Advantages
You save on premiums compared to classic basic insurance.*
Your (tele-)general practitioner knows you and your needs best.
A new option in the general practitioner model: the tele-GP
In the ÖKK CASAMED GENERAL PRACTITIONER basic insurance model, you can now choose a tele-general practitioner as your first point of contact. You will enjoy various advantages if you do so.
Find out more about the tele-GP model
The benefits you receive
The basic insurance covers medically required benefits in the event of illness, accident and maternity. These benefits are defined in the Swiss Health Insurance Act (KVG) and are the same at all health insurers in Switzerland.
Regardless of which basic insurance model you opt for, the benefits remain identical. The difference between the models is only in the choice of your first point of contact for medical questions.
ÖKK pays the statutory benefits for you after deducting your deductible and excess and the hospital cost contribution.
How it works
In the event of illness
- In any situation, you first contact your (tele-)GP from the ÖKK list of general practitioners.
- If necessary, your (tele-)GP will refer you to a specialist or hospital.
- Exceptions: for paediatric, gynaecological, ophthalmological and dental treatment, you may consult a specialist directly without having to contact your tele-GP first.
- You must always have your ÖKK insurance card to hand.
- Submit your doctor’s bills and claim documentation to ÖKK.
In an emergency
- In case of emergency, you do not have to get in touch with your first point of contact. You can contact your nearest hospital or emergency doctor directly.
- Notify your (tele-)GP within twenty days after the emergency and discuss the next steps together.
- If these steps are taken, ÖKK will cover the costs of the emergency medical treatment.
Questions and answers (FAQ)
In the general practitioner model, your first point of contact is always your chosen GP or tele-GP. This is who you must turn to first when you have health-related questions or symptoms of illness. If necessary, that point of contact will then refer you to a specialist or hospital. This coordinated process can make your treatment more efficient.
Yes, you save up to 15.5 percent on your premiums with the general practitioner model. The savings potential depends on the region you live in, your age, your chosen deductible and whether or not you have accident cover. Get a non-binding calculation of your premium with our premium calculator.
You may make appointments with gynaecologists, dentists and ophthalmologists without seeing your general practitioner first. Emergency treatment is also an exception.
Under the general practitioner model, your GP is always your first point of contact. You also have to stick to the same first point of contact under the HMO model, but in this case it is a fixed network of doctors organised in an HMO group practice.
By opting for the general practitioner model ÖKK CASAMED GENERAL PRACTITIONER, you undertake to always contact your GP first when you have health problems. If you go to a specialist directly without a referral, ÖKK may transfer you to the standard basic insurance model, in which case you will lose your discount on the basic insurance premium.
* The premium reduction depends on the premium region, age, deductible and accident cover.
Do you have any questions?
We will be happy to help you if you need further information or would like to arrange a no-obligation consultation.
