Selbstbehalt
Retention Fee
[Zelbst-be-halt]Simple Definition
The Selbstbehalt is the co-payment consisting of 10% of medical costs that you pay *after* your Franchise has been exhausted. This is capped at CHF 700 per year for adults and CHF 350 for children. Once you hit this cap, the insurance pays 100% of covered costs.
Why this matters to Expats.
Many expats confuse this with the Franchise. The Franchise is the "door fee" to enter the insurance coverage; the Selbstbehalt is the "service fee" once inside. You cannot choose this amount—it is fixed by law at 10% (up to the cap).
Actionable Intelligence
Maximum Risk: Your max out-of-pocket exposure is Franchise + CHF 700.
Generic Drugs: If you refuse a generic substitute, your Selbstbehalt can jump to 20%.
Hospital Stay: There is an additional CHF 15/day fee for hospital stays (unrelated to Selbstbehalt).
Frequently Asked Questions
Do children pay this?
Yes, but it is capped at CHF 350/year for children.
Does it reset?
Yes, both Franchise and Selbstbehalt reset every calendar year (Jan 1).
Is it tax deductible?
Medical costs exceeding 5% of your net income are usually tax-deductible.
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