Choosing your Krankenkasse and deductible
Step by step
- 1
Start from the identical-coverage rule
Under the Health Insurance Act (KVG/LAMal), the benefit basket for basic insurance is defined federally by the BAG/OFSP. Every insurer must accept every applicant for basic cover and provide the same catalogue of covered treatments. Premium, franchise, insurance model and customer service are what vary — not what's covered.
- 2
Choose an annual franchise (deductible)
Adults choose between CHF 300, 500, 1,000, 1,500, 2,000 and 2,500. Children choose between CHF 0, 100, 200, 300, 400, 500 and 600. The higher the franchise, the lower the premium. You pay the first CHF X of covered care yourself, then coinsurance kicks in.
- 3
Add the coinsurance and cap on top
Above the franchise, you pay 10% coinsurance (Selbstbehalt / quote-part / aliquota percentuale) on further covered care, capped at CHF 700 per adult and CHF 350 per child per calendar year (Art. 64 KVG / Art. 103 KVV). Maternity care and some prevention are exempt from franchise and coinsurance.
- 4
Pick an insurance model
Standard (free choice of doctor) is the most expensive. Family-doctor (Hausarzt / médecin de famille) — you always go through your GP first — typically saves 10–15%. HMO models tie you to a designated group practice for 15–20% savings. Telmed models require calling a medical hotline first for a similar discount. Each model has enrolment rules; changing GP or practice usually needs insurer approval.
- 5
Switch by the annual deadline
You can change franchise, model or insurer for the following calendar year by giving written notice — sent by registered post so it arrives at the insurer — by 30 November for the basic coverage change to take effect on 1 January. Supplementary insurance (VVG/LCA) is a separate contract with its own notice rules.
Why 'shop by price' is safe for basic cover but not for supplementary
Because KVG/LAMal basic benefits are set by federal law, switching from a cheap insurer to an expensive one changes nothing about what treatments are covered — only the premium and the phone experience. Supplementary insurance (VVG/LCA) is completely different: benefits, exclusions, waiting periods and premiums all vary by contract, and switching often means requalifying medically. Never cancel supplementary cover before the new policy is written.
A worked break-even method (using your own quotes)
Pull two premium quotes from priminfo.admin.ch for the same insurer and model at, say, franchise CHF 300 and franchise CHF 2,500. Suppose the annual premium difference is 'D' francs — i.e. you save D per year on premium by picking the high franchise. Your extra risk is (2,500 − 300) = 2,200 francs of self-paid care plus 10% coinsurance up to CHF 700 above that. Break-even in expected annual medical spend is the point where D equals the extra out-of-pocket. If you consistently spend below that point, the high franchise wins over the year. Do the maths with the real premiums quoted for your region and age — do not rely on illustrative numbers, since premiums are re-set each year.
The four insurance models in practice
Standard: unrestricted access; highest premium; useful if you already have a specialist relationship. Family-doctor (Hausarzt / médecin de famille): you always start with your registered GP; roughly 10–15% cheaper. HMO: you are tied to a specific group practice or health centre; roughly 15–20% cheaper but requires living near the centre. Telmed: you call a medical hotline first for triage; similar savings, best for digital-first users. In every model, emergencies bypass the gatekeeping rule.
Common mistakes newcomers make
Choosing the highest franchise while pregnant or with a chronic condition — you almost certainly hit the CHF 2,500 plus CHF 700 cap and pay more overall than at CHF 300. Forgetting to suspend accident cover once you start a job of 8+ hours/week with the same employer (UVG/LAA takes over) — you end up paying twice. Cancelling supplementary insurance to save money and then being medically declined by the next insurer. Missing the 30 November switch deadline because notice was sent by normal post — always use registered mail (eingeschriebener Brief / lettre recommandée).
Premium subsidies and regional variation
Even within one canton, premiums differ by up to three regions and by three age bands (child, young adult 19–25, adult). Cantons apply premium subsidies (Prämienverbilligung / réduction des primes / riduzione dei premi) to lower- and middle-income households under Art. 65 KVG — application is via your canton, not your insurer, and rules and thresholds are set cantonally each year. If you moved recently or your income dropped, re-check eligibility every year.
Your next step
Turn this guide into action — run the numbers for your own situation, then work through the deadlines for your canton.
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Build my free checklistHighest franchise + chronic condition or pregnancy = the worst combination. If you know you will hit the franchise plus the coinsurance cap anyway, the lowest franchise is usually cheaper overall.
If you are employed at least 8 hours per week for the same employer, accident cover (UVG/LAA) runs through your employer and MUST be suspended on your basic insurance — otherwise you pay twice.
Only priminfo.admin.ch is the official federal comparator. Commercial comparators often earn commissions and may hide non-participating insurers.
People also asked
How do I calculate my personal break-even?
Take the annual premium at franchise A and at franchise B from priminfo.admin.ch. The break-even in expected medical spend equals (annual premium at low franchise − annual premium at high franchise) + (high franchise − low franchise). If you expect to spend less than that in a year, the higher franchise wins; if more, the lower franchise wins. Add 10% coinsurance up to the CHF 700 cap on top of the franchise when in doubt.
Can I switch mid-year?
For basic insurance, no — except in narrow cases (premium increase notified by the insurer, moving abroad). The normal switch window closes on 30 November for a 1 January change. Supplementary insurance runs on its own contract terms.
Are premiums the same across my canton?
No. Cantons are split into up to three premium regions (Prämienregion / région de prime), and premiums differ by region and by age band (0–18, 19–25, 26+). Two neighbouring communes can sit in different regions.
What is Prämienverbilligung / réduction des primes?
It's a cantonal subsidy for households with modest income, funded jointly by the federation and cantons under Art. 65 KVG. Application is made to the canton, not the insurer, and eligibility thresholds are set cantonally — check your canton's site each year.
Can the insurer refuse me?
Not for basic cover — insurers must accept every resident regardless of age or health. For supplementary insurance (VVG/LCA) they can decline, require a health questionnaire, or impose exclusions.
Official sources for this guide
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