Insureds share the cost of the benefits they receive by paying a deductible, a retention fee and a contribution to the costs of a hospital stay.
Insureds contribute to the cost of the benefits they receive. This contribution comprises:
- Standard deductible: CHF 300.00 per year; children and adolescents under 18 years of age are exempt from the standard deductible. Optional higher deductibles may be chosen for insurance models with lower premiums (optional deductible).
- A retention fee of 10 % of the costs exceeding the deductible, but only up to a maximum amount of CHF 700.00 per year (CHF 350.00 for children and adolescents under 18).
- Contribution to the costs of a hospital stay of CHF 15.00 per day (with no time limit). Children and adolescents under 18 years of age, young adults (up to the age of 25) in training and women receiving maternity benefits are exempt from the hospital contribution.
Benefits exempt from cost sharing
Certain benefits are exempt from cost sharing:
- Specific maternity-related services, such as check-ups during and after pregnancy (including ultrasound scans), childbirth, obstetric care, antenatal classes and breastfeeding advice.
- From the thirteenth week of pregnancy and until eight weeks after the birth, women are not required to share the cost of general medical services or care in the event of illness. This exemption from cost sharing also includes the cost of treatment not related to pregnancy (see also the FAQs on services during maternity).
- Certain designated preventive measures are also fully covered.
Higher retention fee for certain medicines
A retention fee of 20% is applied to certain medicines. This provision does not apply if the doctor specifically requests an original product for medical reasons.
Last modification 03.07.2018