How does co-payment work in the Swiss healthcare system?

22 September 2025

In Switzerland, insured persons contribute to healthcare costs in the form of an excess, a deductible and a hospital contribution. The amount of your monthly premiums and how much you have to pay yourself in the event of illness depends on the amount of your selected excess. Below, we explain the role these three terms play and what they specifically mean for you – including a simple example.

Under compulsory basic insurance in Switzerland, co-payment consists of three key elements:

1. Excess: A fixed amount that the insured person chooses each year and pays themselves before the benefits are covered by the health insurance company. The statutory minimum excess is CHF 300 for adults, the maximum is CHF 2,500; for children, it ranges from CHF 0 to CHF 600.
2. Deductible: Once the excess has been reached, insured persons pay 10% of the further costs, up to a maximum of CHF 700 per year (children: CHF 350)
3. Hospital cost contribution: In the event of an inpatient hospital stay, a statutory contribution of CHF 15 per day is payable, except for children under the age of 18, young adults up to the age of 25 in education and pregnant women (from the 13th week of pregnancy to eight weeks after giving birth).

This regulation is enshrined in law in the Federal Health Insurance Act (HIA) and applies to everyone with basic insurance.

The higher the excess you select, the lower the monthly insurance premium and vice versa. If you expect fewer medical benefits, you can save money with a higher excess; if healthcare costs are expected to be higher, it makes sense to have a lower excess.

Luke, 27, comes from Canada to Lausanne for an exchange semester. When taking out health insurance, he opts for an excess of CHF 500 with coverio because he thinks: “If something does happen, I don’t want to pay too much.”
Everything is going well – until he breaks his wrist while snowboarding in winter. After the fall, he goes to hospital, where there are X-rays, a plaster cast, painkillers and a two-night inpatient stay for observation. The total bill: CHF 1,700 for medical treatment plus CHF 30 hospital contribution (CHF 15 per day).

What effect does the co-payment have?
• Luke first pays his excess of CHF 500.
• Of the remaining CHF 1,200 he pays 10% as a deductible – which is CHF 120.
• There is also the CHF 30 hospital contribution.

In the end, Luke has to pay CHF 650 out of his own pocket. The rest – more than CHF 1,000 – is covered by health insurance.

For Luke, the decision to opt for a low excess was the right thing to do in retrospect – the costs for him were manageable and he was able to focus on his recovery rather than on his finances.

The excess is not a complex insurance detail, but rather a clearly defined personal contribution. If you understand the system, you can consciously decide how much risk you want to bear yourself – and avoid any unpleasant surprises.