What is the co-payment?
After the deductible (franchise), you pay a co-payment of 10% of the cost of your care and covered medicines. For adults, this co-payment is capped at CHF 700 a year (CHF 350 for children).
When does it rise to 40%?
Since 1 January 2024, the co-payment is 40% for some medicines, usually original products, when they are significantly more expensive than a generic or biosimilar with the same active ingredient. Before 2024, this rate was 20%.
A generic or biosimilar can also carry 40% if it is more expensive than another medicine with the same active ingredient.
How can I tell?
- Your doctor and pharmacist must tell you if a cheaper generic or biosimilar exists, and inform you if the medicine dispensed carries 40%.
- The FOPH's list of pharmaceutical specialities shows this for every covered medicine.
What if a generic is not suitable for me?
If there are medical reasons against the generic, for example an intolerance to an ingredient, your doctor can expressly prescribe the original. The co-payment then stays at 10%. Talk to your doctor: never change a treatment on your own.
Key points
- Normal co-payment: 10%, capped at CHF 700 a year for adults.
- Original more expensive than an equivalent generic: 40% since 2024.
- Medical reason confirmed by the doctor: 10%.
This article provides general information. It does not replace the advice of a doctor or health professional. Reimbursement rules may change: your health insurer can tell you about your contract. In an emergency, call 144.