Is the 2500.- CHF a federal upper limit for the deductible in health insurance companies?
Is there any way to pay less monthly premium for the expense of higher deductible, say 3500, or even more?
Thanks
Hello
No, 2,500 is the max. And be aware that having that high a deductible means you have to pay out that 2,500 before the insurance will kick in. So while your premiums may be lower you could have to cough up money for longer before the insurance takes over if you do become ill and need a doctor/hospital.
Yes, Medea Fleecestealer is right.
Some people hope to save as much as possible on their monthly premiums, without understanding that the deductible (called "Franchise" in German), is the first slice that every insured has to pay. Increasing the Franchise should be done only when one is, month by month, saving that amount so as to have a little pot instantly ready for any medical treatment.
@ghasemi, perhaps you know that already. If not, you might like to look at the first 6 paragraphs of this post, which explain something about the slice an insured person will have to pay out of his/her own pocket.
I have had the 2500 deductable for a long time, I've rarely (3 times in 20 years) gotten close to or above it, saves me 200 a month or so.
Tom
Yes, it very much depends on what your personal health situation is like. If you rarely need to see a doctor or go to hospital then it may well be worth doing. If you’re on regular medication though (you can’t be refused cover for pre-existing conditions), then it may be better to have a lower deductible so that the insurance takes over the medication costs sooner.
Yes. Also if you engage in high-risk sports, or if you are genetically predisposed to developing particular conditions.
And most especially if your budget is that tight that you cannot, in fact, afford to set that first Fr. 2500 aside in the first place, as well as to replenish those savings each time you dip into your Medical Savings, i.e. keep the fund topped up, in each subsequent year.
The second aspect after the deductible is the type of health plan.
The more restrictions in what you can do and who you can see, the lower the cost. Have a look at Comparis and you will see the more HMO style plans (family doctor, tele medicine etc.). Assura will probably be one of the names offering this type of plan.
But as already mentioned, the major cost factor up/down will be the deductible.
You must calculate your yearly health costs.
CHF2500 + 12x CHF250 = CHF3000 premium payments
CHF1500 + 12x CHF300 = CHF3600 premium payments
SO basically you can get CHF1000 of healthcare for CHF600 - if you need that CHF1000. If you don't, then keep the premiums as low as possible.
If you have a CHF500 franchise and CHF350/month, you get to pay CHF1200 extra in premiums for "CHF2000" of healthcare costs.
Basically if you need any regular costs amount to over CHF1000 a year, pay it via premium instead of higher franchise.
I did this exercise, spelling it out across decreasing franchise and increasing premiums.
Hope my arithmetic is correct.
FRANCHISE of CHF 2500 and a monthly PREMIUM of CHF 250:
12x CHF250 = CHF3000 premium payments
If you never need any medical care in that year, your total costs will be CHF 3000.
If you need CHF 1000 of medical care, your total costs will be CHF 3000 + CHF 1000 = CHF 4000.
If you need CHF 2000 of medical care, your total costs will be CHF 3000 + CHF 2000 = CHF 5000.
If you need CHF 2500 of medical care, your total costs will be CHF 3000 + CHF 2500 = CHF 5500.
Thereafter, for each bill exceeding that first CHF 2500, you will have to cover 10%.
3000 + 2500 = 5500
If you need CHF 3500 of medical care, your total costs will be CHF 5500 + (10% of CHF 1000 = CHF 100) = CHF 5600.
FRANCHISE of CHF 1500 and a monthly PREMIUM of CHF 300:
12x CHF300 = CHF3600 premium payments
If you never need any medical care in that year, your total costs will be CHF 3600.
If you need CHF 1000 of medical care, your total costs will be CHF 3600 + CHF 1000 = CHF 4600.
If you need CHF 1500 of medical care, your total costs will be CHF 3600 + CHF 1500 = CHF 5100.
Thereafter, for each bill exceeding that first CHF 1500, you will have to cover 10%.
3600 + 1500 = 5100
If you need CHF 2000 of medical care, your total costs will be CHF 5100 + (10% of CHF 500 = CHF 50) = CHF 5150.
If you need CHF 2500 of medical care, your total costs will be CHF 5100 + (10% of CHF 1000 = CHF 100) = CHF 5200.
If you need CHF 3000 of medical care, your total costs will be CHF 5100 + (10% of CHF 1500 = CHF 150) = CHF 5250.
If you need CHF 3500 of medical care, your total costs will be CHF 5100 + (10% of CHF 2000 = CHF 200) = CHF 5300.
FRANCHISE of CHF 300 and a monthly PREMIUM of CHF 400:
12x CHF400 = CHF4800 premium payments
If you never need any medical care in that year, your total costs will be CHF 4800.
If you need CHF 300 of medical care, your total costs will be CHF 4800 + CHF 300 = CHF 5100.
Thereafter, for each bill exceeding that first CHF 300, you will have to cover 10%.
4800 + 300 = 5100
If you need CHF 500 of medical care, your total costs will be 5100 + (10% of CHF 200 = CHF 20) = CHF 5120.
If you need CHF 1000 of medical care, your total costs will be 5100 + (10% of CHF 700 = CHF 70) = CHF 5170.
If you need CHF 1500 of medical care, your total costs will be CHF 5100 (10% of CHF 1200 = CHF 120) = CHF 5220.
If you need CHF 2000 of medical care, your total costs will be CHF 5100 + (10% of CHF 1700 = CHF 170) = CHF 5270.
If you need CHF 2500 of medical care, your total costs will be CHF 5100 + (10% of CHF 2100 = CHF 210) = CHF 5310.
If you need CHF 3000 of medical care, your total costs will be CHF 5100 + (10% of CHF 2700 = CHF 270) = CHF 5370.
If you need CHF 3500 of medical care, your total costs will be CHF 5100 + (10% of CHF 3200 = CHF 320) = CHF 5420.
Basic medical insurance is compulsory in Switzerland.
When one doesn't end up claiming anything for a whole, it can feel like paying those premiums was for nothing - except, of course, for the contribution to the solidarity fund for others who have less good fortune, and for the collective benefit to society as a whole that people are covered in the event of ill health. And the day that one does need to claim for the costs of medical care, especially if anything happens that develops into a condition that is either serious or long-term or both... that's when one is glad to be insured.
Or to have diligently saved the amount needed to cover the franchise.
Like all insurances, guessing the right level of the franchise is an uncertain gamble with one's own imaginations of one's future.
the accident insurance covers high-risk sports. this is independent of the franchise.
Yes, you are right for people whose accident insurance runs through their employers.
Employers must insure all their employees against accidents.
Those who work for less than 8 hours per week are insured only for accidents at work and on the direct, uninterrupted journey between work and home. This is called Berufsunfallversicherung BU, and the premium is paid by the employer. To be covered for accidents during their free time, the so-called Nicht-Berufsunfallversicherung NBU, these part-time employees have to take out their own accident insurance.
Those who work for 8 hours or more per week are, in addition, covered for such NBU, i.e. accidents during their free time, i.e. including sports. The employer has the duty to organise this. Generous employers may pay the premium for their employees, but often the premium is paid by the employee, usually as a salary deduction.
However, anyone who is not insured through an employer must buy his/her own additional accident insurance to add on to their illness insurance. This is mandatory. Many non-employed people buy both from the same medical insurance company.
k_and_e, I was under the impression that, for such insured persons, the franchise was across both accident and illness insurances. Am I wrong in that?
No, you are correct.
Thanks, Belgianmum.
I had another thought, though: how does the franchise work for someone who has accident and illness insured in two different places? So I went a-looking, and found this very nice explanation on comparis.
https://www.comparis.ch/krankenkasse...erung-uvg.aspx (in German).
Google translate is not bad, except that it translates the German UVG (Unfall-Versicherungs-Gesetz) at times with UVG and at other times with LAA (the French equivalent: Loi fédérale sur l'assurance-accidents), which can be a bit confusing in a first read of the text. UVG = LAA.
Here's google translate, fixed a bit:
The federal law on accident insurance (UVG in German, LAA in French) applies to accident insurance with private insurance companies and with SUVA.
The premiums for occupational accidents and diseases must be covered by the employer. Premiums for non-occupational accidents are borne by the workers. The employer pays the entire premium amount and deducts the proportion from employee's pay.
The UVG / LAA insurance covers treatment costs in both professional as well as non-occupational accidents, i.e. in case of accidents at leisure.
Whoever is employed by a single employer for at least 8 hours per week, is by this automatically insured against accidents (= is UVG-insured, in German or LAA-insured in French) and can safely conclude his/her own medical insurance without accident coverage. Depending on health insurance, this can results in a premium reduction of up to 10%.
Once someone is not or no longer insured by an employer against accidents, he/she must inform his/her medical insurance company. The accident coverage pursuant to the KVG (Kranken-Versicherungs-Gesetz, in French LAMal Loi fédérale sur l'assurance-maladie) then once again comes into force, and the monthly medical insurance premium increases [to cover both medical expenses from both illness and accident].
A person receiving unemployment benefit is automatically insured by SUVA against accidents.
Incidentally, the accident insurance under UVG / LAA provides a much better protection than the accident insurance pursuant to the KVG / LAMal.
The UVG / LAA insured person does not have to pay a franchise, nor has a deductible on the medical expenses [related to accidents].
In addition, the UVG / LAA provides additional services such as daily allowances, pensions or compensation in cases of serious accidents.