Franchise CHF 300 or CHF 2,500? The break-even is about CHF 1,800 of bills
Updated · 2 sources
Direct answer
Choose the CHF 2,500 franchise if your expected medical bills stay below roughly CHF 1,800–2,000 a year and the CHF 300 franchise if they run above it. The federal rules cap the premium discount for the highest franchise at CHF 1,540 a year, so the mid franchises (500–2,000) are dominated in almost every scenario: they carry most of the risk for a fraction of the discount.
Key facts
- Out-of-pocket maximum: CHF 1,000/yr (franchise 300 + CHF 700 retention cap) vs CHF 3,200/yr (franchise 2,500)
- Maximum legal premium discount for CHF 2,500 vs 300: CHF 1,540 per year (KVV Art. 93)
- At CHF 1,800 of bills you pay CHF 450 out of pocket with franchise 300, CHF 1,800 with franchise 2,500
- Use your actual premium quotes from priminfo.admin.ch; the break-even moves with the real discount offered
Out-of-pocket cost by medical spend (before premiums)
| Your bills in a year | Franchise CHF 300 | Franchise CHF 2,500 |
|---|---|---|
| CHF 0 | CHF 0 | CHF 0 |
| CHF 1,800 | CHF 450 | CHF 1,800 |
| CHF 5,000 | CHF 770 | CHF 2,750 |
| CHF 10,000 | CHF 1,000 (cap reached) | CHF 3,200 (cap reached) |
How to decide with your own numbers
Take the two premium quotes for your insurer and model from priminfo and compute the yearly premium saving S of the 2,500 franchise. Then look at the table: the extra out-of-pocket risk of the high franchise grows franc-for-franc with your bills until about CHF 2,000, where the difference reaches roughly CHF 1,530. If S is close to the CHF 1,540 maximum, the high franchise wins whenever a typical year stays under about CHF 2,000 of bills; if your insurer only discounts CHF 900, the crossover drops to roughly CHF 1,200 of bills.
Decide on your typical year, not your worst year, but keep the worst year affordable: with CHF 2,500 you must be able to absorb CHF 3,200 on top of premiums without stress. Pregnancy changes the maths entirely, since maternity benefits from week 13 are exempt from franchise and retention.
FAQ
- Why do advisers say avoid franchises 500 to 2,000?
- The premium discount is capped at 70% of the additional risk you take (KVV Art. 93). Mid franchises give up most of the maximum discount while still exposing you to four-figure bills, so either extreme wins in nearly all scenarios.
- What is the most I can pay out of pocket in a year?
- Your franchise plus at most CHF 700 of retention (10% cost share), so CHF 1,000 with the 300 franchise and CHF 3,200 with the 2,500 franchise, plus premiums and the CHF 15 per hospital day contribution.
- Does the franchise apply to maternity costs?
- No. From the 13th week of pregnancy to 8 weeks after birth, benefits are exempt from both franchise and retention.
- When can I change my franchise?
- For 1 January: notify your insurer by 30 November to lower the franchise, by 31 December to raise it. The same November deadline applies to changing insurer.
Related guides
- Choosing a Swiss health insurance franchiseAdults in Switzerland choose a franchise of CHF 300, 500, 1,000, 1,500, 2,000 or 2,500. After the franchise, you pay 10% of further costs, up to CHF 700 per year.
- How to change health insurer in Switzerland: deadlines and stepsYou can change your Swiss basic health insurer (KVG) every year for 1 January, with no health check and no right of refusal, as long as your cancellation reaches the old insurer by the last working day of November and you have no unpaid premiums. Supplementary insurance is a separate private contract: never cancel it before the new insurer has accepted you in writing.