RelokeaAt a German or Dutch GP, a consultation costs zero euros at the desk. In Switzerland the same consultation is paid in full until the annual deductible is used up, then at 10 %.
Put another way: the country in the panel with the highest monthly premium is also the one where the first consultation of the year costs most. The two effects add up instead of cancelling out.
This article costs what you take out of your own pocket on the day you consult, in eleven countries, from the official texts. It is the other half of the health bill — the half you cannot see by comparing premiums.
Two amounts, and neither follows from the other
People often assume a high premium buys a free consultation. It is a reasonable intuition. It is wrong.
The monthly premium and the cost sharing at the desk are two separate decisions. A country can choose a low premium and a high charge, or the reverse. Nothing obliges it to compensate.
And in practice, across this panel, the correlation runs the wrong way.
The desk table
| Country | Mechanism | At the GP, adult | Child |
|---|---|---|---|
| Switzerland | deductible then co-payment | full price, then 10 % | 10 % from the 1st franc |
| Germany | nothing at the desk | €0 | €0 |
| Netherlands | nothing at the desk | €0 | €0 |
| Austria | nothing at the desk | €0 | €0 |
| Italy | nothing at the desk | €0 | €0 |
| Spain | nothing at the desk | €0 | €0 |
| Portugal | nothing at the desk | €0 | €0 |
| Belgium | patient contribution | €4 | €4 |
| Luxembourg | patient contribution | 12 % of the fee | 0 % |
| France | patient contribution | €11 advanced | €0 flat-rate charge |
| Liechtenstein | fixed amount then 20 % | CHF 500/year then 20 % | CHF 0 |
Seven of the eleven countries ask the patient for nothing to see a GP. That is the rule, not the exception.
The Swiss case, and why it has no single figure
The Swiss row of the table carries no amount, and that is not an omission. It is the answer.
The ordinary deductible is CHF 300 a year for an adult, and can be raised to CHF 2,500 by choice. Until it is reached, the insured person pays the entire bill. Then comes a co-payment of 10 %, capped at CHF 700 a year. On top of that sits a contribution of CHF 15 per day of hospitalisation — from which under-18s, young adults under 25 in education, and women for maternity services are exempt.
The direct consequence: the same consultation costs two different prices depending on the month of the year. Full price in January, 10 % in November if you have used enough care to exhaust your deductible.
Publishing an average would have masked exactly what distinguishes this system from the others. We prefer to write that there is no amount, and to say why.
Swiss children, and an exemption that is not quite one
The child is exempt from the ordinary deductible. People often conclude that they pay nothing. That is inaccurate: they pay the 10 % co-payment from the first franc, capped at CHF 350 a year.
A Swiss child seen in January therefore costs 10 % of the bill. The same child in the Netherlands costs zero, on no basic-package care, at no point in the year.
Liechtenstein, again, and again the other way round
The same mechanism as Switzerland — a fixed amount then a percentage — and the opposite result for children.
An adult there bears CHF 500 a year, then a Selbstbehalt of 20 % capped at CHF 900, so at most CHF 1,400 over the year. Harsher than Switzerland for an adult.
But children up to their sixteenth birthday are exempt from the premium and from cost sharing. The 16 to 20-year-olds pay half the premium and no cost sharing at all.
A Liechtenstein child therefore pays nothing, neither monthly nor at the desk. Two neighbouring countries, the same mechanism, two opposite tariff childhoods.
The nuances that deserve to be named honestly
A table full of zeros invites over-simplification. Three points need making.
In Germany, the free consultation is exactly that — a consultation. Co-payments remain elsewhere: notably 10 % of the price of a medicine, with a minimum of €5 and a maximum of €10.
In Austria, the e-card carries an annual service charge of €25.00 for 2026. That is not a per-visit contribution, but it is not nothing either. At a contracted doctor, the ÖGK writes: “Als Patient oder Patientin müssen Sie daher nichts extra bezahlen.”
In Belgium, free care for young people rests on the increased reimbursement status, not on age alone. The €4 charge falls to €1 for a beneficiary of increased reimbursement, and to €0 for those same beneficiaries under 25. The global medical file costs €32 — but “payment is settled directly between your doctor and your health fund”: it does not leave the patient’s pocket.
In Italy, free care covers the family doctor and the paediatrician, on weekdays. The Italian charge exists elsewhere — specialists, tests — and its amount is set by each region, which rules out a single national figure.
The French case, line by line
France is the only country in the panel where the patient advances the money and then claims it back, which makes the sum less legible.
A sector 1 GP consultation has cost €30 since 22 December 2024. It is reimbursed at 70 %, less a €2 flat-rate contribution, giving €19 reimbursed.
The patient therefore advances €11: €9 of patient contribution and €2 of flat-rate charge. The patient contribution is often picked up by a complementary insurer; the flat-rate charge is not.
Under-18s are not subject to it: “This contribution does not apply to people under 18.”
What you wait, and what nobody publishes
Price is only part of access. Time is another — and there, countries differ less in their figures than in whether they publish any.
Portugal publishes in real time. The public portal shows waiting times by facility and by Manchester triage colour, refreshed continuously. The SNS open-data portal publishes admissions by triage colour, facility and month in parallel — 6,420 records at the end of August 2026.
France publishes periodically. The DREES emergency departments survey photographs a typical day, ten years apart. 2023 results, published in June 2026: half of the patients fully treated spend more than 3 hours 10 in the department, against 2 hours 15 in 2013 — 55 minutes more in ten years. Between triage and the start of treatment, half wait under 16 minutes, but one in ten more than two hours.
For Switzerland, we found nothing. And it is worth being precise about what that means.
We found no federal publication of emergency department waiting times. That is not the same as asserting that none exists: an absence cannot be proven by a search. What is published are the FOPH’s hospital quality indicators and key figures, and the Obsan’s count of outpatient consultations in emergency services.
The contrast is worth noting. The country that publishes its premiums to the centime, insurer by insurer and municipality by municipality, does not publish what you wait in A&E.
If you are a cross-border worker, your home decides your row in the table
The table above files each country under its own regime. A cross-border worker, though, does not know in advance which row they are in — and the answer does not depend on their employer.
If you live in France, the right of option is what places you in one row or the other. Enrolled in LAMal, you live under the Swiss row: a CHF 300 deductible, then 10 %, with a first consultation of the year at full price. Enrolled in the cross-border CMU, you live under the French row: €11 advanced at the GP, of which €2 your complementary insurer will not pick up.
Two radically different desk regimes, for the same work and the same salary. The form is signed within three months of starting the job, and without a form you are enrolled in LAMal by default.
If you live in Germany, Austria or Italy, exit from compulsory Swiss cover follows the exemption rules specific to each of those countries. Where it applies, you shift to a regime in which a GP consultation costs nothing at the desk — all three sit in the €0 column.
And for emergencies, your home also decides what you can know before setting off. A cross-border worker living in Portugal checks waiting times in real time; in France they have a survey once a decade; on the Swiss side, we found no federal publication. The same journey to hospital is therefore not documented the same way depending on which side of the border you live.
Key points
- Seven of eleven countries ask the patient for nothing for a GP consultation. Germany abolished the Praxisgebühr in 2013; the Netherlands expressly exempts general practice from its €385 deductible.
- Switzerland has no single amount, and that is the answer: full price until the CHF 300 deductible is used up, then 10 % capped at CHF 700 a year.
- The country with the highest premium is also the one where the first consultation costs most. The two effects add up.
- The Swiss child is not exempt, contrary to a widespread belief: exempt from the deductible, they pay the 10 % co-payment from the first franc.
- Liechtenstein exempts under-16s entirely, premium and cost sharing included, and does so with the very same mechanism as Switzerland.
- On emergency waiting times, Portugal publishes in real time where we found no Swiss federal publication at all.
Practical advice
Look at your deductible before choosing your premium. A CHF 2,500 deductible lowers the monthly premium, but you pay everything up to that amount. The calculation depends on your actual use of care, not on an average — and it flips beyond a certain number of consultations.
Group non-urgent care within the same calendar year. The deductible resets on 1 January. Two consultations in December and January cost more than two consultations in December.
If you have children, compare the treatment of childhood, not the adult fee. That is where the gaps between neighbouring countries are widest: €0 in the Netherlands and Liechtenstein, 10 % from the first franc in Switzerland.
In France, check what your complementary insurance picks up. It often covers the patient contribution but not the €2 flat-rate charge, which stays with you.
Common mistakes
“I pay a high premium, so the doctor is free.” No, and across this panel it is the opposite. The premium and the cost sharing are two separate decisions, and in Switzerland they add up.
“My child pays nothing since they are exempt from the deductible.” They are exempt from the deductible, but they pay the 10 % co-payment from the first franc, capped at CHF 350 a year. The exemption from the deductible is real; a full exemption is not.
“A consultation costs X in Switzerland.” It has no single price. It costs full price or 10 % of it depending on the state of your deductible when you consult. Any average quoted erases precisely that mechanism.
“The Belgian charge is €4, so that is what everyone pays.” That amount assumes a contracted doctor and a global medical file kept by your GP. Without the file, or outside the convention, the sum changes.
“Swiss emergency departments are faster.” Perhaps — we do not know, and nobody should assert it without data. What we can say is that we found no federal publication on the subject.
What to check in your own situation
If you are in Switzerland, add up your annual premium and your deductible: that is your floor health cost, before you have seen a doctor at all. Then look at the co-payment ceiling — CHF 700 per adult, CHF 350 per child — to know your worst case.
If you are comparing two countries, do not compare premiums alone. A gap of €200 a month can be overturned by a deductible, and the reverse is true too.
If you have a chronic condition, this calculation changes completely: you will exhaust your deductible every year, and it is then the co-payment and its ceiling that decide. A low deductible becomes rational where it was not.
The amounts and mechanisms in this article come from the authorities of each country — FOPH, the German Federal Ministry of Health, the Dutch Rijksoverheid, Ameli, CNS, INAMI/RIZIV, ÖGK, Ministerio de Sanidad, the Portuguese SNS — and from the CLEISS country files. The emergency data come from DREES and the SNS transparency portal. Every source is dated and listed below.
Frequently asked questions
The premium is only half the bill. The Relokea engine works out your real premium and your deductible by canton, status and the ages of your children — the two amounts that actually decide your year.
Official sources
- FOPH — cost sharing for insured persons resident in Switzerland (deductible, co-payment, ceilings) (accessed on 31/08/2026)
- German Federal Ministry of Health — co-payments in statutory health insurance (Praxisgebühr abolished in 2013) (accessed on 31/08/2026)
- Rijksoverheid — 2026 compulsory deductible and the exemption of huisartsenzorg (accessed on 31/08/2026)
- Ameli — fee and reimbursement of a sector 1 GP consultation (accessed on 31/08/2026)
- CNS — cover of medical consultations (88 % adults, 100 % under 18s) (accessed on 31/08/2026)
- INAMI/RIZIV — patient contribution with a global medical file (accessed on 31/08/2026)
- CLEISS — Liechtenstein: fixed amount, Selbstbehalt and exemption for children (accessed on 31/08/2026)
- DREES — Emergency departments survey 2023, published June 2026 (accessed on 31/08/2026)
- SNS Transparência — emergency admissions by Manchester triage (API, 6,420 records) (accessed on 31/08/2026)
Related guides: the hub · cout sante salaire median · caisses assurance maladie europe · lamal ou cmu · impots frontalier