What does health insurance really cost? Premium plus deductible plus retention fee

How much does health insurance cost per month?

The premium is what appears on the monthly bill. Every year, the FOPH calculates the average premium across all insurers, deductibles and models. In 2026 it is:

Source: FOPH, press release of 23.09.2025 on the 2026 premiums. The FOPH publishes the following year’s premiums at the end of September.

Your own premium can differ considerably from this, because it depends on where you live, your insurer, deductible and model. But it is only the fixed part. As soon as you see a doctor, buy medicines or have to go into hospital, the co-payment comes on top. The honest answer to the question “What does health insurance cost?” is therefore: the premium plus what you pay yourself.

The three components of the co-payment

1. Deductible. The deductible (Franchise) is the amount you first pay yourself per calendar year. The standard deductible for adults is CHF 300 (Art. 103 para. 1 of the Health Insurance Ordinance, KVV). You can also choose CHF 500, 1,000, 1,500, 2,000 or 2,500; for children there are deductibles of CHF 0 to CHF 600 (Art. 93 para. 1 KVV). The higher the deductible, the lower the premium.

2. Retention fee. You pay 10 % of the costs above the deductible (Art. 64 para. 2 of the Federal Health Insurance Act, KVG). The retention fee is capped per year: adults reach the annual maximum retention fee at CHF 700, children at CHF 350 (Art. 103 para. 2 KVV). For medicines that are at least 10 % more expensive than the average of the cheapest third with the same active ingredient, the retention fee is 40 % (Art. 38a para. 1 of the Health Care Benefits Ordinance, KLV).

3. Hospital contribution. For each day in hospital, adults pay CHF 15, but not for the day of discharge (Art. 104 KVV). Children, young adults in education and women in the case of maternity do not pay a hospital contribution. It is added to the maximum retention fee.

What counts is the date of treatment, not the date of the invoice (Art. 103 para. 3 KVV). So a treatment in December counts towards the previous year’s deductible, even if the invoice arrives in January.

On top of this come any hospital contributions and services that basic health insurance does not pay for.

Step by step: calculating your total cost

1. Determine the annual premium. Monthly premium times twelve. The premium calculator shows the premiums of all insurers in your municipality.
2. Estimate the expected costs. Take the total of last year’s invoices for doctors, medicines and therapies. Your insurer’s statements of benefits list them.
3. Deduct the deductible. Up to the deductible, you pay everything yourself.
4. Calculate the retention fee. 10 % of the costs above the deductible, at most CHF 700.
5. Add the days in hospital. CHF 15 per day except the day of discharge, if a stay is planned.
6. Add costs that are not covered. For example the dentist, glasses above the statutory contribution or premiums for supplementary insurance.

Total cost in 2026 in three scenarios

The following calculation takes the median premium of all 128 offers in one municipality. Premiums 2026, municipality of Zurich (region 1), adults born in 1990, with accident cover; source FOPH. With a CHF 300 deductible, the median is CHF 580.00 per month (CHF 6,960.00 per year), with a CHF 2,500 deductible CHF 453.90 (CHF 5,446.80 per year). The costs are assumed annual totals of all invoices, without a hospital stay.

Calculated per month, this means: with a CHF 300 deductible, health insurance in this example costs between CHF 580.00 and CHF 663.33, with a CHF 2,500 deductible between CHF 453.90 and CHF 720.57. With the high deductible, the difference between a healthy year and an expensive year is therefore more than twice as large.

The premiums for the two deductibles differ by CHF 1,513.20 per year. With costs of CHF 1,981.33, you pay the same with both deductibles. Below that, the CHF 2,500 deductible is cheaper; above it, the CHF 300 deductible. The deductible calculator works out this break-even point for your municipality and your age. How to find the right level is explained in the article Choosing your deductible.

Sample calculation: a year with a hospital stay

Example with fictitious people. Martin is 36, lives in Zurich and has a CHF 2,500 deductible with a premium of CHF 453.90 per month, the median from the table above. In March he spends five nights in hospital, six calendar days including the day of discharge.

With a CHF 300 deductible, Martin would have paid CHF 6,960.00 in premiums, CHF 1,000 in co-payments and CHF 75 in hospital contributions in the same year, a total of CHF 8,035.00. In a year without a visit to the doctor, on the other hand, he pays CHF 1,513.20 less with the high deductible. Which variant is cheaper over several years depends on how often such years occur; the example is not a recommendation for your situation.

What changes the calculation

• Model: GP, HMO and telemedicine models lower the premium with the same co-payment. In Zurich, the median of these tariffs in 2026 with a CHF 300 deductible was between CHF 565.80 and CHF 575.00 per month instead of CHF 639.80 in the standard model. How the procedure works is explained in the article Telemedicine model; the model finder helps you work out which model suits you.
• Insurer: With a CHF 300 deductible, there was CHF 206.30 per month between the cheapest and the most expensive offer in Zurich (CHF 517.70 and CHF 724.00), for the same statutory benefits.
• Children: Children have no standard deductible, pay a retention fee of at most CHF 350 and no hospital contribution. Several children in the same family with the same insurer together pay at most the co-payment of one adult (Art. 64 para. 4 KVG).
• Pregnancy: From the 13th week of pregnancy until eight weeks after the birth, there is no co-payment (Art. 64 para. 7 KVG).
• Switching insurer during the year: The new insurer credits the deductible and retention fee already paid (Art. 103 para. 4 KVV).
• Services outside basic health insurance: Basic health insurance only pays for dental treatment in the cases set out in Art. 31 KVG. You pay such invoices entirely yourself or through supplementary insurance, whose premium also belongs to the total cost; there, the general terms and conditions are what count.
• Premium subsidy: If your income is low, the canton reduces your premium. The Premium subsidy page shows whether you are entitled.

Common mistakes

• Only comparing premiums. If you raise your deductible, you lower the premium, but in an expensive year you pay up to CHF 2,200 more yourself.
• Forgetting the retention fee. After the deductible, you continue to pay 10 % until CHF 700 is reached.
• Overlooking the hospital contribution. CHF 15 per day comes on top of the maximum.
• Using the invoice date instead of the treatment date. The deductible depends on the date of treatment.
• Planning too small a reserve. With a high deductible, premiums and up to CHF 3,200 in co-payments can arise in the same year.

What you can deduct from your taxes for premiums and costs you pay yourself is explained in the article Deducting premiums from your taxes. Whether paying your premium annually is worth it is covered in the article of the same name. You will find more ways to save in the Saving money section, and all providers in the health insurer profiles. How we analyse premiums is explained under How we calculate.