Cost sharing

According to the Federal Act on Health Insurance the insured person takes part in cost sharing. This, in turn, consists of: the deductible, the excess, and the hospital stay amount.

The first medical expenses that arise from the treatment must be incurred by the Insured. Such amount is referred to as the deductible. The deductible can be modified every time on the 1st of January of the following calendar year.

Adults:
The official minimum deductible for the Insured aged 18 and more amounts to CHF 300.– per calendar year. At the excess of maximum CHF 700.– the highest amount per calendar year totals the maximum of CHF 1'000.–. KLuG offers its clients the possibility to optionally raise the deductible up to maximum
CHF 2'500.–. The insured will receive thereupon a premium discount.

Children:
There is no officially recorded annual deductible for children. This means that solely parents must assume the excess which will arise from treatment costs. Thereby, the excess amounts to maximum CHF 350.– per calendar year.
Parents have the possibility to optionally choose the deductible also for their children, and so, to reduce premiums. Also in this case the excess totals maximum CHF 350.– per calendar year.

If you have more children insured at KLuG the highest amount per calendar year equals the maximum of double the highest amount per child per calendar year.

The excess amount totals 10 percent and will be charged for those treatment costs which surpass the chosen deductible. For an adult the excess equals maximum CHF 700.– per calendar year, for the Insured under 18 - maximum CHF 350.– per calendar year.
If there are generic products (Generika) more beneficial with respect to the original medication at your disposal, the cost sharing increases to 20 %.

Upon a hospital stay, the mandatory healthcare insurance undertakes not only the treatment costs, but also the costs of accommodation and board. That is why, all Insured over 18 must contribute to the costs of the hospital accommodation and board with CHF 15.– per day in hospital.

Alongside the basic deductible of CHF 300.– KLuG also offers a choice of deductibles CHF 500.–, CHF 1'000.–, CHF 1'500.–, CHF 2'000.– and CHF 2'500.–.

When you choose a higher deductible, your premium is reduced accordingly. Whether the higher deductible is profitable for you depends on medical expenses incurred in the ongoing year, because: higher the deductible, higher the share you have to contribute in case of a health problem. Healthy Insured, who do not face any medical expenses, choose a higher deductible to their advantage.  Upon high medical costs to expect it is better to choose the officially stipulated deductible of CHF 300.–.
It is worthwhile to think through that in the worst case scenario the chosen deductible and furthermore additional excess of maximum CHF 700.– must also be paid. For the highest optional deductible of CHF 2'500.– the maximum costs to bare would be of CHF 3'200.–.
 
This is how you proceed when you would like to change your deductible: tick the field with the desired deductible in your policy and then send it signed back to us until Friday, 30.11.... (inbox KLuG). Soon you will receive a new policy with your chosen deductible.

 

No, you cannot. This modification is only possible at the beginning of the calendar year. The intention to modify the deductible should be registered and communicated to KLuG in writing each time until the end of November.