Policyholders’ co-payment takes the form of a deductible, a retention fee and a contribution to the costs of hospital stays.
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
Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Governance Supervision Section
Tel. +41 58 462 21 11