Choosing your Swiss health insurance franchise (deductible)
Your franchise is the annual amount you pay before your insurer starts contributing - from CHF 300 to CHF 2,500. Pick the wrong one and you can overpay by hundreds. Here's how the maths works, with a quick break-even calculator.
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What the franchise is
The franchise is the fixed annual amount you pay out of pocket before your basic insurance starts to contribute.
Adults choose one of six levels: CHF 300, 500, 1,000, 1,500, 2,000 or 2,500. Children can be enrolled at CHF 0, 100, 200, 300, 400, 500 or 600. Whatever level you pick, you pay every covered treatment yourself until you've spent that amount in the calendar year.
Once your franchise is used up, you don't get a free ride. You still pay a 10% retention on further covered costs, capped at CHF 700 per year for adults and CHF 350 for children. On top of that, an inpatient hospital stay carries a CHF 15 per day contribution to living costs (waived for children, young adults in education and new mothers).
None of this changes what's covered - the benefit catalogue is set by federal law. For the full picture, see Basic insurance (KVG/LaMal).
The trade-off: premium vs risk
A higher franchise lowers your monthly premium but raises how much you'd pay if you actually need care.
Insurers give you a premium discount for taking on more of the first-franc risk. But that discount is capped by federal law - they can't rebate the full statistical value of the extra franchise, because the regulator wants people to keep meaningful cover. In practice this means insurers keep part of the risk premium for themselves.
So the real question isn't "which franchise is cheapest?" - it's will my expected yearly medical costs stay below the point where the premium saving stops paying for itself? That point is your break-even, and it's the only number that really matters for the decision.
The break-even maths
In practice the decision is nearly binary: if you expect low costs, take the highest franchise; if you expect high or regular costs, take the lowest.
The middle franchises (500, 1,000, 1,500, 2,000) rarely win. They give you a smaller premium discount than the CHF 2,500 option without meaningfully reducing your worst-case exposure - so on the numbers, either the top or the bottom of the range tends to come out ahead.
A rough illustration, as of 2025: a healthy adult who almost never visits a doctor can save up to around CHF 1,500 a year in premium by taking the CHF 2,500 franchise instead of CHF 300. The worst case, if a serious health issue happens in that year, is roughly CHF 2,200 more out of pocket (higher franchise plus retention). Multiplied over several healthy years, the maths clearly favours the top franchise.
Flip it around: if you already know you'll hit the retention cap - regular specialist care, planned surgery, a chronic condition - the CHF 300 franchise wins comfortably. Every extra franc of franchise is a franc you'll actually pay, and the premium discount isn't enough to cover it.
Find your franchise break-even
Move the slider to your expected yearly medical costs. We'll show which franchise likely wins for you.
The premium discount is capped by law - check your exact figure when comparing.
Out-of-pocket for the year (franchise + 10% retention, capped at CHF 700).
CHF 1'000 out of pocket, minus CHF 1'500 premium saving.
Your expected costs are low enough that the premium discount more than covers the extra risk.
Indicative, as of 2025 - real premiums vary by insurer and region.
Special cases
Pregnancy, children and mid-year moves change the calculus.
Pregnancy. Maternity care itself has no cost-sharing - no franchise, no 10% retention, no daily hospital contribution. But related care (nausea treatment, complications, non-maternity conditions during the same year) still counts. Many people therefore take the lowest franchise for the year they plan to give birth, then move back up afterwards.
Children. The premium discount for a higher child franchise is small in absolute francs, and even a modest round of doctor visits will burn through it. As a default, keep children on the CHF 0 franchise unless you have a specific reason not to.
Timing. You can only change your franchise at year-end. Raising your franchise or switching insurer for a 1 January change requires written notice that reaches the insurer by 30 November. Lowering your franchise is also a year-end move. It's not something you can do mid-year when your health forecast changes.
Accident cover. If you work 8+ hours a week for a Swiss employer, you're covered for accidents by UVG through your employer - drop accident cover from your basic insurance to save premium. If not (students, non-working spouses, freelancers under 8 hours), keep it on.
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OpenFranchise questions, answered
What franchise options are available?
Adults can choose CHF 300, 500, 1,000, 1,500, 2,000 or 2,500. For children the range is CHF 0 to 600. The higher the franchise, the lower your premium.
Which franchise should I choose?
If you're healthy and rarely see a doctor, the highest franchise (CHF 2,500) usually costs least overall. If you have regular or high expected costs - a chronic condition, a pregnancy, planned surgery - the lowest (CHF 300) usually wins. The middle options rarely come out ahead.
How much can a high franchise save me?
The premium discount is capped by law, but a healthy adult moving from CHF 300 to CHF 2,500 can save up to roughly CHF 1,500 a year (as of 2025), against at most CHF 2,200 of extra exposure if costs are high.
Can I change my franchise whenever I want?
No. You can raise your franchise or switch insurer effective 1 January by giving notice by 30 November; lowering it is also done at year-end. It's not a mid-year change.
What franchise is best during pregnancy?
Maternity care itself has no cost-sharing, but related treatment can, so many people choose the lowest franchise for the year they plan to give birth. It's worth planning a year ahead.
What franchise should children have?
Usually CHF 0. A higher child franchise only pays off if you expect very little medical use, because the premium savings for children are small.
Get the franchise decision right
Compare live premiums for your postcode, or talk it through with an independent expat advisor - free, in English, no obligation.