Saving on health insurance: deductible, model and premium subsidies

What health insurance really costs

Health insurance costs you the premium plus the co-payment. In 2026, the average premium for adults is CHF 465.30 per month (FOPH). On top of that, each year, come the deductible of CHF 300 to CHF 2,500, a 10 % retention fee on the costs above it, at most CHF 700 (Art. 64 para. 2 KVG, Art. 103 para. 2 KVV), and CHF 15 per day in hospital (Art. 104 KVV).

Saving money therefore does not just mean looking for the lowest premium. If you choose a high deductible, you pay a lower premium but bear more yourself in an expensive year. The calculation with the median of all offers in the municipality of Zurich shows this (2026 premiums, region 1, adults, with accident cover; source FOPH; costs assumed):

The levers at a glance, with their deadlines and the article that explores each in depth:

What does health insurance really cost? shows how to add up the premium, deductible, retention fee and hospital contribution to get your total cost, with an example of a year with a hospital stay.

Which deductible pays off?

A CHF 2,500 deductible pays off compared with CHF 300 as long as your healthcare costs stay below the break-even point. With 2026 premiums in Zurich, it lies at CHF 2,011 in costs per year for the same product, and at CHF 1,981 with the median premiums of all offers (2026 premiums, municipality of Zurich, region 1, adults, with accident cover; source FOPH). Above that, CHF 300 is cheaper.

The reason lies in the law: adults have a deductible of at least CHF 300 and can choose CHF 500, 1,000, 1,500, 2,000 or 2,500 (Art. 93 para. 1 KVV). The premium discount for a higher optional deductible may be at most 70 % of the additional risk (Art. 95 para. 2bis KVV). Each additional franc of deductible therefore brings at most 70 centimes of discount, but costs 90 centimes in case of illness, because without it a 10 % retention fee would have been due.

Statutory values under Art. 95 para. 2bis and Art. 103 para. 2 KVV, without the hospital contribution. This is a calculation, not a recommendation: which level suits you depends on your costs and on how much you can bear yourself in a bad year.

Three articles explore the deductible in more depth:

• Deductible of 300 or 2,500? How to find the right one calculates the break-even point for each level and shows four years with two deductibles.
• Is a medium deductible worth it? shows why, in our analysis of all 2026 adult tariffs from six cities, no level between CHF 500 and CHF 2,000 was the cheapest for any amount of costs, and when the middle can still be right: it limits your own share.
• Changing your deductible: by when and in which direction explains the deadlines: a lower deductible must reach your insurer by 30 November; insurers accept a higher one until 31 December (Art. 94 KVV). No change is possible in the middle of the year.

How much does a GP, HMO or telemedicine model save?

In Zurich in 2026, an insurer’s cheapest GP or HMO offer was a median 15.6 % below its standard model, the cheapest telemedicine offer 16.0 % (CHF 2,500 deductible, FOPH data). The benefits stay the same: alternative insurance models are basic health insurance with a restricted choice of service provider; the compulsory benefits are insured in every case (Art. 41 para. 4 KVG). Around 80 % of all insured persons were in such a model in 2025 (Office of the health insurance ombudsperson).

The models differ in the first point of contact:

• GP model: your GP practice is the first point of contact and refers you to specialists and hospitals.
• HMO: the first point of contact is a health centre where several doctors and often therapists work together; the model is only open to insured persons in the centre’s area (Art. 100 para. 1 KVV).
• Telemedicine: before every new doctor’s visit, you call a telemedicine advice centre or register via an app.
• Pharmacy model: the first point of contact is a partner pharmacy that advises, treats simple cases or refers you on.

The insurer may lower the premium for these models (Art. 62 para. 1 KVG). You can switch into a model at any time, but out of it or into another model only at the end of the year, with receipt by 30 November (Art. 100 para. 2 and 3 KVV). You can work out which model suits your everyday life with five questions in the article GP, HMO, telemedicine, pharmacy: which model suits you? or with the model finder.

The rules decide about your money

The saving comes with a condition: the insurer only has to pay for services provided or arranged by the agreed point of contact (Art. 41 para. 4 KVG). If, in the GP model, you go directly to a specialist without a referral, the insurer may reject the bill. You pay a rejected bill entirely yourself, and it does not count towards the deductible. After several breaches, regulations provide for moving you back into the more expensive standard model. Emergencies are exempt, but usually have to be reported afterwards.

Three articles explain the rules in detail: Rules of the cost-saving models shows the typical obligations and what three visits without a referral cost. GP model: straight to a specialist? describes the correct way to see a specialist and the exceptions. Telemedicine model: how the call works guides you through the call before the doctor’s visit; in Bern in 2026, with a CHF 300 deductible, the median premium for telemedicine and other models was CHF 72.30 per month below the standard model (FOPH).

When may you suspend accident cover?

If you work for one employer at least 8 hours per week. You are then also insured against non-work-related accidents under the Accident Insurance Act (UVG) and can suspend your health insurer’s accident cover (Art. 8 para. 1 KVG, Art. 13 UVV). The suspension applies on written application at the earliest from the first day of the following month (Art. 11 para. 1 KVV) and lowers the premium by the accident share, by at most 7 % (Art. 91a para. 4 KVV). In Bern in 2026, with a CHF 300 deductible, this saved between CHF 3.90 and CHF 53.10 per month depending on the offer, a median of CHF 41.10 (FOPH).

If the cover through your employer ends, for example when you lose your job or retire, the health insurer automatically covers accidents again; you must notify it within one month (Art. 8 para. 2 KVG, Art. 11 para. 2 KVV). How to apply and what applies when you change jobs is explained under Suspending accident cover. The suspend accident cover tool checks your case.

Does annual payment bring anything?

Sometimes, but not much. The law only requires the premium to be paid in advance and, as a rule, monthly (Art. 90 KVV); it does not prescribe a discount for annual payment. Some insurers grant one voluntarily, as a small percentage of the annual premium. For comparison in Basel, CHF 300 deductible: a 1 % discount would have brought CHF 76.44 per year on the median premium in 2026, while the difference between the median and the cheapest offer was CHF 733.20 (adults, with accident cover; source FOPH). Paying the premium annually instead of monthly shows which insurers state which discount and when annual payment pays off.

Are you entitled to premium subsidies?

If you live in modest economic circumstances, yes. The cantons must subsidise the premiums of these insured persons and pay the contribution directly to the insurer (Art. 65 para. 1 KVG). Each canton decides who is entitled, how much there is and by when you must apply; the canton of residence on 1 January is decisive (Art. 5 VPVK). For lower and middle incomes, children’s premiums are reduced by at least 80 % and premiums of young adults in education by at least 50 % (Art. 65 para. 1bis KVG).

Many cantons write to those who may be entitled, others require an application with a deadline. For 2026, the deadline ran until 31.12.2025 in Aargau, for example, until 31.03.2026 in St. Gallen, and in Zurich it runs until 31.03.2027. On application, the cantons must take into account the most recent income and family circumstances (Art. 65 para. 3 KVG), for example after a birth, a separation or the loss of a job. Applying for premium subsidies shows the procedure, the responsible offices and a sample calculation with the basic formula of the canton of Aargau. You will find your canton’s rules under Premium subsidies.

Three further articles put premium subsidies into context:

• Paying back: if the final tax assessment shows a higher income, the canton reclaims amounts paid in excess. In Zurich, SVA Zürich first pays out 80 % and settles definitively later. Repaying premium subsidies explains what you can do.
• Premium cap: there is no nationwide cap; the people and the cantons rejected the 10 % initiative on 09.06.2024. Since 01.01.2026, however, every canton must specify the maximum share of disposable income that the premium may account for (Art. 65 para. 1ter KVG). Which cantons state a value is shown under Premium cap: which cantons limit the premium burden.
• Reform: since 01.01.2026, every canton must use a minimum share of the gross costs of basic health insurance for premium subsidies; in 2026 and 2027, it is 3.5 % everywhere (transitional provision to the KVG amendment of 29.09.2023). This does not give you a right to a specific amount. The details are in Premium subsidies: the new rules.

What can you deduct from your taxes?

Two things, in two separate deductions. You enter the premiums in the insurance deduction, together with other insurance premiums and interest on savings, up to a maximum amount (Art. 33 para. 1 let. g DBG). For direct federal tax, that is CHF 1,800 for single people and CHF 3,700 for married couples, plus CHF 700 per child (Art. 33 para. 1bis DBG). The cantons set their own amounts (Art. 9 para. 2 let. g StHG). You subtract premium subsidies received from the premiums paid.

You deduct medical expenses you have borne yourself, such as the deductible, retention fee, dentist, glasses and prescribed therapies, separately, insofar as for federal tax they exceed 5 % of income after deductions for expenses (Art. 33 para. 1 let. h DBG). The cantons must grant this deduction but set the threshold themselves (Art. 9 para. 2 let. h StHG). Premiums are not included.

Where to enter what is shown in Deducting health insurance premiums from your taxes, using Zurich as an example, and in Deducting medical expenses from your taxes, with a calculation for a CHF 300 and a CHF 2,500 deductible.

Common mistakes when saving

• Only looking at the premium. A high deductible lowers the premium but increases your own share in an expensive year by up to CHF 2,200.
• Not knowing the model’s rules. If you skip the first point of contact in the GP or telemedicine model, you risk paying the bill entirely yourself.
• Lowering the deductible too late before a planned treatment. Notice must reach your insurer by 30 November, otherwise the high deductible applies for another year.
• Forgetting the suspension after a change of job. If accident insurance through your employer ends, you must notify your insurer within one month.
• Not applying for premium subsidies. In cantons where you have to apply, the entitlement lapses if you miss the deadline.

Where to start?

1. Know your total cost. Work out what health insurance cost you last year: premium plus deductible plus retention fee. The article What does health insurance really cost? shows how.
2. Compare premiums. The biggest lever is often the insurer. In the premium calculator, you see all offers in your municipality, sorted by premium.
3. Check deductible and model. Work out the break-even point with the deductible calculator and check whether a model with a first point of contact suits your everyday life.
4. Clarify accident cover and premium subsidies. Both lower the premium without changing your benefits.
5. Note the deadlines. Lower deductible and change of insurer by 30 November, higher deductible by 31 December. The dates are listed under Deadlines.