Swiss Franchise: The Deductible That Decides Your Monthly Premium
The Franchise is the single biggest cost lever in Swiss health insurance. Switching from CHF 300 to CHF 2,500 saves CHF 100–130 per month — that is CHF 1,200–1,560 per year. For healthy students who visit the doctor once or twice a year, the high Franchise almost always wins. For students with chronic conditions or regular medication, the low Franchise is cheaper. The break-even point sits at roughly CHF 1,800 in annual medical costs.
This guide walks you through the math, the rules, and the edge cases. If you are new to Swiss health insurance, start with our complete Switzerland KVG guide first — it covers providers, Prämienverbilligung (premium subsidies), and how to sign up. This article is the deep-dive on the Franchise decision.
What Is the Franchise?
The Franchise (Franchise — your annual deductible) is the amount you pay out of pocket each calendar year before your health insurance starts covering costs. Every KVG-insured person in Switzerland has a Franchise. It resets on January 1.
Here is how costs flow in a given year:
- You pay 100% of medical costs until you hit your Franchise amount.
- You pay 10% of all costs above the Franchise (this is the Selbstbehalt — co-insurance). The Selbstbehalt is capped at CHF 700 per year for adults.
- Insurance pays 100% of everything above your Franchise + Selbstbehalt cap.
That means your maximum out-of-pocket per year (excluding premiums) is:
Franchise + CHF 700 = your annual risk ceiling
With CHF 300 Franchise: maximum CHF 1,000 out-of-pocket. With CHF 2,500 Franchise: maximum CHF 3,200 out-of-pocket.
The Franchise applies to doctor visits, specialist consultations, prescriptions, lab work, imaging, hospital stays, and most other KVG-covered treatments.
Available Franchise Levels for Adults
Switzerland offers six Franchise levels for adults (age 19+). Not all insurers offer every level — but the two extremes (CHF 300 and CHF 2,500) are available everywhere.
| Franchise Level | Approx. Monthly Premium (Zurich, age 22) | Approx. Monthly Savings vs. CHF 300 | Max. Annual Out-of-Pocket |
|---|---|---|---|
| CHF 300 | CHF 380–420 | Baseline | CHF 1,000 |
| CHF 500 | CHF 365–405 | CHF 10–20 | CHF 1,200 |
| CHF 1,000 | CHF 340–380 | CHF 35–50 | CHF 1,700 |
| CHF 1,500 | CHF 315–355 | CHF 55–75 | CHF 2,200 |
| CHF 2,000 | CHF 295–335 | CHF 80–100 | CHF 2,700 |
| CHF 2,500 | CHF 260–300 | CHF 100–130 | CHF 3,200 |
Premiums vary by canton, insurer, age, and insurance model (Standard, Hausarzt, Telmed, HMO). The table above uses Zurich as a reference — one of the more expensive cantons. In cheaper cantons like Appenzell or Zug, all premiums are lower, but the relative savings between Franchise levels remain similar.
Why Middle Franchises Are a Bad Deal
Insurance mathematicians have shown that no scenario exists where middle Franchises (CHF 500–2,000) are the optimal choice. The premium discount per additional CHF of deductible is proportionally smaller in the middle range. You either save too little on premiums to justify the higher risk, or you take on enough risk that you might as well go all the way to CHF 2,500.
The practical advice: choose CHF 300 or CHF 2,500. Nothing in between.
The Break-Even Calculation: Real Numbers
This is the calculation every student should run before choosing. We use a Zurich example with a 22-year-old on a Telmed model.
Scenario: CHF 300 vs. CHF 2,500 Franchise
| CHF 300 Franchise | CHF 2,500 Franchise | |
|---|---|---|
| Monthly premium | CHF 380 | CHF 250 |
| Annual premium (× 12) | CHF 4,560 | CHF 3,000 |
| Premium savings per year | — | CHF 1,560 |
Now add what you actually pay when you get sick:
If You Spend CHF 0 on Healthcare (No Doctor Visits)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Out-of-pocket | CHF 0 | CHF 0 |
| Total cost | CHF 4,560 | CHF 3,000 |
| Winner | CHF 2,500 saves CHF 1,560 |
If You Spend CHF 500 on Healthcare (One GP Visit + Lab Work)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Franchise portion | CHF 300 | CHF 500 |
| Selbstbehalt (10% of CHF 200 above franchise) | CHF 20 | CHF 0 |
| Total cost | CHF 4,880 | CHF 3,500 |
| Winner | CHF 2,500 saves CHF 1,380 |
If You Spend CHF 1,500 on Healthcare (Several Visits + Medication)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Franchise portion | CHF 300 | CHF 1,500 |
| Selbstbehalt (10% of remaining) | CHF 120 | CHF 0 |
| Total cost | CHF 4,980 | CHF 4,500 |
| Winner | CHF 2,500 saves CHF 480 |
If You Spend CHF 2,000 on Healthcare (Moderate Medical Year)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Franchise portion | CHF 300 | CHF 2,000 |
| Selbstbehalt | CHF 170 | CHF 0 |
| Total cost | CHF 5,030 | CHF 5,000 |
| Winner | Roughly equal — CHF 2,500 saves CHF 30 |
If You Spend CHF 5,000 on Healthcare (Surgery or Chronic Condition)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Franchise portion | CHF 300 | CHF 2,500 |
| Selbstbehalt | CHF 470 | CHF 250 |
| Total cost | CHF 5,330 | CHF 5,750 |
| Winner | CHF 300 saves CHF 420 |
If You Spend CHF 10,000+ on Healthcare (Hospital Stay)
| CHF 300 | CHF 2,500 | |
|---|---|---|
| Premium | CHF 4,560 | CHF 3,000 |
| Franchise portion | CHF 300 | CHF 2,500 |
| Selbstbehalt (capped at CHF 700) | CHF 700 | CHF 700 |
| Total cost | CHF 5,560 | CHF 6,200 |
| Winner | CHF 300 saves CHF 640 |
The Break-Even Point
The two options cost the same when your annual medical expenses hit approximately CHF 1,800–2,000. Below that, CHF 2,500 wins. Above that, CHF 300 wins.
For a healthy 22-year-old student, average annual medical costs are well below CHF 500. Most young adults visit a doctor 1–2 times per year.
When to Choose CHF 2,500 (High Franchise)
The high Franchise is the better choice for the majority of students. Choose CHF 2,500 if:
- You are 18–30 and generally healthy. Young adults have the lowest healthcare utilization in Switzerland. Your odds of needing significant medical care are low.
- You visit the doctor 0–2 times per year. A standard GP visit costs CHF 150–250. Two visits per year means CHF 300–500 in costs — well below the break-even.
- You do not take regular medication. If your only pharmacy expenses are occasional painkillers or cold medicine, they will not push you past the break-even.
- You want to maximize monthly cash flow. As a student, saving CHF 100–130 per month matters. That is CHF 1,200–1,560 back in your pocket — enough for 3–4 months of groceries.
- You can handle an emergency. If you had an accident or sudden illness, could you pay CHF 2,500 + CHF 700 = CHF 3,200 out of savings? If yes, the high Franchise is a rational bet.
The risk you are taking: In a bad-luck year (broken bone, appendectomy, unexpected illness), you pay up to CHF 3,200 out of pocket. But the premium savings of CHF 1,560 per year mean that even one bad year every 2–3 years still makes the high Franchise cheaper in the long run.
Think of it as self-insurance. You are betting that your medical costs stay below CHF 1,800 per year. For a healthy student, that bet pays off in 9 out of 10 years.
When to Choose CHF 300 (Low Franchise)
The low Franchise makes sense when you know you will use healthcare regularly. Choose CHF 300 if:
- You have a chronic condition. Diabetes, asthma, epilepsy, autoimmune disorders — if you see specialists regularly and take daily medication, your annual costs will exceed CHF 2,000 almost certainly. CHF 300 is cheaper.
- You are pregnant or planning pregnancy. While maternity care itself is exempt from Franchise after the 13th week of pregnancy, all care before week 13 (including the initial GP visits, early ultrasounds, and blood tests) goes through your Franchise. If you plan to become pregnant, switch to CHF 300 before December 31 of the prior year.
- You take regular prescription medication. Medication for ADHD, depression, thyroid conditions, or birth control pills (if not covered under maternity exemptions) adds up. Calculate your annual pharmacy costs. If they exceed CHF 1,000, the low Franchise starts making sense.
- You have a known upcoming procedure. Wisdom tooth removal under general anesthesia, a planned surgery, or orthodontic treatment — if you know a big expense is coming, lock in CHF 300.
- You cannot absorb a CHF 3,200 surprise. If your emergency fund is thin, the peace of mind from a CHF 1,000 maximum out-of-pocket may be worth the extra premium.
What the Franchise Does NOT Apply To
Several categories of care are completely exempt from the Franchise. You pay nothing out of pocket (beyond premiums) for:
| Exempt Service | Details |
|---|---|
| Maternity care (from week 13) | All prenatal checkups, ultrasounds, delivery, postnatal care — zero Franchise, zero Selbstbehalt |
| Certain preventive screenings | Mammography (in some cantons), childhood vaccinations, certain cancer screenings on the federal list |
| General prevention examinations | Eight-yearly health check (Vorsorgeuntersuchung) for specific age groups as defined by KVG |
Important: Maternity exemption starts at the 13th week of pregnancy. All care in weeks 1–12 (including the pregnancy confirmation, early blood tests, and dating ultrasound) counts toward your Franchise.
Accident Coverage: A Separate Layer
If you work 8+ hours per week for a single employer, your employer must provide accident insurance (UVG — Unfallversicherungsgesetz). UVG covers all accident-related costs from the first franc — no Franchise, no Selbstbehalt. This includes sports injuries, falls, traffic accidents, and any other non-illness-related treatment.
In that case, you can exclude accident coverage from your KVG policy (Unfallausschluss), which reduces your premium by another 3–7%.
If you do not work (or work less than 8 hours/week), accident coverage stays in your KVG policy and follows the same Franchise rules as illness.
For students with a part-time job of 8+ hours: Exclude accident coverage from KVG. Your employer’s UVG handles accidents franchise-free. Your KVG Franchise only applies to illnesses.
How to Change Your Franchise
You can change your Franchise once per year, effective January 1 of the following year. The deadlines are:
| Change Direction | Deadline |
|---|---|
| Increase Franchise (e.g., CHF 300 → CHF 2,500) | December 31 |
| Decrease Franchise (e.g., CHF 2,500 → CHF 300) | November 30 |
Step by Step
- Decide by October–November. Review your medical costs for the current year and your health outlook for next year.
- Notify your insurer in writing. Most insurers accept changes via their app, online portal, or a simple email. Some require a signed letter.
- Confirm the new premium. Your insurer sends an updated premium notice for the coming year. Verify the new monthly amount.
Key Rules
- You cannot change your Franchise mid-year. It is locked from January 1 to December 31.
- If you are switching insurers at the same time (deadline: November 30), you choose your Franchise as part of the new application.
- If you are moving to Switzerland for the first time, you select your Franchise when you initially sign up. You are not locked into your first choice forever — you can change it the following year.
- There is no penalty for changing. No extra fees, no waiting periods, no health checks.
Pro Tip: Set a Calendar Reminder
Put “Review Swiss Franchise” in your calendar for October 15 every year. That gives you time to evaluate your health costs and submit a change before the November 30 deadline. Many students set CHF 2,500 when they arrive and forget about it — which is fine if they stay healthy, but expensive if their situation changes.
Franchise for Children (Under 18)
If you have children enrolled in Swiss health insurance, their Franchise levels are different:
| Children’s Franchise | Available Levels |
|---|---|
| Range | CHF 0, 100, 200, 300, 400, 500, 600 |
| Default | CHF 0 (no deductible) |
| Selbstbehalt cap | CHF 350/year (vs. CHF 700 for adults) |
| Family cap | Combined children’s Franchise costs capped at CHF 1,000/year across all children |
Recommendation: For children, CHF 0 Franchise is almost always the best choice. The premium difference between CHF 0 and CHF 600 for children is tiny — often less than CHF 10/month. One sick child with a single GP visit wipes out the savings. Children get sick more often than adults. Keep their Franchise at zero.
The Selbstbehalt: What You Pay After the Franchise
After you have paid your full Franchise for the year, insurance does not cover 100% of the remaining costs. You still pay a 10% co-insurance (Selbstbehalt) on all additional costs. This is capped at CHF 700 per year for adults and CHF 350 for children.
How It Works in Practice
Say you have CHF 2,500 Franchise and CHF 8,000 in medical costs this year:
- You pay CHF 2,500 (your Franchise) → covered
- Remaining costs: CHF 5,500
- You pay 10% of CHF 5,500 = CHF 550 (Selbstbehalt)
- Insurance pays the other 90% = CHF 4,950
- Your total out-of-pocket: CHF 2,500 + CHF 550 = CHF 3,050
If costs were CHF 15,000:
- You pay CHF 2,500 (Franchise)
- Remaining: CHF 12,500
- 10% of CHF 12,500 = CHF 1,250 — but capped at CHF 700
- You pay CHF 700 (Selbstbehalt cap)
- Insurance pays CHF 11,800
- Your total out-of-pocket: CHF 2,500 + CHF 700 = CHF 3,200 (the absolute maximum)
Hospital Stays: Extra Daily Contribution
If you are hospitalized, you pay an additional CHF 15 per day on top of the Franchise and Selbstbehalt. This daily contribution (Spitalkostenbeitrag) is not counted toward the CHF 700 cap. It applies to adults only — children are exempt.
Real Student Scenarios
Scenario 1: Maria, 23, Healthy Exchange Student in Zurich
Maria visits the doctor once for a cold (CHF 180). She buys one prescription (CHF 40). Total medical costs: CHF 220.
| CHF 300 Franchise | CHF 2,500 Franchise | |
|---|---|---|
| Premium (Telmed, 12 months) | CHF 4,440 | CHF 2,940 |
| Out-of-pocket | CHF 220 | CHF 220 |
| Total | CHF 4,660 | CHF 3,160 |
| Savings with CHF 2,500 | CHF 1,500 |
Maria saves CHF 1,500 by choosing the high Franchise. That covers 5 months of groceries.
Scenario 2: Luca, 24, Master’s Student with Asthma in Bern
Luca sees his pulmonologist quarterly (4 × CHF 200 = CHF 800). He takes daily medication (CHF 60/month = CHF 720/year). Annual blood work: CHF 250. Total medical costs: CHF 1,770.
| CHF 300 Franchise | CHF 2,500 Franchise | |
|---|---|---|
| Premium (Hausarzt, 12 months) | CHF 4,200 | CHF 2,760 |
| Franchise portion paid | CHF 300 | CHF 1,770 |
| Selbstbehalt (10% of remainder) | CHF 147 | CHF 0 |
| Total | CHF 4,647 | CHF 4,530 |
| Winner | CHF 2,500 still cheaper by CHF 117 |
Even with regular specialist visits and medication, Luca’s costs of CHF 1,770 are still below the break-even point. The high Franchise wins by a small margin. But if Luca needs one additional treatment — an emergency visit, a scan — costs tip over CHF 2,000 and the low Franchise becomes cheaper.
For Luca’s situation, CHF 300 may be the safer choice. The margin is thin, and one bad month flips the calculation.
Scenario 3: Yuki, 26, PhD Student with Planned Knee Surgery in Basel
Yuki needs arthroscopic knee surgery (estimated CHF 8,000). She will also have physical therapy (10 sessions × CHF 120 = CHF 1,200) and follow-up visits (CHF 500). Total medical costs: CHF 9,700.
| CHF 300 Franchise | CHF 2,500 Franchise | |
|---|---|---|
| Premium (Standard, 12 months) | CHF 5,280 | CHF 3,720 |
| Franchise | CHF 300 | CHF 2,500 |
| Selbstbehalt | CHF 700 (capped) | CHF 700 (capped) |
| Total | CHF 6,280 | CHF 6,920 |
| Savings with CHF 300 | CHF 640 |
With a major procedure, the low Franchise saves money. Yuki should have switched to CHF 300 before January 1 of the surgery year.
The Decision Flowchart
Ask yourself these questions in order:
1. Do you have a chronic condition or take daily medication? → Yes: Choose CHF 300. → No: Continue to question 2.
2. Are you planning a medical procedure this year? → Yes: Choose CHF 300. → No: Continue to question 3.
3. Are you pregnant or planning to become pregnant this year? → Yes: Choose CHF 300 (early pregnancy care counts toward the Franchise). → No: Continue to question 4.
4. Can you handle a CHF 3,200 emergency expense? → No: Choose CHF 300 for peace of mind. → Yes: Choose CHF 2,500. You save CHF 1,200–1,560 per year.
Most healthy students end up at CHF 2,500. That is the right answer for roughly 70–80% of young adults.
Combining Franchise with Other Savings
The Franchise is not your only cost lever. Combine it with other strategies for maximum savings:
| Strategy | Savings | Details |
|---|---|---|
| CHF 2,500 Franchise | CHF 1,200–1,560/year | vs. CHF 300 Franchise |
| Telmed or HMO model | 15–25% off premium | Must call hotline or use health center first |
| Prämienverbilligung | CHF 1,200–4,200/year | Premium subsidy for low-income residents — see our guide |
| Cheapest provider for your canton | CHF 240–960/year | Compare on Priminfo (priminfo.admin.ch) |
| Accident exclusion (if employed 8+ hours) | 3–7% off premium | Employer UVG covers accidents |
Combined example (Zurich, age 22):
| Component | Without Optimization | Fully Optimized |
|---|---|---|
| Franchise | CHF 300 | CHF 2,500 |
| Model | Standard | Telmed |
| Provider | Mid-range | Cheapest in canton |
| Monthly premium | CHF 420 | CHF 220 |
| Prämienverbilligung | CHF 0 | −CHF 100 |
| Net monthly cost | CHF 420 | CHF 120 |
From CHF 420/month to CHF 120/month — same KVG coverage, same benefits, same hospital access. The difference is CHF 3,600 per year.
Frequently Asked Questions
What is the Franchise in Swiss health insurance?
The Franchise is your annual deductible — the amount you pay out of pocket for medical costs before your insurance starts covering expenses. Adults can choose between CHF 300, 500, 1,000, 1,500, 2,000, or 2,500 per year. A higher Franchise means lower monthly premiums but more out-of-pocket risk. The Franchise resets every January 1.
Which Franchise should a healthy student choose?
CHF 2,500. A healthy student aged 18–30 who visits the doctor once or twice a year saves CHF 1,200–1,560 annually by choosing the highest Franchise. The break-even point is approximately CHF 1,800 in annual medical costs. Most young adults spend well under CHF 500 per year on healthcare.
What is the Selbstbehalt and how does it work with the Franchise?
The Selbstbehalt (co-insurance) is the 10% you pay on medical costs after your Franchise is used up. It is capped at CHF 700 per year for adults and CHF 350 for children. Your maximum annual out-of-pocket is Franchise + CHF 700. With CHF 2,500 Franchise, the worst case is CHF 3,200. With CHF 300 Franchise, it is CHF 1,000.
Can I change my Franchise during the year?
No. Franchise changes take effect on January 1 only. To increase your Franchise, notify your insurer by December 31. To decrease it, the deadline is November 30. You cannot change mid-year, even if your health situation changes. Set a calendar reminder for October to review your Franchise annually.
Does the Franchise apply to maternity care?
Not after the 13th week of pregnancy. From week 13 onward, all prenatal checkups, ultrasounds, delivery, and postnatal care are exempt from the Franchise and the Selbstbehalt. However, care in weeks 1–12 (initial GP visit, early blood tests, dating ultrasound) does count toward your Franchise.
What Franchise levels exist for children?
Children (under 18) can choose from CHF 0, 100, 200, 300, 400, 500, or 600. The default is CHF 0. Children’s Selbstbehalt is capped at CHF 350/year. The family cap on children’s combined Franchise costs is CHF 1,000/year. For most families, CHF 0 is the best choice — the premium savings from higher children’s Franchises are minimal.
Does the Franchise apply to accidents?
It depends. If you work 8+ hours per week for a single employer, your employer’s UVG (accident insurance) covers all accident costs without any Franchise or co-payment. You can exclude accident coverage from your KVG policy to save 3–7% on your premium. If you do not work (or work less than 8 hours), accidents are covered through your KVG policy and your Franchise applies.
Is CHF 500 Franchise a good compromise?
No. Middle Franchises (CHF 500–2,000) are mathematically inferior. The premium savings per additional CHF of deductible are proportionally smaller than at the extremes. Experts recommend choosing either CHF 300 (if you expect frequent care) or CHF 2,500 (if you are healthy). There is no realistic medical-cost scenario where a middle Franchise is the cheapest option.
What if I have an emergency with CHF 2,500 Franchise?
You pay up to CHF 3,200 out of pocket (CHF 2,500 Franchise + CHF 700 Selbstbehalt). But you do not pay it all at once. Swiss hospitals and doctors bill you after treatment — you receive invoices that you can pay in installments. Some insurers offer a “Tiers payant” system where they pay the provider directly and bill you for your share. Contact your insurer if you cannot pay immediately.
How do I check which Franchise I currently have?
Check your insurance policy (Versicherungspolice), your insurer’s app, or your last premium notice. The Franchise level is always stated on these documents. If unsure, call your insurer’s customer service. You can also log into the Priminfo portal to see your registered coverage details.
Related Articles
- Student Health Insurance in Switzerland: KVG, Costs & How to Save — The complete guide to Swiss health insurance for international students
- Understanding Health Insurance Deductibles & Copayments — How deductibles work across different countries
- How to Choose the Right Health Insurance as an International Student — Framework for comparing plans and providers
- Cheapest Health Insurance for International Students 2026 — Budget options across all study destinations
Make the Right Franchise Choice
The Franchise decision is straightforward once you do the math. Healthy students save CHF 1,200–1,560 per year with CHF 2,500. Students with ongoing medical needs save hundreds with CHF 300. Either way, avoid the middle Franchises — they help no one.
Combine your Franchise choice with a Telmed model, the cheapest provider in your canton, and Prämienverbilligung to get your total monthly cost as low as CHF 80–150. Swiss health insurance is expensive, but it does not have to be.
Ready to compare health insurance options? Start with our complete Switzerland KVG guide or compare insurance plans for your study destination.
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