In Switzerland, when you sign up with a health insurance provider, you have to choose a deductible. It’s not the same as in Spain. The excess is the amount you pay out of your own pocket before the health insurance provider starts covering your medical expenses. There are six possible levels: 300, 500, 1,000, 1,500, 2,000 and 2,500 francs a year.
The logic is simple: the higher the excess you choose, the less you pay in monthly premiums. The difference between the minimum of 300 francs and the maximum of 2,500 francs amounts to around 1,500 francs a year in premiums. If you choose 2,500 francs and rarely visit the doctor, you’ll save up to 1,500 francs a year compared with someone who has a low excess. However, if at any point your medical expenses exceed 2,000 francs a year, the 300-franc excess works out cheaper overall. The break-even point, according to Swiss advisers, lies between 1,500 and 1,720 francs in annual medical expenses, depending on the canton and the health insurance provider.
The most common mistake has two aspects. Firstly, many newcomers opt for the 300-franc cover ‘just in case’ and end up paying high premiums for years whilst only visiting the doctor once or twice a year. The second: choosing an intermediate excess of 500, 1,000, 1,500 or 2,000 francs, which, mathematically speaking, are almost always the worst options because the discount on the premium does not offset the risk. Industry experts are clear on this: for most people, only the two extreme options – 300 or 2,500 – are truly optimal.
The deadlines for changing your excess are: before 30 November to increase it, and before 31 December to reduce it. The change takes effect on the following 1 January. You cannot change it mid-year, even if you fall ill. One more thing: the Federal Council is considering raising the minimum excess from 300 to 400 francs, but this has not yet come into force. For 2026, the current rules still apply.