The deductible is the fixed annual amount that insured persons pay towards their treatment costs. The deductible ranges between CHF 300 and CHF 2,500 per calendar year. The lower your deductible, the higher your monthly premium, but the lower your cost share will be.
Insureds can choose one of the following deductibles for basic insurance. The amount of the deductible influences the amount of the health insurance premium. You can opt for a higher deductible to benefit from attractive premium discounts.
| Children | 0 | 100 | 200 | 300 | 400 | 500 | 600 |
|---|---|---|---|---|---|---|---|
| Adult | 300 | 500 | 1,000 | 1,500 | 2,000 | 2,500 |
Children and adult deductibles (in CHF)
You are free to choose your deductible. Both a high and a low deductible can be financially worthwhile.
You can choose a new deductible for basic insurance each year. You can change your deductible for basic insurance without a health check and regardless of your state of health and ongoing medical treatments.
If you want to reduce your deductible, your notification must reach Sanitas by 30 November. Requests to increase your deductible must reach Sanitas by 31 December. Your deductible can only be changed with effect 1 January of the following year.
You can change the deductible for your basic insurance quickly and easily yourself in the Sanitas Portal. Interested? Sign up now to get started straight away. Or you can change your deductible on our website.
The deductible is the insured person’s contribution to healthcare costs. Once this amount has been exhausted, the health insurance company covers 90% of the costs under basic insurance. Insureds have to pay the remaining 10% of the costs. This cost share is known as the copayment.
You pay a copayment as soon as your chosen deductible is exhausted. From this point, insured persons pay 10% of their treatment costs, up to a maximum of CHF 700 per year (children up to CHF 350). This cost share is known as the copayment.
The copayment is 10%. For original drugs for which a generic is available, the copayment is 40%.
The maximum copayment per year is CHF 700 for adults and CHF 350 for children. Once more than two children in a family are insured with the same company, the copayment is limited to CHF 700 for all children.
The copayment for generic drugs is usually 10%, compared to 40% for original drugs.
The higher copayment for original drugs does not apply:
You can use the Sanitas Generic drug finder to find out whether you have to pay an increased copayment for your medication.
The hospital copayment is an additional cost share incurred during a hospital stay. Adults aged 18 and over who are not in education and aren’t receiving maternity benefits pay CHF 15 per day towards the cost of their stay. More information about the hospital copayment.
Health insurers do not apply a deductible or copayment to maternity benefits. This means that during pregnancy, no deductible is applied to maternity-related benefits. For health insurance purposes, maternity begins at the 13th week of pregnancy and ends eight weeks after the birth. This also applies to illnesses and complications related to pregnancy and the birth.
Important: Let Sanitas know in good time if you are pregnant so that you are not charged the deductible and copayment. You will find a wealth of information on maternity topics here.