The insurance policy proof notes your level of accident insurance. Only gainfully employed people with a weekly work schedule of eight hours or more that have mandatory UVG insurance for occupational accidents and non-occupational accidents from their employer can waive the accident risk in the BASIS insurance plan with a matching premium reduction.

» Waive accident coverage online.

Required health insurance. The benefits are precisely determined by the Krankenversicherungsgesetz (KVG). They are the same at all health insurance companies. Coverage includes:

• medical check-ups and treatments, including prescribed therapies
• prescribed medications
• hospital stays in the general ward of a public hospital in the canton of residence
• premiums for nursing in a nursing home and extra-hospital care in accordance with cantonal rates
• costs abroad up to a maximum of double the rate of the canton of residence

Compulsory health insurance. The exact benefits are determined by the Krankenversicherungsgesetz (KVG). They are the same at all health insurance companies. The insurance plan includes:

• medical examinations and treatments, including prescribed therapies
• prescribed medications
• hospital stays in the general ward of a public hospital in the canton of residence
• premiums for nursing in a nursing home and extra-hospital care in accordance with cantonal rates
• costs abroad up to a maximum of double the rate of the canton of residence

Premiums for transportation costs, adjuvants, regimens, and prevention.

Federal Occupational Retirement, Survivors’ and Disability Pensions Act (BVG). The occupational provision (2nd pillar) guarantees continuance of the previous standard of life for the insured person up to a certain income in old age, in case of disability, or for dependants in case of death together with the 1st pillar (AHV/IV/EO).

The legally required basic health insurance plan can be cancelled subject to a three month cancellation period at the end of June and the end of December. In cases of premium increases that must be announced two months in advance, the insurance plan can be cancelled within 30 days at the end of the following month.

The corresponding AVB (General insurance conditions) are standard for cancellation of the VVG supplementary insurance plans. Normally, supplementary insurance plans as per VVG (private insurance law) can be cancelled subject to a three month cancellation period at the end of December. In cases of premium increases, the insurance plan can generally be cancelled within 30 days at the end of the following month.

ÖKK expressly waives its right to cancellation in case of claims as per the Versicherungsvertragsgesetz (VVG) in the treatment cost supplementary insurance plans, and/or waives the right to refuse extension of the contract in case of poor contract history.

ÖKK CASAMED: The affordable ÖKK general practitioner and HMO system guarantees comprehensive and holistic medical care. CASAMED members choose their trusted contact ahead of time from a list of doctors. In case of illness, members always turn to the permanent general practitioner or HMO practice first. If it is medically necessary, the patients will be transferred to a specialist by the general practitioner. Emergencies are exempt from this requirement. ÖKK CASAMED is offered in various regions throughout Switzerland.

» Generate a quote online

ÖKK guarantees children and youths up to 18 years old a premium rebate of up to 75% in the BASIS insurance plan.

ÖKK CLASSIC is the ÖKK product line with the four solid classics:

ÖKK COMFORT offers general members the comfort of a one or two bed room during a hospital stay at a low cost. This offer for a more private space applies to all ÖKK comfort-contract hospitals.

ÖKK COMPENSA: Loss of income insurance for individuals (as per VVG) covers financial losses caused by inability to work due to illness, accident, or birth. The following persons can take out a policy

• self-employed people
• employees (for the part of the salary not insured by the employer)
• homemakers
• students or trainees

According to federal regulations, anyone who takes out a basic insurance policy (BASIS) must contribute to the costs for medical treatment, hospital stays, and medications. For adults, cost sharing consists of the yearly deductible and the retention, for children without increased deductible, only of the retention.

If costs are incurred for a doctor, a hospital, or medication, the insurance policy holders must first, in accordance with the law (KVG), assume a certain portion of these costs themselves in every calendar year. This first instance of cost sharing is called the yearly deductible.

By increasing your yearly deductible, you can save up to 44% on your basic insurance plan (BASIS) premiums.

ADULTS	CHILDREN
CHF 300.-	CHF 0.- (without yearly deductible)
CHF 500.-	CHF 200.-
CHF 1'000.-	CHF 400.-
CHF 1'500.-	CHF 600.-
CHF 2'000.-
CHF 2'500.-

Only when the costs exceed the agreed deductible within the calendar year will the health insurance company take on 90 percent of those additional costs. 10 percent (=retention) of these costs are charged to the insurance policy holder. You can only change your deductible at the beginning of the calendar year.

» You can change your deductible online here.

A disability fund of between CHF 10'000.- und CHF 1'050'000.- is paid out regardless of the selected class of insurance plan or degree of disability.

Members between 19 and 25 years of age save up to 17% of the regular adult premiums on compulsory basic insurance ÖKK.

ÖKK FLEX gives you the freedom to choose your hospital ward (general, half-private, private) immediately before entry into the hospital. Corresponding, easily calculable cost sharing with clear limits is provided for treatment in the half-private or private hospital ward for additional hospital costs. Otherwise, ÖKK FLEX offers the same additional benefits as ÖKK HALF PRIVATE (increased premiums for alternative medicine, orthodontics, glasses, home help).

Border crossers in the EU are generally required to have insurance in Switzerland.

ÖKK offers the statutory health insurance for frontier workers: ÖKK EUROLINE.

Doctors in the ÖKK CASAMED general practitioner and HMO system, which members should always contact first in case of illness. The gatekeeper will transfer the patient to a specialist if it is medically necessary.

A complete health declaration is required in order to take out a supplementary insurance policy. The health declaration must be filled out truthfully. Incorrect information can result in refusal or curtailment of benefits, reclamation, retroactive conditions or retroactive rejections, or exclusion or withdrawal of the insurer.

ÖKK CASAMED: The cost-efficient ÖKK general practitioner and HMO system guarantees comprehensive and holistic medical care.

CASAMED members choose their trusted contact ahead of time from a list of doctors. In case of illness, members always turn to the permanent general practitioner or HMO practice first. If it is medically necessary, the patients will be transferred to a specialist by the general practitioner.

HMO = Health Maintenance Organization. This health organisation consisting of HMO practices and partially affiliated general practitioners and doctors guarantees comprehensive and holistic medical care. The HMO systems provide services for members of the cost-efficient CASAMED general practitioner system.

In case of illness, members always turn to the permanent general practitioner or HMO practice first. If it is medically necessary, the patients will be transferred to a specialist by the general practitioner. Emergencies are exempt from this requirement. For routine treatments, the prior paediatrician or gynaecologist may be consulted.

ÖKK offers HMO systems in various regions throughout Switzerland.

» Generate a quote online.

The new KVG was accepted by the people and cantons on 4 December 1994 and went into effect on 1.1.1996. It replaced the old law from the year 1911. The following improvements were introduced, among others:

• Introduction of insurance mandate
• Acceptance of alternative insurance models
• Right to cantonal premium reduction
• Risk sharing among health insurers
• Separation of basic social insurance and supplementary private insurance

Loss of income means loss of salary or salary cut due to inability to work. Businesses cover their obligation to continue to pay salaries to employees who are unable to work due to illness and with loss of income insurance and can voluntarily insure their employees’ income beyond the legally required minimum amount.

The loss of income insurance plan for businesses (VVG) covers the company’s obligation to continue paying a salary to employees that are unable to work due to illness. Coverage of loss of income due to accident and birth can be included. ÖKK offers variations with and without health exceptions, as well as variations specifically adjusted to the company’s BVG insurance plan.

ÖKK COMPENSA: The loss of income insurance plan for individuals (as per VVG) provides coverage for financial losses caused by inability to work due to illness, accident, or birth. The following persons can take out a policy

• self-employed people
• employees (for the part of the salary not insured by the employer)
• homemakers
• students or trainees

ÖKK COMPENSA offers the variations of daily allowance for illness, daily allowance for accident, or daily allowance for illness and accident.

In the event of conclusion of the KOMBI supplementary hospital insurance plan before the 40th or 50th birthday, ÖKK guarantees a loyalty rebate of 20% of 10%, respectively. This applies for KOMBI HALF PRIVATE, KOMBI FLEX, KOMBI PRIVATE and KOMBI GLOBAL. Long-term members also receive a loyalty rebate in the inpatient private patient supplement.

As an ÖKK member, you automatically benefit from the attractive offer of the ÖKK CLUB. ÖKK Club offers you fun and games throughout the year with active recreational programmes, as well as exciting experiences and admission thanks to family-friendly perks.

On your ÖKK insurance policy, you will find your insurance plan type and the amount of your premium. Take good care of this proof.

Lost your policy? » Order a new one here

Premiums are determined by age and differ due to varying regional costs and partly also by sex. The premiums of the place of residence apply.

The ÖKK offer is organised in packages in the interests of clarity. This guarantees that no unknown insurance gaps arise. The choice of package is mainly determined by the decision.

• between free choice of doctor or general practitioner system
• according to the desired level of hospital comfort

By increasing your yearly deductible, you can save up to 40% on your basic insurance plan (BASIS) premiums (up to 50% with CASAMED). Choose from the following options:

ADULTS	CHILDREN
CHF 500.-	CHF 200.-
CHF 1'000.-	CHF 400.-
CHF 1'500.-	CHF 600.-
CHF 2'000.-
CHF 2'500.-

The deductible can be changed at the beginning of a calendar year.

The KOMBI hospital insurance plans (except those with yearly deductible) offer a variation with a rebate for unused benefits. If a debit exists on the insurance plan or if no benefits are used during three consecutive observation periods, a tiered system will be instituted beginning on 1 January of the following year.

If the costs of outpatient and inpatient treatment exceed the agreed yearly deductible, in the calendar year, the health insurance company takes over 90% of the additional costs. The remaining 10%, the retention, is charged to the insurance policy holder. The highest amount per year is CHF 700.- for adults and CHF 350.- for children. In addition, people without support obligations are charged another CHF 15 per hospital day (from age 18).

Save on premiums with

• an increased yearly deductible
• the popular CASAMED general practitioner and HMO insurance plan
• the accident exclusion for full-time employees

Since the introduction of the Krankenversicherungsgesetzes (KVG), the voluntary treatment cost supplementary insurance plans are no longer subject to the Sozialversicherungsgesetz, but to the Versicherungsvertragsgesetz (VVG). ÖKK calculates the premiums according to the principle of partial solidarity.

For surviving spouses, half-orphans and orphans, as well as divorced spouses. Maximum of 70% of the insured earnings for all survivors, or 90% for divorced spouses eligible for pensions.

Pricing system between health insurers and doctor’s organisations for flat settlements for outpatient medical services. For services included in the basic insurance plan as per (KVG), Tarmed went into effect on 1 January 2004.

The third child (and each additional one) is free of premiums, in the (treatment costs) supplementary insurance plans (VVG), as long as the two older siblings living in the same household and under the age of 25 are insured for an equal amount with ÖKK.

Costs incurred by medical examinations, therapies, medications, hospital stays, nursing, transportation of a patient, adjuvants, regimens, prevention etc.

ÖKK offers the right treatment cost insurance plan for every situation:

• STANDARD: General hospital ward throughout Switzerland
• PRIVATE ACCIDENT: World-wide private coverage in case of accident
• COMFORT: Room with one or two beds in the general ward
• FLEX: Choice of ward (general / half-private / private) upon entry into hospital
• HALF-PRIVATE: Room with two beds with free choice of hospital doctor
• PRIVATE: Single bed room with free choice of hospital doctor
• GLOBAL: Private hospital ward world-wide

According to the Bundesgesetz über die Unfallversicherung (UVG) of 1.1.1984, every employer is required to provide accident insurance for his or her employees in accordance with the provisions of the law. The UVG insurance plan covers

• the employer’s obligation to continue to pay a salary to employees who are unable to work due to an accident
• pension in case of disability due to accident

The UVG insurance plan covers the health-related, financial, and intangible consequences of accidents. It provides

• Care and benefits in kind (treatments, necessary adjuvants, travel and transport costs)
• Cash benefits (daily allowance, disability pension, severance pay, integrity compensation, helplessness allowance and survivor’s pension)

The employer owes the total sum of the premiums. Premiums for insurance of non-occupational accidents (NBU) can be charged to the employees.

Versicherungsvertragsgesetz (VVG). It governs the insurance contracts for private insurance. This includes

• treatment cost supplementary insurance plans of health insurance companies
• Loss of income insurance for businesses
• Supplementary and complementary insurances plans for the UVG