The term “deductible” is one of the most widely used words in the insurance world, but it is also one of the most misunderstood.
A deductible is a type of out-of-pocket payment. The insurance company only pays covered costs which exceed your deductible. By making claimants pay a certain part of the costs of a claim yourself, insurance companies protect themselves against excessive or abusive claims.
Other variations such as a franchise deductible (the insurance only covers costs which exceed a predefined amount, but it covers these 100%) or a time deductible (the insurer only covers costs after a predefined time-period) are not used in Switzerland.
Swiss insurance providers normally mention the term “deductible” in relation to a fixed amount you are required to pay towards covered costs ahead of receiving insurance coverage, or to a percentage of additional covered costs which you pay as coinsurance.
In Switzerland, the term always refers to the fixed amount you pay before the insurance takes over, and never to the coinsurance portion of out-of-pocket costs (this is shown as a percentage).
Deductibles play an especially prominent role among Swiss health insurance providers. You will often find deductibles mentioned in relation to compulsory health insurance, hospital insurance, outpatient insurance and pet insurance. With each of these insurance policies, you will likely be required to pay both a deductible and a percentage of subsequent costs as coinsurance.
Basic compulsory Swiss health insurance: Swiss health insurers currently offer six annual deductible options (300, 500, 1000, 1500, 2000 and 2500 francs) for adults and seven options for children (0, 100, 200, 300, 400, 500 and 600 francs). The lowest deductible you can get is referred to as the base deductible.
No matter which deductible model you choose, you are required to pay 10 percent of any covered costs above your annual deductible as coinsurance, up to a maximum of 700 francs per year in coinsurance payments for adults (equal to 7000 francs of healthcare expenses above those covered by your deductible). A maximum annual coinsurance payment of 350 francs applies to children (3500 francs in healthcare expenses above what is covered by the deductible).
The deductible and the coinsurance limits apply on a per-calendar-year basis. The date of treatment, rather than the billing date, is used. The examples here help explain how to go about choosing the right deductible for your compulsory health insurance policy.
While deductibles and coinsurance amounts are identical across compulsory health insurance policies, they can vary widely on other insurance types. On pet insurance policies, for example, deductibles and coinsurance limits differ between insurance providers and products.
Here to, moneyland.ch can help you find the best-value policy: The pet insurance comparison automatically calculates the most affordable insurance option for the estimated healthcare costs.
The moneyland.ch team
More on this topic:
Health insurance deductible calculator
Health insurance comparison
Swiss pet insurance: compare premiums and services
Health insurance deductibles: getting it right
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