Swiss Health Insurance Franchise: How to Choose the Right Deductible

What Is the Franchise?

The franchise (Franchise / franchise in French) is the annual deductible on your Swiss mandatory health insurance (KVG). It is the amount you pay out of your own pocket each calendar year before your insurer starts covering medical costs. Once you have spent up to your franchise amount, the insurer takes over — but you still pay a 10% co-payment on further costs, up to an annual cap.

You choose your franchise level when you sign up for health insurance, and you can change it once per year. The franchise applies to all medical costs covered under the basic insurance package, with one important exception: maternity care is fully exempt from the franchise and co-payment.

For a full overview of how Swiss health insurance works, including coverage, models, and subsidies, see our comprehensive health insurance guide.

Available Franchise Levels

The Swiss Federal Council sets the allowed franchise levels. You cannot pick an arbitrary amount. For adults (age 19+), the options are:

• CHF 300 (minimum)
• CHF 500
• CHF 1,000
• CHF 1,500
• CHF 2,000
• CHF 2,500 (maximum)

For children (under 19), the franchise options range from CHF 0 to CHF 600, in steps of CHF 100 (0, 100, 200, 300, 400, 500, 600). The co-payment cap for children is CHF 350 per year, compared to CHF 700 for adults.

How Cost-Sharing Works: Franchise + Co-Payment

Swiss health insurance cost-sharing has two layers. First, you pay 100% of your medical costs until you hit your franchise. Second, once the franchise is used up, you pay 10% of all further costs (the co-payment, or Selbstbehalt), up to a maximum of CHF 700 per year for adults. After you have paid both the franchise and CHF 700 in co-payments, the insurer covers 100% of remaining eligible costs for the rest of the calendar year.

Total Maximum Out-of-Pocket by Franchise Level

This table shows the absolute worst case — the maximum you would pay in a year before the insurer covers everything. It is calculated as: franchise + CHF 700 co-payment cap.

The difference between the best case (CHF 300 franchise) and the worst case (CHF 2,500 franchise) is CHF 2,200 in maximum out-of-pocket exposure. But the monthly premium savings from the CHF 2,500 franchise typically offset CHF 1,000–2,000 of that gap per year.

The Math: Premium Savings vs. Out-of-Pocket Risk

This is where most people get confused — or just guess. The table below shows realistic numbers for an adult in an average-premium canton. Premium differences vary by canton and insurer, but these figures reflect a typical spread based on 2026 premium data.

Look at the "Total Worst-Case Annual Cost" column. The numbers are remarkably close — ranging from CHF 6,000 to CHF 6,680. This tells you something critical: if you use a lot of medical care, the franchise level barely matters. The worst-case total cost is similar regardless of your choice.

But now look at the best case — a year where you see the doctor zero times. With a CHF 300 franchise, you still pay CHF 5,040 in premiums. With a CHF 2,500 franchise, you pay only CHF 3,480. That is a saving of CHF 1,560 per year for staying healthy.

The Break-Even Point

The crossover point — where the CHF 300 and CHF 2,500 franchises cost the same total amount per year — occurs at approximately CHF 1,500–2,000 in annual medical costs (depending on your canton and insurer). Below this threshold, the high franchise wins. Above it, the low franchise wins.

To put that in perspective, CHF 1,500 covers roughly 3–4 standard GP visits plus a blood panel. If you visit the doctor fewer than 4 times per year and have no ongoing prescriptions, the CHF 2,500 franchise is almost certainly the better financial choice.

The pattern is clear: the CHF 2,500 franchise wins in nearly all scenarios except heavy medical use. Even at CHF 3,000 in annual medical costs, the high franchise still comes out slightly ahead. It only loses when costs climb above roughly CHF 4,000–5,000 per year.

When to Choose the CHF 300 Franchise

The minimum franchise is the right choice when you know you will use the healthcare system heavily. Specifically:

• Chronic conditions: If you take regular medication, see specialists routinely, or have an ongoing treatment plan, you will almost certainly exceed the crossover point.
• Planned pregnancy: While maternity care itself is exempt from the franchise, the many additional appointments, tests, and potential complications around pregnancy make a low franchise prudent. Note: you must be on the CHF 300 franchise before becoming pregnant — you cannot switch mid-year.
• Families with young children: Children get sick frequently. If you are budgeting for a family, predictable costs (higher premiums, lower surprises) are often preferable.
• Age 50+: Statistically, medical costs increase significantly with age. If you are over 50, the probability of exceeding the crossover point rises substantially.
• Risk aversion: If the possibility of a CHF 3,200 out-of-pocket bill would cause genuine financial stress, the CHF 300 franchise acts as insurance against insurance costs.

When to Choose the CHF 2,500 Franchise

The maximum franchise is the right choice when the math is in your favour and you can absorb the risk:

• Young and healthy (under 35): If you rarely visit the doctor and take no regular medication, the premium savings are substantial — CHF 1,000–2,000 per year kept in your pocket.
• No chronic conditions: If your medical use is limited to the occasional cold or minor injury, you will rarely exceed your franchise.
• Financial buffer available: You can comfortably absorb a CHF 3,200 worst-case expense without borrowing or stress. Ideally, set aside the premium savings in a dedicated account to self-insure.
• Minimal prescription needs: No ongoing medications that require regular doctor visits and pharmacy costs.
• Gym-goer / active lifestyle: Paradoxically, physically active people sometimes have more sports injuries — but if you have accident insurance through your employer (UVG), those costs are covered separately and do not touch your KVG franchise.

Children: CHF 0 Franchise Is Almost Always Best

For children under 19, the franchise options range from CHF 0 to CHF 600. The premium difference between a CHF 0 and CHF 600 franchise for children is typically only CHF 5–15 per month. Given that children visit the doctor far more frequently than adults (routine check-ups, vaccinations, childhood illnesses), the savings from a higher franchise rarely outweigh the cost.

Recommendation: Choose the CHF 0 franchise for all children. The premium savings from a higher franchise are negligible, and the convenience of never worrying about the deductible is worth the small monthly difference.

Changing Your Franchise: The Annual Window

You can change your franchise level once per year, effective 1 January of the following year. The deadline to notify your insurer is 30 November. If you miss this deadline, your current franchise carries over unchanged.

1. Late October: Your insurer sends you the premium announcement for the following year. Review it carefully.
2. November: Decide if you want to change your franchise, switch insurance models, or switch insurers entirely. Compare premiums on priminfo.admin.ch or our comparison tool.
3. By 30 November: Submit your change request or cancellation letter in writing. Some insurers accept online changes via their portal.
4. 1 January: Your new franchise (and possibly new insurer) takes effect.

Life change tip: if you develop a chronic condition during the year, switch to the CHF 300 franchise by 30 November so it takes effect the following January. Conversely, if you had a one-off expensive year (surgery, injury) but expect to be healthy next year, switch to CHF 2,500.

Key Takeaways

• The franchise is the annual deductible you pay before insurance kicks in. Available levels: CHF 300 to CHF 2,500 for adults.
• Higher franchise = lower monthly premium. For healthy adults, CHF 2,500 saves CHF 1,000–2,000 per year in premiums.
• Total worst-case cost (franchise + CHF 700 co-pay cap) ranges from CHF 1,000 to CHF 3,200.
• The break-even point is roughly CHF 1,500–2,000 in annual medical costs. Below that, high franchise wins.
• Choose CHF 300 for chronic conditions, planned pregnancy, or if you cannot absorb a CHF 3,200 bill.
• Choose CHF 2,500 if you are young, healthy, and have an emergency fund.
• For children, CHF 0 franchise is almost always the right call.
• You can change your franchise every year by 30 November for the following year.
• Accident costs are covered by employer UVG (if employed 8+ hours/week) and do not touch your KVG franchise.