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.
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.
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.
How it 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.
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.
