing the choice annually. Your health, income and family situation change — so should the franchise level, if the maths no longer works in your favour.
What this means for you
Choosing a franchise is not about picking the lowest premium on a comparison site — it is about matching your annual excess to the healthcare you realistically expect to use, and to the financial risk you can absorb. Review the decision every autumn, before the 30 November deadline, and adjust as your circumstances change.
Before you decide
Estimate your expected annual healthcare costs based on the last two to three years.
Request the premium difference between CHF 300 and CHF 2,500 for your canton and age group.
Calculate the break-even point (premium saving vs. additional out-of-pocket risk).
Check whether you have savings to cover the full higher franchise if needed.
Consider planned events for next year (pregnancy, elective surgery, therapy).
Submit any franchise change in writing to your insurer by 30 November.
Frequently asked questions
Is the franchise the same as the deductible?
Yes. “Franchise” is the Swiss term for what English-speaking readers often call a deductible or excess under basic health insurance.
Do I pay the franchise every month?
No. You pay it only when you use healthcare services covered by basic insurance, and only up to your chosen annual amount. It resets each 1 January.
Does the franchise apply to dental care?
Most routine dental care is not covered by basic health insurance in Switzerland, so it does not count towards the franchise. Dental treatment following certain accidents or specific serious illnesses may be covered — check with your insurer.
What happens if I do not pay a bill that counts towards my franchise?
You remain personally liable for costs within your franchise. Insurers can pursue unpaid amounts through the standard Swiss debt collection process.
Can I have a different franchise from my partner or children?
Yes. Each insured person has their own franchise, and it can be set independently.
Does the franchise apply to accidents?
If you are employed for at least eight hours per week with the same employer, accident cover is normally provided through your employer under UVG/LAA, and your health insurer suspends accident cover — no franchise applies to those accident costs. Otherwise, accidents fall under basic health insurance and are subject to your normal franchise and co-payment.
A helpful next step
If you are unsure which franchise level fits your situation — especially if your circumstances have recently changed — an independent review can save several hundred francs a year. Request a free consultation to talk through your options with a licensed Swiss insurance specialist, or continue reading in the Knowledge Centre.
Official Swiss sources
Federal Office of Public Health (FOPH/BAG) — Compulsory health insurance
ch.ch — Health insurance in Switzerland
Federal Council — Federal Act on Health Insurance (KVG)
Priminfo (FOPH premium information service) — Premium comparison for basic insurance
General information only. This article does not replace personalised insurance, legal, financial or medical advice. Rules, amounts and deadlines are subject to change; always confirm current details with your insurer or the relevant Swiss authority.