Franchise (Deductible)
Understanding how your deductible affects your health insurance costs and coverage
The franchise (deductible) is a key component of Swiss health insurance that directly impacts both your premiums and out-of-pocket expenses. By understanding how the franchise works and choosing the right level for your needs, you can optimize your health insurance costs while maintaining adequate coverage.
Optimize Your Franchise Choice
Our experts can help you calculate the optimal franchise level for your situation and guide you through the selection process.
What is a Franchise?
A franchise is the amount you must pay for medical services before your health insurance begins to cover costs. It's essentially your share of healthcare expenses that you pay directly each year.
How It Works
- You pay for medical services up to your franchise amount
- Once you reach your franchise, insurance covers 90% of costs
- You pay 10% coinsurance on covered services
- Franchise resets annually on January 1st
- Higher franchise means lower premiums
- Lower franchise means higher premiums
Franchise Options
- CHF 300 (minimum for adults)
- CHF 500 (popular choice)
- CHF 1,000 (good balance)
- CHF 1,500 (higher savings)
- CHF 2,000 (maximum savings)
- CHF 2,500 (premium option)
Cost Impact
Your franchise choice has a significant impact on both your monthly premiums and potential out-of-pocket expenses. Understanding this relationship helps you make an informed decision.
Premium Reduction
Higher franchises result in lower monthly premiums, with potential savings of 10-30% compared to the minimum franchise.
Out-of-Pocket Costs
You must be prepared to pay your full franchise amount before insurance coverage begins, plus 10% coinsurance on covered services.
Overall Savings
For healthy individuals, higher franchises typically result in net savings, while those with frequent medical needs may benefit from lower franchises.
How to Choose Your Franchise
Selecting the right franchise requires careful consideration of your health status, financial situation, and risk tolerance. The goal is to balance premium savings with manageable out-of-pocket costs.
Factors to Consider
- Your current health status
- Expected medical expenses
- Financial ability to pay franchise
- Risk tolerance level
- Family medical history
- Age and lifestyle factors
Break-Even Calculation
- Compare premium differences
- Estimate annual medical costs
- Calculate total annual costs
- Consider worst-case scenarios
- Factor in emergency savings
- Review historical spending
Important Considerations
While franchise choice can significantly impact your costs, it's important to consider both the benefits and potential risks of different franchise levels.
Potential Risks
- High out-of-pocket costs if sick
- Difficulty paying franchise amount
- Delayed medical care due to costs
- Unexpected medical emergencies
- Annual reset of franchise amount
- Limited flexibility once chosen
Key Benefits
- Lower monthly premiums
- Potential for significant savings
- Incentive for healthy lifestyle
- Control over healthcare spending
- Flexibility in provider choice
- Annual cost predictability
Changing Your Franchise
You can change your franchise level annually, but it's important to understand the process and timing requirements to ensure a smooth transition.
Change Process
Annual Deadline
Submit franchise change request by November 30th for changes effective January 1st of the following year.
Provider Notification
Notify your insurance provider in writing of your desired franchise change, including your policy number and personal details.
Confirmation
Receive confirmation from your insurance provider acknowledging the franchise change for the upcoming year.
Effective Date
New franchise level becomes effective on January 1st, with the annual reset of your franchise amount.