An unexpected visit to the emergency room, a physiotherapy that takes a long time or a planned treatment can completely change the response to high versus low deductible. It's not just about paying less each month. It's about deciding how much of the health risk you want to take on and what part you prefer to cover through a higher premium.
In Swiss compulsory basic insurance , the legal coverage is the same regardless of the deductible you choose. What changes is the distribution of costs during the year. A higher deductible usually reduces the monthly premium, but raises the amount you pay out of pocket before the insurance starts participating. A low deductible does the opposite.
The right decision isn't universal. It depends on your likely use of medical services, your ability to take on an unexpected expense, and the actual difference in premium between the options available in your region.
What the excess means in basic insurance
The deductible is the annual amount of covered medical costs that you pay first on your own. For adults, the usual options are 300, 500, 1,000, 1,500, 2,000, and 2,500 francs. The minimum deductible of 300 francs is usually considered low; the 2,500 francs is high.
Once the excess has been reached, not all payments disappear. As a rule, you continue to bear 10% of the subsequent costs, up to an annual maximum of 700 francs for adults. In addition, in the event of hospitalization, a daily contribution may be applied to the stay, except for exceptions provided for by law, such as maternity.
This explains a common mistake: thinking that a 300 franc franchise automatically limits the annual expenditure to 300. In reality, this is only the first tranche of personal participation. The premium, the deductible, the 10% fee and a possible hospital contribution are part of the total cost.
In the case of minors, the deductibles start at 0 francs and the maximum subsequent participation is also lower. That is why it is advisable to review the decision of each family member separately. The right choice for a healthy adult does not have to be the best for a child who needs recurrent controls or therapies.
High vs. Low Franchise: The Real Difference
The useful comparison does not start with the question "which is cheaper?", but with this: "in what scenario would I pay more during the year?". The answer requires adding up your own premium and expenses, not looking at a single number.
With a high deductible, you agree to cover a larger part of the medical expenses if you need them. In return, the premium is usually lower. This alternative may fit if you are in good health, use few covered benefits and have enough liquidity to face several thousand francs in a difficult year.
With a low deductible, you pay a higher premium to limit your exposure to medical expenses sooner. It usually provides more predictability to those who have regular treatments, ongoing medication, planned pregnancy, monitoring of a chronic illness or a reasonable probability of needing care during the year.
However, having a medical condition does not always require you to choose the minimum deductible. It depends on the expected cost covered, the difference in premiums, and whether certain treatments are already fully defined. Similarly, being healthy does not automatically make the deductible of 2,500 francs the best option. An accident or an unexpected diagnosis can happen, and the relevant question is whether that risk really fits into your budget.
A simple example of calculation
Imagine two options with the same insurance model. The first has a deductible of 300 francs and an annual premium of 5,400 francs. The second has a deductible of 2,500 francs and an annual premium of 4,500 francs. The difference in premium is 900 francs per year.
If your covered medical expenses are 200 francs, you will pay those 200 with either of the two deductibles. In this scenario, the high option may be cheaper because of the lower premium.
If the expenses covered reach 1,000 francs, with the low franchise you would pay 300 francs for the franchise and 70 francs for the 10% fee. With the high deductible you would pay the full 1,000 francs, because you would not have reached 2,500 francs yet. The advantage of the lower premium is significantly reduced.
If the expenses go up to 3,000 francs, the difference is even more visible. With a 300 franchise, you would assume 300 francs plus 10% of the remaining 2,700, i.e. 570 francs before considering other applicable amounts. With a 2,500 allowance, you would pay 2,500 plus 10% of the remaining 500: 2,550 francs. In that year, the 900 francs saved in premium would not make up the difference.
These numbers are illustrative. Premiums change by insurer, canton, premium region, age, insurance model, and accident coverage. But they show why an honest comparison needs scenarios and not generic promises.
How to Choose a Franchise Without Guessing
Start by reviewing the last one or two years. Not to assume that the next one will be identical, but to recognize patterns: frequent consultations, specialists, medications, diagnostic tests, physiotherapy or treatments already prescribed. Then, separate the foreseeable from the exceptional.
Next, calculate the annual premium difference between two deductibles you're considering. Don't use a guideline figure. Use the specific premium for your profile and area of residence. In Switzerland, the same insurer may apply different premiums depending on the region, so moving municipalities or cantons deserves a specific review.
The third step is to define your financial cushion. If you choose a high deductible, you should be able to pay the full deductible without going into debt or committing essential expenses. Having that amount available doesn't mean you're going to spend it, but it prevents a health issue from becoming a liquidity problem as well.
Finally, include the insurance model in the analysis. Telmed, GP, HMO and standard model can modify the premium and access to care rules. A high deductible with a model that doesn't fit with how you receive care can create friction precisely when you need help. The savings should be compatible with a care route you can follow.
Errors that make the decision more expensive
The first mistake is to compare only the monthly premium. A visible difference of 60 or 80 francs per month seems decisive until it becomes a much higher deductible in a year with medical expenses.
The second is to choose out of fear without quantifying it. A low deductible can provide peace of mind, but it is important to know how much you pay for that additional protection and whether you will use it predictably. Peace of mind can also be built by setting aside a monthly amount for health expenses.
The third is to confuse the excess with the coverage. In basic insurance, the benefits defined by law do not change by choosing 300 or 2,500 francs. What changes is when and how much you share in the costs. To assess differences in service, review the model, contact processes and service experience, not just the excess.
The calendar also deserves attention. The deductible is applied per calendar year and the possibility of modifying it is subject to deadlines. In general, reducing it requires notice before increasing it. Always confirm the deadline with your insurer and keep a written confirmation of the request.
A personal decision, based on verifiable data
The best choice combines numbers and personal reality. If you anticipate low expenses, have reservations and agree to assume variations, a high deductible can be consistent. If you anticipate recurring costs or prefer less exposure to unforeseen events, a low deductible can offer a safer balance.
A neutral comparison should show the premiums, model, region, and rules of participation clearly. Lamalux® organizes verified public data into a visual experience so you can understand what's behind each amount, without sponsored rankings or unsolicited business contact.
Before confirming your next policy, do a simple test: calculate the annual cost in a quiet year and in a year with relevant expenses. The right deductible will be the one you can sustain in both scenarios with clear information and without pressure.