I'm shopping around for insurance and I'm familiar with the franchise (deductible) in the US system, but haven't been able to find much info on how the Swiss do it. For instance, I know there is a compulsory 300CHf franchise for the year per adult. Is the franchise only used when hospitalization occurs? What does a patient pay for a standard doctor's appointment? What about prescriptions?

Also, do I, as an employee need to be covered for accidents, or is that covered by my accident insurance that the employer provides?

The 300 applies to any medical expense. Depending on your policy, you might also have to bear 10% of the costs once you bust the franchise treshold

Employer if you work more than 8h a week.

Krankenkassen Prämien vergleichen, Wohnung und Immobilien finden, Hypotheken Börse.

can help.


But I would suggest you to use the search option in EF.

I have searched on here, but don't get too much detail on how the nuances of franchises. For instance, in the US (and I know we have one messed up system, but it's the one I know). I have a $1500 deducatble currently, but the deductable doesn't come into play when I see my General Practitioner for a "normal" appoitment EG I have the flu. I give a $20 "co-pay" and the insurance company covers the rest. If I need some other medical treatment or tests, like X-rays, MRIs, etc. That's when the deductable kicks in. If I get a 1500CHf franchise, do I need to pay that 1st regardless of what expenses occur (check-up, prescriptions, etc)?

P.S. I have checked Comparis too. Also no great detail.

Exactly. You will pay all expenses up to CHF 1500 by yourself. In addition you will have to pay 10% "Selbstbehalt" of any expenses exceeding the franchise. The Selbstbehalt is capped at CHF 700 p.a., e.g. if you select the CHF 1500 franchise, you'll end up paying CHF 2200 p.a. in the worst case, i.e. if the annual expenses amount to CHF 8500 or more.

Is there anything that's exempted (or included, depending on how you look at it)? For example: a woman needs to visit the OB-GYN at least 10 times during pregnancy. In a situation like that it seems that if one has to pay their franchise for any medical care at all, they would choose the lowest franchise. In my current insurance in the US pregnancy was kind of a "special circumstance" that didn't impact the deductable. So, and I know I repeating a question that has probably been answered: are there any circumstances that are considered exempt/included where the franchise is not considered? Like pregnancy, an annual check-up?

Sorry to beat a dead horse. I'm just trying to get my brain wrapped around it.

No special circumstances as far as I'm aware of. Might want to check your policy details but in general everything impacts the deductible.

Thanks. I guess I'm done asking this question now.

Me and my wife have a 1500 CHF Franchise, basic insurance. My wife got pregnat, insurance paid everything, excluding some vitamins.

In Switzerland pregnancy and birth is covered by the insurance companies(or Govt) and it doesn't goes into your franchise. Our all medical bills (including hospital bills) are paid without touching the Franchise.
But there is a restriction of time means you have to be insured for more than 9 months (depend on the insurance companies).

Rats. You guys just contradicted everything Shorrick said. However, it was good news, so you're given a pass.

Next question: mind if I ask what scheme you guys are in; what scheme covers the pregnancy, or is it all of them?

Thanks for the good news!

did you see these
Health Insurance FAQs
Medical Insurance
Health System in CH and insurance

Sorry, not being of the fair sex i tend to not think of the maternity exception so as I speedread your post I zapped straight to annual checkup.

For normal pregnancies you will get 2 echographies and eight exams, seven before, one after; also giving birth fees.

I had seen one of them. Very helpful though, thanks for the info.