Optional deductible

What is an optional deductible?

An optional deductible is a deductible that is higher than the statutory minimum deductible in basic health insurance. The minimum deductible is called the standard deductible and is CHF 300 for adults and young adults and CHF 0 for children. If you voluntarily want to bear more of the costs yourself, you choose an optional deductible.

For adults aged 19 and over there are five optional deductibles: CHF 500, 1,000, 1,500, 2,000 and 2,500. For children up to 18 there are six: CHF 100, 200, 300, 400, 500 and 600. Together with the standard deductible they make up the deductible levels. No other amounts are permitted in basic health insurance.

In legal terms, the optional deductible is a “special type of insurance” alongside standard insurance, just like the GP model or the telemedicine model. You can combine the two, for example by choosing a GP model with a CHF 2,500 deductible. The optional deductible exists only in basic health insurance under the Health Insurance Act (KVG). Deductibles and retention fees in supplementary insurance under the Insurance Contract Act (ICA) follow their own contractual rules.

How it works

With an optional deductible you pay bills yourself up to the level you have chosen. After that, your health insurer covers the costs, minus a 10% retention fee up to a maximum of CHF 700 a year (children CHF 350). The maximum retention fee is the same for the optional and the standard deductible.

In return, the insurer lowers your premium. It decides by how much itself, but within two limits:

• At most 70% of the additional risk. The additional risk is the difference from the standard deductible. With CHF 1,500 that is CHF 1,200, so the discount may be at most CHF 840 a year. With CHF 2,500 it is at most CHF 1,540.
• At least 50% of the premium remains. The premium for special types of insurance may not fall below 50% of the standard premium with accident cover for your region and age group, even when combined with an insurance model.

Separate dates apply to changes. You can only choose a higher deductible with effect from 1 January; it is enough to notify your insurer by 31 December. Switching to a lower deductible or to a different health insurer is also only possible with effect from the end of the year, with notice by 30 November after you receive the premium notification. The mid-year switch on 30 June does not exist with an optional deductible.

Legal basis

Art. 93 para. 1 KVV allows insurers to offer insurance with selectable deductibles alongside standard insurance and lists the amounts exhaustively. Para. 2 states that the maximum retention fee stays the same. Para. 3 limits the co-payment for several children of one family insured with the same insurer to twice the maximum amount per child.

Art. 94 para. 1 KVV states that this insurance is open to everyone and that a higher deductible can only be chosen with effect from the start of a calendar year. Under para. 2, switching to a lower deductible or to another insurer is possible with effect from the end of a calendar year, subject to the notice periods in Art. 7 para. 1 and 2 KVG. Para. 3 governs switching during the year under Art. 7 para. 2 to 4 KVG. Art. 95 para. 2bis KVV limits the premium reduction to 70% of the risk taken on, and Art. 90c para. 1 KVV sets the minimum premium at 50%.

Example: when does CHF 2,500 pay off?

Lara is 36, lives in Zurich and compares the standard deductible of CHF 300 with the optional deductible of CHF 2,500. She works with the median premiums of all offers: premiums 2026, municipality of Zurich (region 1), adults, with accident cover; source FOPH.

With a specific insurer instead of the median, the break-even point shifts. You can find every insurer’s premiums for each level in the premium calculator; the deductible calculator works out the break-even point for your insurer.

What this means for you

An optional deductible is a bet on a healthy year. It suits you if your costs have been low in the past and you could pay the maximum amount in an emergency. Check three points:

1. Your costs in recent years. If they are clearly below your insurer’s break-even point, there is a strong case for a high optional deductible.
2. Your reserves. With CHF 2,500 you may have to pay up to CHF 3,200 yourself in one year. Set this amount aside.
3. Planned treatment. If an operation or a longer course of therapy is coming up, switch to a lower deductible in good time. Your notice must reach the insurer by 30 November.

If you want to change your level, you will find the procedure under changing your deductible and all dates under deadlines. Lower amounts apply to children; read more under deductible for children. If you are also planning to switch health insurer, the overview under switching will help.

Common mistakes

• Planning on the mid-year switch. With an optional deductible you cannot switch on 1 July. The next possible date is 1 January.
• Asking for a lower deductible too late. You must request a reduction by 30 November; in December it is too late for the new year.
• Overestimating the discount. By law the discount is limited to 70% of the additional risk. At the middle levels it is often much smaller.
• Not submitting bills. You should send your insurer bills below the deductible too, so that they count towards the deductible.
• Comparing only the monthly premium. What matters is the sum of the annual premium and the share you may have to pay yourself.

We explain how we calculate medians and break-even points under How we calculate.