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All in one place: your basic insurance in the HMO model

With ÖKK CASAMED HMO, your first point of contact for any health questions is your HMO group practice. You benefit from medical expertise from a single source and save on premiums.

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Advantages
Benefits
Instructions
Documents
FAQ
Contact

Advantages

You save on premiums compared to classic basic insurance.*

You have a personal doctor in an HMO health centre.

Wide range of medical specialist knowledge all under one roof.

Basic insurance benefits

Hospital

Basic insurance

General

General ward (tariff in canton of residence)
General ward (tariff in canton of residence)

Double the tariff in the canton of residence

Up to double the tariff for the general ward in the canton of residence, in the EU according to bilateral agreements
Up to double the tariff for the general ward in the canton of residence, in the EU according to bilateral agreements

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General

General ward (tariff in canton of residence)
General ward (tariff in canton of residence)

General

General ward (tariff in canton of residence)
General ward (tariff in canton of residence)

Transport, rescue, search

Up to CHF 500

50%, up to CHF 500 per calendar year (transport)
50%, up to CHF 5,000 per calendar year (rescue in Switzerland)
no benefits for repatriation
50%, up to CHF 500 per calendar year (transport)
50%, up to CHF 5,000 per calendar year (rescue in Switzerland)
no benefits for repatriation

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Medical treatment

Double the tariff in the canton of residence

Up to double the tariff in the canton of residence, in the EU according to bilateral agreements
Up to double the tariff in the canton of residence, in the EU according to bilateral agreements

100%

All costs covered (taking into account the deductible and the excess)
All costs covered (taking into account the deductible and the excess)

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Alternative medicine

Five methods

Acupuncture, anthroposophical medicine, Chinese medicine, homeopathy, phytotherapy by doctors with relevant training
Acupuncture, anthroposophical medicine, Chinese medicine, homeopathy, phytotherapy by doctors with relevant training

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Visual aids

CHF 180 up to 18 years

CHF 180 per calendar year (up to 18 years of age)
CHF 180 per calendar year (up to 18 years of age)

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Aids

According to List of Objects and Resources

According to List of Objects and Resources
According to List of Objects and Resources

Prevention

100% every 3 years

One examination every three calendar years (taking into account the deductible and the excess)
One examination every three calendar years (taking into account the deductible and the excess)

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In accordance with Benefits Ordinance

In accordance with Benefits Ordinance
In accordance with Benefits Ordinance

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Dental treatment

Masticatory system, dental accidents

Illness to masticatory system, dental accidents
Illness to masticatory system, dental accidents

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Maternity

CHF 150 for antenatal course, 3 nursing consultations

Antenatal course with midwife: CHF 150
Nursing consultations with midwife: 3 meetings
No benefits for postnatal courses
Antenatal course with midwife: CHF 150
Nursing consultations with midwife: 3 meetings
No benefits for postnatal courses

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Treatment and assistance at home

Examination, treatment, care

Examination, treatment, care (by a recognised institution)
Examination, treatment, care (by a recognised institution)

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Medication

According to medication and specialist lists

According to medication and specialist lists
According to medication and specialist lists

Balneotherapy and convalescent therapy

Medical treatment

Medical treatment
Medical treatment

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CHF 10 per day

CHF 10 per day, up to 21 days per calendar year
CHF 10 per day, up to 21 days per calendar year

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Non-medical psychotherapy

For therapists authorised under KVG

Medically prescribed psychotherapy with therapist authorised under KVG
Medically prescribed psychotherapy with therapist authorised under KVG

ÖKK pays the statutory benefits for you after deducting your deductible and excess and the hospital cost contribution. Find out more about the benefits covered by basic health insurance on the website of the Federal Office of Public Health (FOPH).

Good to know

An HMO, which is short for Health Maintenance Organisation, is a kind of health centre. The HMO model is available in many, but not all regions of Switzerland. Find a health practice in your area here. Please make sure that the HMO group practice you wish to join is still accepting new patients.

The right insurance for me.

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How the model works

In the event of illness

  • HMO stands for Health Maintenance Organisation. In any situation, you first contact your doctor in an HMO centre nearby.
  • If necessary, you will be referred to a specialist or hospital.
  • Exceptions: for paediatric, gynaecological, dental and ophthalmological treatment, you may consult a specialist directly without having to first contact the HMO centre.
  • 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 the HMO centre 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.
Find an HMO group practice

Find an HMO centre in your area

Documents

Questions and answers (FAQ)

HMO stands for Health Maintenance Organisation. Often, multiple general practitioners and specialists work together under one roof in a group practice. They benefit from the knowledge and experience of a network of doctors.

Under the HMO model, several GPs work together under one roof as part of a group practice. If necessary, your medical practice will refer you directly to specialists, hospitals or therapists.

You can use our HMO list to search for an HMO practice near you. Please note that not all group practices offer the HMO insurance model. Clarify in advance with your desired practice whether it can accept you.

By opting for the HMO model, you undertake to always contact your HMO practice first in the event of health problems. If you go to a hospital, therapist or 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 savings potential depends on the region you live in, your age, your chosen deductible and whether or not you have 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.

Get in touch now

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