Deductible of 300 or 2,500? How to find the right one

What choosing a deductible is about

The deductible (Franchise) is the amount you pay yourself in basic health insurance each calendar year before your insurer contributes to the costs. For adults it is at least CHF 300 (Art. 103 para. 1 of the Health Insurance Ordinance, KVV). Instead of this standard deductible, you can choose an optional deductible of CHF 500, 1,000, 1,500, 2,000 or 2,500 (Art. 93 para. 1 KVV). The same levels apply to young adults; for children, it is CHF 0 to CHF 600.

The decision is a trade-off: with a higher deductible you pay a lower premium every month, but you pay more yourself when you need a doctor, medicines or hospital. Which level is cheaper depends on two figures: the premium difference between the levels and your healthcare costs for the year. You know the first figure; you have to estimate the second.

The co-payment consists of the deductible and the retention fee (Art. 64 para. 2 of the Federal Health Insurance Act, KVG). The retention fee is 10 % of the costs above the deductible, for adults at most CHF 700 per year (Art. 103 para. 2 KVV). More on this under annual maximum retention fee. For hospital stays, adults also pay a contribution of CHF 15 per day (Art. 104 KVV), regardless of the deductible.

Step by step to the right deductible

1. Add up the costs of recent years. Your insurer sends you a statement of benefits every year. Add up the invoice amounts for two or three years, not just what the insurer paid.
2. Include foreseeable costs. Regular medicines, a planned treatment, glasses that basic health insurance only partly pays for: everything you already know about belongs in the estimate.
3. Compare premiums for two levels. Take the same insurer, the same model and your municipality, once with CHF 300 and once with CHF 2,500. The difference per year is your discount.
4. Calculate the break-even point. The formula is below; it is quicker with the deductible calculator.
5. Check the worst case. Could you pay CHF 3,200 in co-payments at once in the worst year? If not, that argues against the highest level, regardless of the calculation.
6. Notify in good time. You choose a higher deductible by 31 December; a lower one must reach your insurer in writing by 30 November.

What the law says

Levels and discounts. Insurers may offer optional deductibles but do not have to; their offers apply to the whole canton in each case (Art. 93 para. 1 KVV). They set the discount themselves, but per calendar year it may not exceed 70 % of the risk you additionally take on with the higher deductible (Art. 95 para. 2bis KVV). With CHF 2,500, you take on an additional CHF 2,200 of deductible compared with CHF 300; the discount may therefore be at most CHF 1,540 per year.

Changing the deductible. You can only choose a higher deductible with effect from the start of a calendar year (Art. 94 para. 1 KVV). Switching to a lower deductible is possible at the end of a calendar year with the notice periods of the KVG (Art. 94 para. 2 KVV in conjunction with Art. 7 para. 2 KVG). The FOPH gives 30 November as the date of receipt for this and 31 December for the higher deductible. In 2026, 30 November falls on a Monday.

Switching insurer with an optional deductible. With an optional deductible, you can only switch insurer at the end of the year, not on 1 July (Art. 94 para. 2 KVV). Switching mid-year under Art. 7 para. 1 KVG is only open to insured persons with the standard deductible of CHF 300 in the standard model.

Treatment date as the key date. What counts for the deductible and retention fee is the date of treatment, not the date of the invoice (Art. 103 para. 3 KVV). A treatment in December counts towards the previous year’s deductible, even if the invoice arrives in January.

The 2026 figures: discount and break-even point for each level

The following table uses the cheapest offer for each level. For all levels this is the same HMO product from one insurer, so the comparison only shows the effect of the deductible. Premiums 2026, municipality of Zurich (region 1), adults born in 1992, with accident cover; source FOPH. We calculated the break-even point and the worst case using the statutory co-payment values.

Deductible	Monthly premium	Discount compared with CHF 300 per year	Statutory maximum discount	Worth it up to costs of	Extra cost in the worst case
CHF 300	CHF 517.70	–	–	–	–
CHF 500	CHF 506.10	CHF 139.20	CHF 140	CHF 455	CHF 60.80
CHF 1,000	CHF 476.90	CHF 489.60	CHF 490	CHF 844	CHF 210.40
CHF 1,500	CHF 447.70	CHF 840.00	CHF 840	CHF 1,233	CHF 360.00
CHF 2,000	CHF 418.60	CHF 1,189.20	CHF 1,190	CHF 1,621	CHF 510.80
CHF 2,500	CHF 389.40	CHF 1,539.60	CHF 1,540	CHF 2,011	CHF 660.40

How to read the table: the discount is what you save at best with the higher level, namely in a year without any costs. “Worth it up to” is the break-even point: if your costs are below it, the higher level is cheaper; above it, the CHF 300 deductible is. “Extra cost in the worst case” is how much more you pay with the higher level than with CHF 300 if your costs are very high. With this product, the insurer uses almost the full statutory maximum discount; with other insurers and models, the discount may be lower.

In 2026, the median of all offers in Zurich is CHF 580.00 (CHF 300 deductible) and CHF 453.90 (CHF 2,500 deductible). This puts the break-even point at CHF 1,981. In Bern (region 1), the medians are CHF 609.30 and CHF 482.70 and the break-even point is CHF 1,988 (2026 premiums, adults, with accident cover; source FOPH). The FOPH publishes the following year’s premiums at the end of September; until they are released, we calculate with the 2026 premiums.

How to calculate the break-even point yourself

With a CHF 300 deductible and healthcare costs K, you pay CHF 300 plus 10 % of (K minus CHF 300), i.e. CHF 270 plus 10 % of K. With the higher deductible, as long as K is below it, you pay the full costs K. The difference is 90 % of K minus CHF 270. At the break-even point, it equals the premium discount. This gives:

Break-even point = (discount per year + CHF 270) ÷ 0.9

For CHF 2,500 in the example above: (CHF 1,539.60 + CHF 270) ÷ 0.9 = CHF 2,010.67. The formula applies as long as the break-even point is below the chosen deductible. This is the case for all levels in the table.

Sample calculation: four years, two deductibles

Example with fictitious people. Jana, 34, lives in Zurich and is insured in the same HMO product as in the table. She compares a CHF 300 and a CHF 2,500 deductible for four possible years with different healthcare costs. 2026 premiums as above: CHF 6,212.40 per year with CHF 300, CHF 4,672.80 with CHF 2,500.

Healthcare costs per year	Total with CHF 300	Total with CHF 2,500	cheaper
CHF 0	CHF 6,212.40	CHF 4,672.80	CHF 2,500, by CHF 1,539.60
CHF 1,000	CHF 6,582.40	CHF 5,672.80	CHF 2,500, by CHF 909.60
CHF 3,000	CHF 6,782.40	CHF 7,222.80	CHF 300, by CHF 440.40
CHF 10,000	CHF 7,212.40	CHF 7,872.80	CHF 300, by CHF 660.40

Special cases

• Children: There is no standard deductible for children; you can choose CHF 100 to CHF 600 (Art. 64 para. 4 KVG, Art. 93 para. 1 KVV). The retention fee is at most CHF 350 per year. The break-even points are therefore different from those for adults.
• Young adults: They have the same deductibles as adults, but lower premiums. For the cheapest offers in Zurich in 2026 (born 2003), the discount for CHF 2,500 is also CHF 1,539.60 per year (CHF 371.20 compared with CHF 242.90 per month; source FOPH).
• Pregnancy: For benefits from the 13th week of pregnancy, during the birth and up to eight weeks afterwards, the insurer may not charge any co-payment (Art. 64 para. 7 KVG). A high deductible therefore works differently during this period from what the calculation above assumes.
• Regular treatment: If you are certain to be above the break-even point every year, you pay extra with the higher level every year. This is a calculation, not a medical assessment.
• Premium subsidy: How your canton calculates the subsidy and what changes from 2026 is explained in the article Premium subsidies: the new rules.
• Model: You can combine your deductible and model. The model finder helps you work out which model suits you.

Common mistakes

• Only looking at the premium. The lowest monthly premium with CHF 2,500 is not automatically the cheapest. What matters is the premium plus the co-payment.
• Ignoring the statement of benefits. Your costs of recent years are the best basis for the estimate.
• Missing the deadline for the lower deductible. It must reach your insurer by 30 November; only a change upwards is possible until 31 December.
• Not submitting invoices below the deductible. Then they are missing when the deductible and retention fee are calculated.
• Trying to insure the co-payment. The deductible and retention fee may not be insured either with a health insurer or with a private insurance company (Art. 64 para. 8 KVG).

Whether a level between CHF 500 and CHF 2,000 is worth it is explored in more depth in the article Medium deductible. You compare the premiums in your municipality for each level in the premium calculator, and the insurers with their key figures under Health insurers. You will find all articles on saving money in the Saving money section. More on the co-payment is in the glossary.