Swiss Health Insurance Calculator

Work out how a franchise choice affects your yearly health costs under Switzerland's mandatory insurance system.

Every resident of Switzerland must take out basic health insurance (LAMal/KVG) within three months of arrival, and one of the first decisions you face is the franchise, the annual amount you pay yourself before your insurer starts covering costs. Our Swiss health insurance calculator helps you see how different franchise levels change your likely yearly outlay, so you can compare options before you call an insurer.

The tool below is a planning aid, not a quote. It applies the legal constants of the LAMal system to the figures you enter, but it cannot know your actual premium, which varies by insurer, canton and age bracket, or your real healthcare use for the year ahead.

This is an indicative estimate, not an official decision or advice.

What the franchise simulator calculates

You choose a franchise level and enter an estimate of your expected annual healthcare costs, such as consultations, medication or treatments you already anticipate. The calculator applies the franchise first: you pay these costs yourself up to the chosen amount, and the insurer covers the rest, subject to the cost-sharing rule described below.

The result gives you an indicative total of what you would pay out of pocket for the year, on top of your monthly premium, at each franchise level. Comparing that total against the premium difference between franchise levels is the calculation that actually matters when you choose a franchise, and it is one many new arrivals skip.

The legal constants behind the calculation

Switzerland's basic insurance law sets fixed franchise brackets rather than letting insurers or policyholders set an arbitrary figure. Adults choose among several annual franchise levels, and a lower franchise means a higher monthly premium, while a higher franchise lowers the premium but increases your own risk if you need care.

On top of the franchise, the law adds a cost-sharing rule (quote-part, or Selbstbehalt): once you have paid your franchise, you still contribute 10 percent of further costs during the year, up to an annual cap. Children are covered by the same basic insurance obligation but sit on a different, lower franchise scale, and their cost-sharing cap is also lower than the adult one.

Structure of the LAMal franchise and cost-sharing system (illustrative structure, not a quote)
Element	How it works
Adult franchise	A fixed annual amount you pay yourself before insurance cover starts, chosen from the brackets set by federal ordinance
Child franchise	A separate, lower set of brackets applies to children under 18, and a franchise of zero is available for children
Cost-sharing after the franchise	You contribute 10 percent of costs above the franchise, until you reach the annual cap
Annual cap on cost-sharing	A fixed ceiling applies per year for adults, and a lower fixed ceiling applies for children
Hospital daily contribution	A separate fixed daily amount can apply for adults during a hospital stay, with exemptions for children and young adults in training

If you expect low healthcare use in your first year in Switzerland, a higher franchise usually reduces your combined premium plus out-of-pocket cost. If you have ongoing treatment, chronic medication or a pregnancy planned, model the lowest franchise as well before deciding.

What the calculator cannot tell you

Premium amounts themselves are not fixed by law: they are set by each insurer, per canton, per age group and per insurance model, and they change every year. The calculator works from the franchise and cost-sharing structure you enter or select, not from a live premium database, so it cannot recommend an insurer or predict next year's premium for you.

It also cannot account for your personal medical history, family planning, or the alternative insurance models, such as a family doctor or telemedicine model, which can lower your premium independently of the franchise you choose. These factors matter as much as the franchise itself when the total cost of a policy is what counts.

It does not compare insurers or fetch real premium quotes
It does not account for supplementary (complementary) insurance, which is optional and separately priced
It does not model mid-year changes of insurer, franchise, or insurance type
It does not replace the official premium comparison tools

Choosing a franchise and an insurance model that fit your actual situation, and coordinating basic and supplementary cover with your other insurance needs on arrival, is exactly the kind of decision our consultants help you work through case by case.

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When to revisit your franchise choice

In Switzerland, the franchise for the following year is normally chosen once a year, with a change request due by a fixed deadline set by your insurer under federal rules, typically toward the end of the calendar year for cover starting the following January. Changing insurer follows a separate deadline and notice period.

It is worth rerunning the calculation whenever your situation changes materially: a new pregnancy, a chronic diagnosis, a child reaching adulthood, or simply a year where your actual costs turned out very different from what you assumed the year before.

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Frequently Asked Questions

What is a franchise in Swiss health insurance?

The franchise is the fixed annual amount you pay yourself for healthcare costs before your mandatory basic insurance (LAMal) starts reimbursing. You choose your franchise level from brackets set by federal ordinance, and a higher franchise typically lowers your monthly premium but raises what you pay if you need care during the year.

Is basic health insurance compulsory for everyone living in Switzerland?

Yes. Anyone taking up residence in Switzerland must take out basic health insurance (LAMal/KVG) with a recognised insurer, generally within three months of arrival, with cover then applying retroactively to the date you took up residence. This applies to employees, self-employed people and non-working residents alike, subject to specific exemption rules in limited cases.

Can I choose a different franchise for each family member?

Yes. Each person insured under LAMal, including each child, has their own policy and can be assigned a different franchise. Adults and children use separate franchise scales, and insurers often apply reductions when several children in the same family are insured with them.

Does a higher franchise always save money?

Not necessarily. A higher franchise lowers your premium, but if your actual healthcare costs exceed the premium saving during the year, you pay more overall. Comparing the premium difference between franchise levels against your realistic expected healthcare use, rather than the franchise amount alone, is what determines whether it pays off.

What happens once I reach my franchise for the year?

Once your costs pass the franchise, LAMal covers further costs but you still contribute 10 percent of them as cost-sharing, up to an annual cap that is lower for children than for adults. After that cap is reached, covered costs are reimbursed in full for the rest of the calendar year.

Where can I compare actual insurer premiums for my canton?

The Federal Office of Public Health publishes an official premium comparison tool covering all recognised insurers by canton, region and franchise level. Our calculator helps you reason about the franchise trade-off itself; for a binding premium figure, the official comparison tool or a direct insurer quote is the reliable source.

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A consultant will get back to you within 24 hours on business days, with no obligation. Your data is treated confidentially.