Assurance pour les médecins

My first AVS statement as a self-employed doctor: what I should have

First AVS (Old-Age and Survivors' Insurance) statement of a newly established doctor: instalments set too low, a catch-up payment of CHF 9'840, then monthly…

Medcourtage - My first AVS statement as a self-employed doctor: what I should have

The move from salary to assessment: what the fund calculated

The letter from the compensation fund arrived in March. Amount claimed as a balance: CHF 9'840. Yet I had paid every instalment on its due date. I did not understand the discrepancy, and it is something many healthcare professionals discover in turn when they set up their own practice.
In hospital, the AVS/AI/APG (old-age and survivors', disability and income-compensation) contribution was deducted at source. As a self-employed person, nobody deducts it for you. The fund sets provisional instalments based on an income that you estimate when you start out. It does not yet know your fee-for-service billing, so it relies on your figure.
My case: I had declared a net income of CHF 90'000 for the first year of operation. The fund applied the contribution rate for self-employed persons, which is 10.0 % (AVS/AI/APG) for incomes of CHF 60'500 and above. Below that threshold, the sliding scale applies lower rates, from 5.371 % to approximately 9.95 %. The minimum contribution is CHF 530 per year (FSIO scales in force in 2026, to be checked each year in the official guidance notes).
In practice: 10.0 % of CHF 90'000, plus the fund's administrative costs, came to approximately CHF 9'200 per year, i.e. quarterly instalments of approximately CHF 2'300. I paid these instalments without a second thought.
What the fund uses for its calculation is called the determining income. It corresponds to the net profit of the self-employed activity, after deduction of justified expenses and certain contributions, increased by 2nd pillar amounts depending on the case. It is neither your turnover nor your cash receipts for the year.

The estimation error: instalments too low, catch-up payment

My estimated income was CHF 90'000. My final tax assessment, notified by the cantonal tax administration, recorded CHF 178'000 of net income from self-employed activity. The difference: CHF 88'000.
The mechanism is simple. The tax administration communicates its assessment to the compensation fund. The fund then recalculates the contribution on the final income, compares it with the instalments already collected and invoices the difference. In my case: 10.0 % of CHF 178'000, i.e. approximately CHF 17'800, less CHF 9'200 of instalments paid. Balance claimed, including interest and fees: CHF 9'840.
A useful rule: where the final income significantly exceeds the estimated income, the fund may charge default interest on the difference. The rate is set by the federal ordinance (RAVS, the AVS Ordinance) and can be checked on the FSIO website.
The settlement is made in a single payment. The payment deadline for the statement is 30 days. This is where cash flow takes a hit: this sum fell due at the same time as my tax instalment and my practice rent. Nothing dramatic, but a tight month that could have been avoided.
This was not a calculation error by the fund. It is the normal operation of the system for self-employed persons: the contribution is provisional until the tax assessment is known. The fund may depart from your estimate if it has more recent information, but in the first year it generally has none.
A newly self-employed person almost always underestimates their net income for the first year, because they are unaware of how quickly the patient base builds up. In my case, the practice reached its cruising speed in the sixth month, not the twelfth.

Professional expenses and limited companies: what changes

The determining income is not your turnover. The starting point is the income from the activity, from which justified business expenses are deducted: practice rent, medical assistant's salary, equipment, depreciation, professional liability insurance, loss-of-earnings insurance contributions. The more complete and documented the deduction, the lower the AVS basis.
Buying back 2nd pillar contribution gaps is tax-deductible, and for the AVS fund, the deduction in principle follows the tax assessment. Pillar 3a contributions, on the other hand, are not deducted from AVS income. The difference is subtle and is worth putting to the fund as a question.
The legal form changes the logic. As a sole proprietorship, the entire net profit is subject to AVS contributions, whether or not it is withdrawn. In an SA (limited company) or Sàrl (limited liability company), you are an employee of your own company: the company pays joint contributions on your salary, and the balance of the profit stays in the company. Dividends are not subject to AVS, but the fund examines whether your salary is in line with what a third party would receive for the same role. A salary that is too low is reclassified.
For a natural person, the 10.0 % rate applies to total net income, whereas for an employee, the combined employer and employee rate is 10.6 % on gross salary. It is the difference in calculation basis, more than the difference in rate, that makes the difference.
These structural choices are matters for the fiduciary and the fund. They are decided before opening, not after the first assessment.
AVS contribution basis
Sole proprietorshipTotal net income from the self-employed activity
SA or SàrlSalary paid to the operator, an employee of their own company
Applicable rate
Sole proprietorship10.0 % on net income (from CHF 60'500)
SA or Sàrl10.6 % joint (employer + employee) on gross salary
Balance of the profit
Sole proprietorshipSubject to contributions, whether or not it is withdrawn
SA or SàrlStays in the company
Dividends
Sole proprietorshipNot applicable
SA or SàrlNot subject to AVS, but salary reclassified if lower than that of a third party for the same role
Timing of the decision
Sole proprietorshipBefore opening, with the fiduciary and the fund
SA or SàrlBefore opening, with the fiduciary and the fund
As a sole proprietorship, the entire net profit is subject to AVS contributions; in an SA or Sàrl, only the salary is, under the fund's scrutiny

Key takeaway

The difference lies less in the rate (10.0 % versus 10.6 %) than in the calculation basis: total net profit for a sole proprietorship, salary paid for an SA or Sàrl, a choice to be settled before opening with the fiduciary and the fund.
Source: FSIO scales 2026 (to be checked each year in the official guidance notes) — RAVS — ofas.admin.ch

The decisions taken afterwards: provisions and adjustment

After this first statement, I changed three things.
Firstly, a separate account for reserves. Each month, I transfer 22 % of the net profit received: approximately 10 % for AVS/AI/APG and the balance for tax. Before, I had zero provisions. Afterwards, a reserve that automatically covers the following year's statement.
Secondly, in-year income monitoring. At the end of each quarter, I extract the cumulative net profit from the accounts and annualise it. In the second quarter of my second year, the projection showed CHF 195'000 against CHF 120'000 declared to the fund. The gap was visible six months before the invoice.
Thirdly, a request to adjust the instalments. The fund agrees to change instalments during the year on simple written request, with supporting evidence (interim closing of accounts or projection). I requested the move from CHF 120'000 to CHF 195'000. My quarterly instalments rose from approximately CHF 3'000 to approximately CHF 4'900. The year-end balance was CHF 1'150, against CHF 9'840 the first time.
For practices whose income varies considerably from one month to the next, this quarterly monitoring is sufficient. It requires neither specific software nor an advisory mandate. It simply requires up-to-date bookkeeping, which is also useful for fee-for-service billing and profitability control.

What is transferable to another healthcare professional setting up

Three quantified reflexes emerge from my experience.
  • Set aside each month approximately 10 % of net profit for AVS/AI/APG (2026 scale for incomes above CHF 60'500), in addition to the tax reserve.
  • Annualise income at the end of each quarter and compare it with the figure declared to the fund. As soon as the gap exceeds 15 to 20 %, request an adjustment of the instalments.
  • For the first year, allow for a possible gap between estimate and final assessment, and keep in reserve at least one quarter's worth of contributions.
What is not transferable: my default interest rate, my deductions, my legal form and my statement dates. These depend on the cantonal or professional fund chosen, your canton of assessment and the structure of your practice. Some funds charge different administrative fees. The cantonal compensation fund remains the point of contact for your personal situation.
The income used as the basis for AVS also determines your other coverage: the benefit from a loss-of-earnings insurance is calculated on the insured income, and your buy-back options in occupational pension provision depend on the income subject to contributions. Checking these two points at the same time as AVS avoids costly inconsistencies.
"This article is provided for information purposes only and does not constitute personalised legal, tax or financial advice; amounts and rates may change. MedCourtage (FINMA F01502264) recommends that you consult your compensation fund or a specialist before making any decision concerning your AVS contributions."

FAQ

It applies to the net income from the self-employed activity, i.e. profit after expenses. The rate is 10.0 % from CHF 60'500 of annual income, with a sliding scale below that and a minimum contribution of CHF 530 per year (FSIO scales 2026).

The provisional instalments are based on the income that you estimate. When the tax administration communicates the final assessment to the fund, the fund recalculates the contribution on the actual income and invoices the difference, possibly with interest.

Yes. A written request to the fund, accompanied by supporting evidence such as an interim closing of accounts or an income projection, allows the instalments to be adjusted. This is the best way to avoid a large balance to be paid in a single payment.

Yes, the salary paid by the company is subject to joint AVS/AI/APG contributions. Dividends are not, but the fund checks that your salary remains in line with what a third party would receive for the same role.

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