Health insurance deductible in Switzerland: how to choose between CHF 300 and CHF 2,500

The LAMal deductible is the simplest lever for adjusting your annual health insurance premium. The right choice depends on your health, your income and your tolerance for financial risk. This guide explains how to calculate the break-even point and choose between the six available levels.

At a glance

Adult deductibles range from CHF 300 to CHF 2,500 (levels: 300, 500, 1,000, 1,500, 2,000, 2,500).
The higher the deductible, the lower your monthly premium — but the more you pay out of pocket when you need care.
On top of the deductible, you pay a 10% co-payment on costs, up to CHF 700 per year (CHF 350 for children).
You must notify your insurer of any deductible change before 30 November for it to take effect on 1 January.

What you need to understand

The LAMal system works in three financial layers each year:

The monthly premium you pay regardless of how much care you use.
The deductible you pay out of pocket for your first medical costs of the year.
The co-payment: 10% of medical costs above the deductible, capped at CHF 700 per year (CHF 350 for children).

Example for an adult with a CHF 1,000 deductible who has CHF 3,500 in medical costs during the year:

The first CHF 1,000: your responsibility (deductible).
The next CHF 2,500: 10% your responsibility = CHF 250 (co-payment).
Total out of pocket: CHF 1,250, plus the monthly premium.

Beyond roughly CHF 8,000 in annual costs, the co-payment hits its cap of CHF 700 and all further costs are fully covered.

How to calculate your break-even point

The idea is straightforward: at what point does the premium saving offset the higher deductible?

Quick method

Note your current annual premium (deductible CHF 300).
Note the annual premium with the deductible you are considering.
Annual premium difference = X CHF.
Maximum extra cost from the higher deductible = new deductible – 300.
You come out ahead if your annual medical costs are lower than: new deductible – X.

Worked example

Premium at CHF 300 deductible: CHF 4,800 per year.
Premium at CHF 2,500 deductible: CHF 3,600 per year.
Difference: CHF 1,200 per year.
Maximum extra deductible cost: 2,500 – 300 = CHF 2,200.
You come out ahead if your costs are below CHF 1,300/year (2,500 - 1,200).
You lose out if your costs exceed CHF 1,300/year.

In other words: if you are in good health and spend less than this threshold, the high deductible pays off.

Typical profiles

CHF 2,500 deductible (the highest)

Generally good health.
No regular treatment or chronic medication.
Ability to pay CHF 3,200 (deductible + maximum co-payment) in the event of an unexpected health episode.
Potential saving: CHF 800 to CHF 1,500 per year depending on canton and insurer.

CHF 1,500 or CHF 2,000 deductible

Stable health, infrequent consultations.
Moderate risk tolerance.
Balance between premium saving and financial exposure.

CHF 500 or CHF 1,000 deductible

A few consultations per year, occasional treatments.
The most common profile.

CHF 300 deductible (the lowest)

Regular care, chronic medication.
Ongoing or planned pregnancy.
Elderly person or someone in recovery.
Known chronic illness.

Special situations

Pregnancy

Maternity-related costs are fully covered with no deductible or co-payment from the 13th week of pregnancy.
Outside maternity care, medical costs remain subject to your usual deductible.
If you know you will be pregnant the following year, it is not the right time to raise your deductible.

Children

Deductible: CHF 0 (default option) up to a maximum of CHF 600.
Co-payment capped at CHF 350 per year per child.
For families with several children, cumulative caps apply.

Young adults (18 to 25)

Same levels as adults, but significantly lower premiums.
The high deductible is very often worthwhile at this age.

Alternative insurance models

In addition to the deductible, you can switch model to reduce your premium further:

Family doctor model (HausarztModell): you consult your GP first, who refers you on if needed. Saving 10 to 15%.
Telmed (telephone first): you call a medical advice centre before any consultation. Saving 10 to 20%.
HMO (Health Maintenance Organization): you are linked to a specific medical centre. Saving 15 to 25%.
Pharmacy-first model: a less common model where you go through a partner pharmacy for initial advice.

The standard model (free choice of doctor) is the most expensive but the most flexible.

Changing your deductible or model

Notify your insurer by registered letter before 30 November.
The change takes effect on 1 January of the following year.
You do not need to switch insurer to change your deductible or model.
If you miss the deadline, you remain on your current deductible and model for the entire following year.

Common mistakes

Choosing a high deductible without a financial buffer. If you cannot advance CHF 3,200 in the event of an unexpected episode, the risk is real.
Keeping the CHF 300 deductible out of habit. If you have been in good health for years, you are probably overpaying.
Comparing only the premium without factoring in the insurance model. A family doctor model with a mid-range deductible can be more advantageous than the maximum deductible with free choice of doctor.
Confusing the deductible and the co-payment. The co-payment is additional, but it is capped at CHF 700 (CHF 350 for children).
Forgetting the 30 November deadline. No exceptions if you send your letter on 5 December.

Comparing premiums

Use the official comparison tool priminfo.admin.ch, the only independent and comprehensive one.
Simulate several combinations (deductible, model, insurer) to find where your break-even point lies.
Check premiums for each member of your household — the best choices can differ.

Official useful links

ch.ch · Health insurance
FOPH · Compulsory health insurance
priminfo.admin.ch · Official comparison tool
Fédération romande des consommateurs (FRC), helpline 0848 575 105, for disputes with insurers.

How Admini helps

Choosing your deductible is an annual decision that deserves 30 minutes of analysis — provided you have the right documents to hand. Admini helps you:

Centralise your benefit statements, medical invoices and insurance policies.
See your annual medical costs at a glance to calculate your real break-even point.
Receive a reminder every autumn before 30 November to review your deductible and model.
Prepare the change letter to send to your insurer in just a few clicks.

The aim is to turn a decision that is often put off year after year into an informed choice that can save you more than CHF 1,000 a year.