deductibles switzerland health insurance

Health Insurance Deductibles: Getting It Right

Obligatory health insurance policies in Switzerland come with different deductible options. This moneyland.ch guide will help you choose the right deductible for your needs.

Adults over 26 years old and young adults between the ages of 19 and 25 years old can choose between 6 different deductible tiers: CHF 300, CHF 500, CHF 1000, CHF 1500, CHF 2000 and CHF 2500.

Policies for children and adolescents under the age of 18 may have one of seven deductible tiers: CHF 0, CHF 100, CHF 200, CHF 300, CHF 400, CHF 500 and CHF 600. The lowest deductible you can pay is sometimes called the base-deductible.

Aside from the base-deductible, insurers are not obligated to offer all of the other deductible tiers. Availability of different deductible tiers may vary depending on the insurance provider and the region in which you live.

The multiple tiers for deductibles are often criticized as being overly-complicated, and the criticism isn’t completely unfounded.

Deductibles and co-payments

A deductible is a fixed out-of-pocket expense: You pay the costs of all medicines and visits to hospitals or doctors up to the annual deductible limit every year.

Additionally, all medical costs above your selected deductible are subject to a 10% out-of-pocket payment.

Fortunately, combined 10% co-payments are limited to 700 francs per year for adults and 350 francs per year for children. So aside from your deductible, you will never have to pay more than that amount out of your own pocket each year.

Exception for hospitals: Policyholders over the age of 26 are required to make an additional CHF 15 out-of-pocket daily payment towards the costs of accommodation and care. This expense does not apply to maternity cases.

How the deductible system works

Here’s an example of how deductibles work: Let’s say you have a deductible of CHF 2500 and you receive treatment valued at CHF 5500 within a single calendar year. The CHF 2500 deductible must be paid out of your own pocket. On top of that, you pay 10% of the remaining CHF 3000, or CHF 300, out-of-pocket. So your insurer pays out benefits totaling 2700 francs towards your 5500 franc medical expenses.

Choosing the right deductible

Choosing the right deductible is made more complicated by the fact that your deductible has a major impact on the insurance premiums you pay. The higher the deductible you choose, the lower the premiums you pay, as a rule.

The logic is simple: The more you are prepared to pay towards medical expenses out of your own pocket, the higher the discount you will receive from the health insurance company.

This example makes it easier to understand: A low-cost adult insurance policy offered by a specific health insurer costs CHF 360.40 per month with a CHF 300 deductible, but the same policy only costs CHF 232.10 francs per month with a CHF 2500 deductible.

The difference comes to a whopping 128.30 francs per month, or CHF 1539.60 per year. In this case, the 300-franc deductible only pays off if your medical expenses reach CHF 2013 or more per year. When calculating the savings potential of different deductible models, make sure to account for the 10% out-of-pocket costs as well.

Compare deductibles using a neutral calculator

To help you bypass the complicated calculation process, the unbiased health insurance policy comparison from moneyland.ch includes a practical tool. This automatically calculates the best deductible model for each insurance policy based on your projected health care costs. The optimal deductible for each policy is shown on the results page. Just choose “optimal deductible” from the “deductible” dropdown under “insured persons” on the “your data” page.

With the health insurance deductible calculator, you can calculate the costs and benefits of different health insurance deductible models.

Best deductible: Rule of thumb

In most cases, there are only two deductibles worth bothering with: If your healthcare costs are high, the base deductible is generally the cheapest solution. If your healthcare costs are low, the highest deductible is usually the cheapest option. This rule applies both to adults and to children. All other deductibles are normally less than optimal, regardless of your health.

In 2018, the following guideline applies for adults (including young adults): On average, the CHF 2500 deductible is the most affordable option for people with medical expenses of up to CHF 1900 per year.

For those with medical costs above CHF 1900, a CHF 300 deductible usually makes more financial sense. But depending on the policyholder, a CHF 300 deductible can work out cheaper for those with annual medical expenses as low as CHF 1350 or more expensive for those with medical costs as high as CHF 2012 per year.

The following applies to children’s policies in the 2018 premium year: The CHF 600 deductible can work out cheaper for medical costs of up to CHF 380 on average. Annual medical expenses higher than that amount make a CHF 0 deductible (no deductible) policy the most affordable choice in most cases. Depending on your profile as a policyholder, annual medical expenses as low as 137 francs can already make a CHF 0 deductible worthwhile.

Which deductibles are most popular in Switzerland

In Switzerland, more than 90% of children are insured with the base-deductible (CHF 0). Around 47% of young adults choose the base deductible (300 francs), followed by the highest deductible of CHF 2500 being used by 23% and the CHF 1500 deductible chosen by around 14%.

Among adults, the share of deductibles looks somewhat different: 43.8% (CHF 300), 15.4% (CHF 500), 4.6% (CHF 1000), 11.9% (CHF 1500), 3.9% (CHF 2000), 20.5% (CHF 2500). The share of deductible tiers used varies slightly depending on the insurance model in question.

Deductible: How to change it

Changing your deductible is easy. You can adapt your deductible (higher or lower) every year. Just make sure to pay attention to notice periods: Deductibles take effect on January 1 each year, so you will have to send your insurer a written request well ahead of that.

Conclusion: Remember that the highest and lowest deductibles are normally the best options financially speaking. All other deductibles do not generally offer optimal value for money.

More information:
Health insurance deductible calculator
Health insurance comparison tool

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