LAMal deductible 2026: five common beliefs put to the test. Break-even thresholds, deadlines, children and Geneva subsidies, so you can test your own case.
FALSE. At CHF 2'500, an adult in Geneva saves around CHF 1'600 in premiums per year, but may pay up to CHF 1'600 more in the event of a medical mishap. It all depends on actual costs.
Reference profile for this whole article: Geneva adult, aged 26 and over, average FOPH (OFSP) 2026 premium of around CHF 4'800 per year with a CHF 300 deductible. The discounts shown are orders of magnitude: they vary by insurer and model. Check them in the official comparison tool, priminfo.admin.ch.
The calculation method is always the same. You compare the annual premium saving with the maximum increase in costs you bear, namely the difference in deductible plus the 10% co-payment, capped at CHF 700 per year for an adult (art. 64 LAMal, art. 103 OAMal).
In practice, the break-even threshold is the amount of annual costs above which the low deductible becomes more advantageous. Below that threshold, the high deductible wins. Above it, it loses.
The table below compares each deductible with the CHF 300 deductible (estimated savings based on the reference profile):
CHF 500: premium reduced by around CHF 150 per year, break-even threshold at around CHF 350 of costs
CHF 1'000: saving of around CHF 500, threshold at around CHF 800
CHF 1'500: saving of around CHF 900, threshold at around CHF 1'300
CHF 2'000: saving of around CHF 1'250, threshold at around CHF 1'700
CHF 2'500: saving of around CHF 1'600, threshold at around CHF 2'000
Take Julie, 34, in Carouge. Her costs last year: CHF 450. An optional CHF 2'500 deductible would have saved her around CHF 1'600 in premiums. She comes out well ahead. And if an operation costing CHF 10'000 comes up? She pays CHF 2'500 in deductible plus CHF 700 in co-payment, i.e. CHF 3'200 instead of CHF 1'000 with the CHF 300 deductible. The difference of CHF 2'200 then exceeds her saving of CHF 1'600.
Under art. 64 LAMal, the 10% co-payment is capped at CHF 700 per year for an adult, in addition to the chosen deductible, which ranges from CHF 300 to CHF 2'500.
Rank
Item
Value
Detail
1
CHF 500 deductible
Saving ~CHF 150 / year
Break-even threshold at around CHF 350 of annual costs
2
CHF 1'000 deductible
Saving ~CHF 500 / year
Break-even threshold at around CHF 800 of annual costs
3
CHF 1'500 deductible
Saving ~CHF 900 / year
Break-even threshold at around CHF 1'300 of annual costs
4
CHF 2'000 deductible
Saving ~CHF 1'250 / year
Break-even threshold at around CHF 1'700 of annual costs
5
CHF 2'500 deductible
Saving ~CHF 1'600 / year
Break-even threshold at around CHF 2'000 of annual costs
1
ItemCHF 500 deductible
ValueSaving ~CHF 150 / year
DetailBreak-even threshold at around CHF 350 of annual costs
2
ItemCHF 1'000 deductible
ValueSaving ~CHF 500 / year
DetailBreak-even threshold at around CHF 800 of annual costs
3
ItemCHF 1'500 deductible
ValueSaving ~CHF 900 / year
DetailBreak-even threshold at around CHF 1'300 of annual costs
4
ItemCHF 2'000 deductible
ValueSaving ~CHF 1'250 / year
DetailBreak-even threshold at around CHF 1'700 of annual costs
5
ItemCHF 2'500 deductible
ValueSaving ~CHF 1'600 / year
DetailBreak-even threshold at around CHF 2'000 of annual costs
The higher the deductible, the further away the break-even threshold: from CHF 350 of costs at CHF 500 to nearly CHF 2'000 at CHF 2'500
Key takeaway
Each deductible step earns more premium saving, but requires staying below a higher cost threshold: at CHF 2'500, the high deductible only wins if your annual costs stay below around CHF 2'000.
Source: Art. 64 LAMal, art. 103 OAMal — fedlex.admin.ch. Profile: Geneva adult aged 26 and over, average FOPH (OFSP) 2026 premium ~CHF 4'800 with a CHF 300 deductible (estimates to be checked on priminfo.admin.ch)
Is the CHF 300 deductible a comfort that costs a lot?
TRUE, BUT. The CHF 300 deductible costs around CHF 1'600 more in premiums per year than a CHF 2'500 deductible. It becomes worthwhile as soon as your annual costs exceed around CHF 2'000.
The threshold is calculated as follows: at CHF 300, you pay a maximum of CHF 300 in deductible plus CHF 700 in co-payment, i.e. CHF 1'000. At CHF 2'500, you pay CHF 2'500 plus CHF 700, i.e. CHF 3'200. The maximum difference is CHF 2'200. Since your premium saving is around CHF 1'600, the low deductible wins when costs exceed around CHF 2'000 (your full costs over the year, for care covered by compulsory health insurance (AOS)).
This low deductible is therefore not a whim. It protects people with regular treatment, a chronic illness, a planned pregnancy or repeated physiotherapy sessions.
Take Marc, 58, who is being treated for diabetes: around CHF 3'200 in costs per year. With a CHF 300 deductible, he pays CHF 1'000 out of pocket. With CHF 2'500, the bill would rise to CHF 3'200. The difference of CHF 2'200 exceeds the premium saving. Marc is right to keep CHF 300.
There is no reason to feel guilty if you keep this deductible. The test is simple: add up your medical and pharmacy costs from last year. Above CHF 2'000, the low deductible is justified. Below that, you are paying for cover you do not use.
According to the FOPH (OFSP), the standard minimum deductible of compulsory health insurance is set at CHF 300 per year for an adult (art. 103 OAMal). Any optional deductible is a voluntary choice.
CHF 300 deductibleAnnual costs above around CHF 2'000
CHF 2'500 deductibleAnnual costs below around CHF 2'000
Typical case
CHF 300 deductibleMarc, 58, diabetes: CHF 3'200 in costs, i.e. CHF 1'000 out of pocket
CHF 2'500 deductibleJulie, 34, Carouge: CHF 450 in costs, gain of around CHF 1'600 in premiums
Verdict
CHF 300 deductibleMarc is right to keep the low deductible
CHF 2'500 deductibleJulie comes out well ahead, but a maximum gap of CHF 2'200 exceeds her saving of CHF 1'600 in the event of an operation
Beyond CHF 2'000 of costs per year, the CHF 2'500 deductible costs more than it saves
Key takeaway
The CHF 2'500 deductible saves around CHF 1'600 in premiums, but only remains the winner if your annual costs stay below around CHF 2'000.
Source: Art. 64 LAMal, art. 103 OAMal — fedlex.admin.ch. Reference profile: Geneva adult, average FOPH (OFSP) 2026 premium of around CHF 4'800 per year with a CHF 300 deductible. Indicative discounts, to be checked on priminfo.admin.ch
Do children have the same deductible as adults?
FALSE. For a child, the deductible ranges from CHF 0 to CHF 600 in steps of CHF 100, and the co-payment is capped at CHF 350 per year, compared with CHF 700 for an adult. The CHF 2'500 amounts do not exist.
Children (up to age 18) pay no deductible by default. Parents may choose CHF 100, 200, 300, 400, 500 or 600 in exchange for a premium discount.
The discount is small. Between a CHF 0 and a CHF 600 deductible, the premium saving is around CHF 250 to CHF 350 per year depending on the insurer (estimate, to be checked on priminfo.admin.ch). The risk, on the other hand, is CHF 600 plus CHF 350 in co-payment, i.e. a maximum of CHF 950 per child.
Imagine a family with three young children. Paediatrician visits, antibiotics, a trip to A&E: the bills mount up quickly. A high deductible for each child can cost close to CHF 2'850 in a difficult year, for a premium saving of around CHF 900 in total. The high deductible then makes no sense.
Conversely, for a child who has not seen a doctor in two years, a mid-level deductible may be justified. The calculation remains the same: premium saving against deductible plus co-payment. It is done child by child, since each deductible is chosen separately.
Under art. 64 LAMal, a child's co-payment is limited to CHF 350 per year, and siblings insured together are exempt from the deductible in certain cases provided for by law.
Can I change my deductible whenever I want?
FALSE. Moving to a higher deductible is possible until 30 November 2026 for 2027, but lowering your deductible requires notice. The rule differs depending on the direction of the change.
Increasing the deductible: the request must reach the insurer by 30 November 2026 at the latest to take effect on 1 January 2027. It is generally accepted without conditions.
Lowering the deductible: this is stricter. The notice period is the same, namely 30 November 2026. There is no switch to the low deductible during the year, unless your insurer provides for it in the event of a change in circumstances (for example a pregnancy). Check its general conditions.
Note: the request must reach the insurer before 30 November, not simply be posted on that day. A letter received on 1 December is too late.
Sophie, for her part, is considering a planned operation in 2027. If she fails to lower her deductible before 30 November 2026, she will pay CHF 2'500 instead of CHF 300 for the whole year. Missing the deadline by a few days can cost up to CHF 2'200.
For 2027, your insurer's new premium arrives in the autumn. Insurers must notify their policyholders at the latest by the end of October. A few weeks therefore remain to calculate and decide.
According to the FOPH (OFSP), insured persons who wish to change deductible or insurer for the following year must do so in compliance with the deadlines set by the Health Insurance Ordinance (OAMal), with a final date of 30 November.
With a subsidy, does the choice of deductible make no difference?
FALSE. The Geneva cantonal subsidy reduces your premium, but it does not cover your deductible. A CHF 2'500 deductible can put a tight budget in difficulty in the event of illness.
In Geneva, the subsidy is calculated according to income and household composition. It is paid as a direct premium reduction. The amount is based on a cantonal reference premium, not on the actual premium of a high deductible. The higher the deductible you choose, the more the premium discount adds to a subsidy that is itself still calculated on the reference premium. Check with the Geneva health insurance service (Service de l'assurance-maladie) how it applies to your case.
The real pitfall is cash flow. Fatima, a single mother on a modest income with a subsidy, illustrates it. With a CHF 2'500 deductible, she saves around CHF 1'600 in premiums. But in the event of hospitalisation, she must advance up to CHF 3'200 of out-of-pocket costs over the year. Without that sum in reserve, she is exposed to unpaid bills, debt enforcement proceedings or going without care.
This is the opposite myth, just as real: a high deductible can lead people to delay a consultation. A problem treated late often costs more than an appointment made in time.
For a tight budget, the CHF 300 or CHF 500 deductible often remains the safest, even if it increases the premium. It is a risk-management choice, not a comfort one.
According to the FOPH (OFSP), the cantons grant premium reductions to insured persons of modest economic means (art. 65 LAMal), but these reductions do not replace the deductible or the co-payment.
Do 2026 premiums make a high deductible more advantageous?
TRUE, BUT. When premiums rise, the saving in francs from a high deductible grows, but the break-even threshold moves little. The risk in the event of large costs remains the same.
The average FOPH (OFSP) 2026 premium for an adult on the standard deductible is around CHF 4'800 per year in Geneva, according to data from the Price Supervisor and the FOPH (to be checked on priminfo.admin.ch). Across Switzerland as a whole, the average is lower. On that amount, the discount for the CHF 2'500 deductible reaches around CHF 1'600.
What rising premiums really change: the premium saving increases in absolute terms, so the break-even threshold rises slightly. A high deductible becomes attractive for slightly more people.
What they do not change: the maximum costs you bear. Deductible plus a CHF 700 co-payment make CHF 3'200 at worst with CHF 2'500, and this ceiling is set by law, not by premiums.
Thomas, 45, in good health, consulted twice last year for CHF 380 in total. With 2026 premiums, a CHF 2'500 deductible would save him around CHF 1'600. But a broken leg would cost him CHF 3'200 instead of CHF 1'000. The gain of CHF 1'600 covers only part of the risk.
Good practice: simulate with your insurer's actual premiums for 2027, not with an average. In Geneva, the gap between insurers can exceed CHF 1'000 per year for the same deductible.
According to the FOPH (OFSP), the average premium of compulsory health insurance varies considerably between cantons and insurers, which makes a personalised comparison essential before 30 November.
Key takeaways
Four points are enough to decide without being caught out by a comparison tool.
The break-even rule: compare the annual premium saving with the maximum increase in your out-of-pocket costs (deductible difference plus co-payment, capped at CHF 700 for an adult, CHF 350 for a child). With CHF 2'500, the threshold is at around CHF 2'000 of costs per year.
The deadline: your request must reach the insurer by 30 November 2026 at the latest for a deductible valid from 1 January 2027.
The personal test: add up your medical, pharmacy and care costs from last year, then add those you expect (pregnancy, treatment, operation). Compare with the table.
The cash-flow trap: a high deductible only makes sense if you can advance CHF 3'200 without going without care. Otherwise, the more expensive premium buys peace of mind, and that is not waste.
Cross-border workers choosing between LAMal and CMU must also calculate with their own costs. Our guide on the cross-border worker's choice between LAMal or CMU details the rules specific to that situation.
"This article is for information only and does not constitute personalised legal or financial advice; it does not replace the advice of a professional. LAMal premiums and deductibles for 2026 may change, and assurance-genevoise.ch, registered with FINMA under number F01502264, invites you to check your individual situation before any decision."
FAQ
There is no ideal deductible for everyone. Add up your medical costs from last year, then compare them with the break-even threshold of each deductible. Below around CHF 2'000 of costs per year, a high deductible often wins.
Test your deductible before 30 November
We work out the break-even threshold with you, based on last year's costs and your insurer's 2027 premiums. A single appointment is enough to decide with full knowledge of the facts.
