Health insurance: Co-payment for persons resident in Switzerland

Policyholders’ co-payment takes the form of a deductible, a retention fee and a contribution to the costs of hospital stays. 

Co-payment

Services are subject to co-payment by policyholders. This comprises:

  • Standard deductible: CHF 300 per year (children and adolescents under 18 are exempt). For insurance models with reduced premiums, optional higher deductibles may be chosen.
  • A retention fee of 10% of the costs exceeding the deductible, up to a maximum of CHF 700 per year (CHF 350 for children and adolescents under 18).
  • Contribution to the costs of a hospital stay: CHF 15 per day (with no time limit). Children and adolescents under 18, young adults up to the age of 25 in education/training, and women receiving maternity-related services are exempt.

Services not subject to co-payment

Certain services are not subject to co-payment:

  • Specific maternity-related services, such as routine examinations during and after pregnancy (including ultrasound scans), childbirth, obstetric care, antenatal classes and breastfeeding consultations.
  • From the 13th week of pregnancy until 8 weeks after childbirth, women are exempt from co-payment for general medical services. This includes the costs of treatment for non-pregnancy-related illness.
  • Certain preventive measures are also fully covered.

Increased retention fee for certain medicines

A retention fee of 20% is applicable for certain medicines, except in cases where a branded product is specifically prescribed by a physician for medical reasons.

Last modification 30.04.2020

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Contact

Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Governance Supervision Section
Schwarzenburgstrasse 157
3003 Berne
Switzerland
Tel. +41 58 462 21 11
E-mail

Print contact

https://www.bag.admin.ch/content/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherte-mit-wohnsitz-in-der-schweiz/praemien-kostenbeteiligung/kostenbeteiligung.html