Like anywhere else in the world, the Swiss Insurance system too, has its own set of regulations and structure. Whether you are new in Switzerland, planning to move here or considering switching to a different Insurance provider, it’s good to know the essentials and ground rules.
We have put together a few common concerns and questions that give you an overview of the Swiss Insurance Franchises and deductibles.
1. What does the term franchise mean?
Franchise is an annual amount, which the insured person must bear as part of the incidental health or cure costs from the age of 19 years. The franchise is therefore considered a kind of deductible. The insurance takes over only if the costs exceed the agreed franchise. Thereafter, the health or cure costs are covered by the insurance deducting any deductible.
2. When do I agree on the amount of the franchise and when can I adjust it?
The franchise is agreed upon completion of the policy. This can be adjusted for the following year. However, this must happen prematurely, observing the change periods. Thus, a change of the franchise is possible every year.
3. Which franchise models are available?
In Switzerland, the legally regulated franchises apply to all and are offered by all health insurance companies. The lowest franchise is CHF 300 a year. The following franchises are available per calendar year: CHF 300, 500, 1000, 1500, 2000 or 2500.
It is generally accepted that the monthly health insurance premium will be lower if the highest franchise is agreed. On the whole, however, this is only advisable if you rarely visit the doctor.
4. What does deductible mean?
Once the franchise amount is reached, you pay 10% of the medical costs. This also applies to children in the family. However, there are exceptions. Maternity benefits and certain medical prevention measures are exempt from franchise and deductible.
5. Is the amount of the deductible limited?
The limit of the deductible for children is a maximum of CHF 350 for cure costs per year. However, adults pay up to a maximum of CHF 700.
6. Do you have to pay the deductible for a franchise as a pregnant woman?
When you are pregnant, the benefits of maternity apply. There is no franchise or deductible for the basic insurance.
7. What about an accident? Do you pay a deductible?
You also pay a deductible at the health insurance, as long as the accident insurance is included. For persons insured for accident insurance, other provisions apply.
If you have any other questions or queries specific to your requirements, our advisors would be hear you out and help. Book your free appointment today.