Co-payment

This is the amount that you have to pay from your own pocket for your health care every year. If these costs exceed your annual deductible, Sympany pays 90% of the additional costs (10% is your retention fee).

Insured persons residing in Switzerland:
You independently decide the amount of your deductible. The rule is: the higher the deductible, the lower the premium. The deductible can be altered as of 1 January of each year. The deadlines are:

• Reducing your deductible: 30 November
• Increasing your deductible: 31 December

Please note: The notification by telephone or post must be received by Sympany by no later than 5 pm on the last working day before these deadlines. 

You have a choice of the following deductibles (amounts in CHF):

Adults	Children
300 500 1000 1500 2000 2500	0 200 400 600

For basic insurance, the statutory minimum deductible for people aged 18 years and over is 300 francs. No deductible is charged for children. Adults can voluntarily increase their deductible to a maximum of 2500 francs, children to 600 francs.

Reaching the age of majority: at the age of 18, a deductible must be chosen for the first time. In order to keep your premiums low, we will suggest a deductible of 2500 francs in the next policy. This will become valid on 1 January of the year in which you turn 19.

Once you have reached your deductible, the compulsory basic insurance pays the costs of medical services and medications. However, you pay a legally stipulated but limited retention fee of 10% (40% for original preparations for which a generic or biosimilar is available. The maximum co-payment arising from the retention fee is as follows:

• Children 350 francs per calendar year,
• Adults 700 francs per calendar year.

Once you have reached your maximum retention fee, Sympany pays 100% of the further costs incurred in that calendar year as detailed on the basic insurance benefits list.

 

Save money with generics: lower prices, lower co-payment

• Original preparations are often more expensive than generics. For this reason, a higher retention fee of 40% applies to original preparations. 
• Of this, only 25% can be credited towards the regular annual retention fee of 350 francs (children) / 700 francs (adults). 
• You must pay the remaining 15% yourself, up to a maximum of 420 francs per year. 
• This means that your retention fee for original preparations can amount to as much as 1120 francs per year. 
• Only once you have reached the maximum co-payment (deductible + annual retention fee + non-creditable personal share) does the basic insurance cover 100% of the cost of original medicines.
• With generics you save twice: on the price of the medicine and on the retention fee.
   

Calculation example: costs of original preparation vs. generic
	Original preparation	Generic
Price	200 CHF	140 CHF
Your retention fee	40% 80 CHF	10% 14 CHF
Of which creditable	25% 50 CHF	10% 14 CHF
Not creditable	15% 30 CHF
Basic insurance covers	120 CHF	126 CHF

More information on generics and branded medicines ›

 

In the event of hospital admission, the compulsory basic insurance pays both the treatment costs and the costs of accommodation and food. However, the law stipulates that, if you are admitted to hospital as an inpatient, you must contribute 15 francs per day to the costs.

The following are exempt from the hospital contribution:

• Children aged up to 18
• Young adults in training/education (aged up to 25)
• Women, for benefits in the event of maternity