Children’s deductible

What is the children’s deductible?

The children’s deductible is the deductible in basic health insurance for children up to their 18th birthday. It works in the same way as for adults: up to the chosen amount, the parents pay the child’s doctor’s, pharmacy and hospital bills themselves, after which the insurer takes over. The difference lies in the amounts.

The law does not provide for a deductible for children. The standard deductible for children is therefore CHF 0. However, parents can voluntarily choose a higher level: CHF 100, 200, 300, 400, 500 or 600. In return, the children’s premium falls. These voluntary levels are a form of optional deductible.

The children’s deductible only exists in basic health insurance under the Federal Health Insurance Act (KVG). Supplementary insurance for children, for example for braces, has its own excess arrangements set out in the contract.

How it works

You choose a level for each child. Bills are first counted towards this deductible. After that, you pay a 10% retention fee, at most CHF 350 per child and year. With a CHF 0 deductible you therefore pay at most CHF 350 a year, with CHF 600 at most CHF 950.

With several children, a family cap protects you if all the children are insured with the same insurer:

• With the standard deductible (CHF 0): for all children together, you pay at most the deductible and the maximum retention fee of one adult, i.e. at most CHF 700 retention fee a year.
• With an optional deductible: the co-payment of all the children together may not exceed twice the maximum amount per child. With a CHF 600 deductible, that is 2 × CHF 950 = CHF 1,900. If the children have different deductibles, the insurer sets the cap.

Insurers do not have to offer all levels. In Zurich in 2026 there were 128 offers for children with CHF 0 and 113 with CHF 600, but only 88 with CHF 100 and 88 with CHF 300 (source FOPH). You can only change the level with effect from 1 January: a higher one up to 31 December, a lower one with notice by 30 November.

For a hospital stay, children do not pay the contribution of CHF 15 per day. However, the deductible and retention fee also apply in hospital.

Legal basis

Art. 64 para. 4 KVG states that no deductible is charged for children and that half the maximum retention fee applies. If several children in a family are insured with the same insurer, together they owe at most the deductible and the maximum retention fee of one adult. Art. 64 para. 1bis KVG states that, until the end of the month in which the child comes of age, the child’s co-payment is owed exclusively by the people who owe the premiums.

Art. 93 para. 1 of the Health Insurance Ordinance (KVV) lists the optional deductibles for children: CHF 100, 200, 300, 400, 500 and 600. Art. 93 para. 3 KVV caps the co-payment for several children with an optional deductible at twice the maximum amount per child. Art. 103 para. 2 KVV sets the maximum retention fee for children at CHF 350. Art. 104 para. 2 let. a KVV exempts children from the hospital contribution.

Example: CHF 0 or CHF 600 for Noah

Noah is 10 and lives in Zurich. His parents compare the standard children’s deductible of CHF 0 with the highest level of CHF 600. They calculate with the median premiums of all offers: premiums 2026, municipality of Zurich (region 1), children, with accident cover; source FOPH.

The median covers different numbers of offers, because not every insurer offers the CHF 600 level. The premium calculator shows you the premium of your child’s insurer for each level. You can compare the children’s premiums of all insurers for your municipality in the children’s premium calculator.

What this means for you

With children, the amounts are smaller than with adults, but the principle stays the same. Ask yourself:

1. How often has your child seen a doctor in recent years? The insurer’s statements of benefits show the total. If it is below CHF 425, as in the example, that speaks for a higher level.
2. Is anything bigger coming up? For planned treatment or regular therapy, CHF 0 is usually cheaper.
3. Do you have several children with the same insurer? Then the family cap applies and limits your risk further. You can find an overview of the insurers’ children’s premiums under health insurers.

Your child’s premium also depends on where you live, the insurer and the model; the entry on the children’s premium explains how the age groups affect the premium. All levels for children and adults are listed under deductible levels.

Common mistakes

• Assuming the adult deductible applies. Children do not have a minimum deductible of CHF 300. The standard children’s deductible is CHF 0.
• Asking for a level the insurer does not offer. Many insurers only offer individual optional levels for children. Check what is on offer before you decide.
• Factoring in braces. Basic health insurance only pays for dental treatment and orthodontics in exceptional cases. They usually do not change the choice of deductible.
• Forgetting the family cap. With several children at the same insurer, the total co-payment is capped. This can be an argument for a single insurer.
• Reporting the change too late. A lower level for next year must reach the insurer by 30 November.

We explain how we calculate premiums and medians under How we calculate.