Deductible, excess? Explained simply! - simpego

Deductible, excess? Explained simply!

simpego Pet

Unlike car or home contents insurance, pet insurance – just like health insurance – has two important terms: the annual deductible and co-insurance. Our calculation examples will help you understand step by step how your own veterinary bills are calculated.

The structure is the same as for health insurance.

Simpego’s accident and health insurance for dogs and cats is structured in the same way as health insurance. As with health insurance, there is an annual excess and a percentage-based deductible, which determine the proportion of veterinary costs you pay and when simpego takes over.

The most important difference to health insurance:

  • Simpego bases the insurance year on the start date of your contract, rather than the calendar year. This makes your contract and billing more flexible and transparent.

Insurance year: Example:

  • Contract start date: 15 March 2025
  • Insurance year: 15 March 2025 to 14 March 2026
  • You pay the agreed deductible during this period.
  • A new insurance year begins on 15 March 2026, at which point the deductible resets.
No time for long explanations?
Here are the most important points in brief:
  • How is the deductible calculated? Your deductible applies per insurance year – not per calendar year.
  • When does the excess apply? The excess is applied only after deduction of any deductible amount.

Annual deductible

What does deductible mean?

The annual deductible is the fixed amount you must pay each insurance year before simpego starts to cover the costs of treatment.

Important:

  • The deductible always applies to an insurance year, not the calendar year.
  • An insurance year begins on your contract’s start date, which you selected when taking out the contract.
  • It lasts 12 months.
  • The deductible is applied once within this period.
  • Simpego will only contribute to further beneficiary veterinary costs once the deductible has been used up completely.

Calculation example: Understanding the annual excess

Example:

  • Inception of insurance: 15 March 2025
  • Selected annual excess: CHF 500
  • Waiting period: 30 days
  • Selected excess: 0% (= 100% of costs covered by simpego)
Date Invoice amount
Veterinarian		 Your share / deductible Remaining deductible Your co-payment Simpego reimbursement
May 17, 2025 CHF 264.– CHF 264.– CHF 236.– CHF 0.– (0%) CHF 0.–
June 6, 2025 CHF 98.– CHF 98.– CHF 138.– CHF 0.– (0%) CHF 0.–
November 29, 2025 CHF 347.– CHF 138.– CHF 0.– CHF 0.– (0%) CHF 209.–
Statement on billing

The veterinary treatments on 17 May and 6 June 2025 do not utilise the full annual excess of CHF 500. After these two treatments, there is a remaining excess of CHF 138.

This amount will be deducted first from the invoice for the treatment on 29 November 2025.

Simpego will then cover the remaining amount of the invoice in full, as 0% excess was selected when the contract was taken out.

Please note that from the age of 9, 80% of costs will always be covered.

Excess

How is this calculated?

Once the excess has been reached, the excess applies. This determines the percentage of veterinary costs that you will pay after the excess has been deducted.

The following applies to simpego pet insurance:

  • Cost coverage is determined when the contract is concluded (e.g. 80% or 100%), resulting in an excess of either 20% or 0%.
  • Please note that from the age of 9, the cost coverage is always 80%.

Calculation example: Excess + deductible

Example:

  • Inception of insurance: 15 March 2025
  • Selected annual deductible: CHF 500
  • Waiting period: 30 days
  • Selected excess: 20% (80% cost coverage by simpego)
Date Invoice amount
Veterinarian		 Your share /
deductible		 Remaining
deductible		 Your co-payment Simpego payment
17 May 2025 CHF 264.– CHF 264.– CHF 236.– CHF 0.– (20%) CHF 0.–
6 June 2025 CHF 98.– CHF 98.– CHF 138.– CHF 0.– (20%) CHF 0.–
29 November 2025 CHF 347.– CHF 138.– CHF 0.– CHF 41.80 (20%) CHF 167.20

Explanation of settlement

First, the annual deductible amount of CHF 500 is deducted from the veterinary costs. Following the treatments on 17 May and 6 June 2025, the deductible amount has not yet been fully used up – CHF 138 remains.

For the treatment on 29 November 2025, this remaining amount is deducted first.
The 20% excess then applies to the remaining invoice amount.

This means that, once your deductible amount has been deducted, simpego will cover 80% of your veterinary costs.
In this example, simpego will pay CHF 167.20 for the three submitted invoices.

Important to know

Simpego does not calculate on a calendar year basis, but on an insurance year basis.

  • The decisive factor is always your personal insurance year, which begins at the start of the contract.
  • The annual excess applies to each insurance year.

Pet insurance: Seamless continuation of cover

From 2026, simpego will directly manage all pet insurance customers – with the same protection and new services. No changes to the contract, no cancellation necessary. Read the FAQ now.

Learn everything about switching