Advantages
You save up to 13 percent on premiums compared to classic basic insurance*.
For all health-related questions, your first point of contact is Medgate (via telephone or app).
Medgate can be reached around the clock, seven days a week.
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. Find out more about the benefits covered by basic health insurance on the website of the Federal Office of Public Health (FOPH).
How the Telmed model works
In the event of illness
- Contact the specialist doctors at Medgate (by phone or via the app) around the clock.
- If necessary, Medgate will refer you to a specialist or hospital.
- Exceptions: for paediatric, gynaecological, dental and ophthalmological treatment, you may consult a specialist directly without having to contact Medgate first.
- Always have your ÖKK insurance card with you.
- 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 Medgate within twenty days after the emergency and discuss the next steps together.
- You must always have your ÖKK insurance card to hand.
- Submit your doctor’s bills and claim documentation to ÖKK.
- If these steps are taken, ÖKK will cover the costs of the emergency medical treatment.
Questions and answers (FAQ)
You must always contact Medgate first when you have health-related questions or symptoms of illness. If necessary, Medgate will then refer you to a specialist or hospital. Medgate is available around the clock.
The Telmed model is primarily aimed at cost-conscious people who would like to use a telephone or digital advice service first when they have health-related questions.
The team of doctors at Medgate can issue prescriptions when there is a medical necessity. That way, you can obtain your chosen medicine quickly and easily in a pharmacy or order it from a mail-order pharmacy.
If you opt for the Telmed model, Medgate is always your first point of contact – over the phone or via the app. This does not include emergencies. If you go to a practice directly without a referral from Medgate, ÖKK may transfer you to the standard basic insurance model, in which case you will lose your discount on the basic insurance premium.
Digital medical advice can be obtained from Medgate free of charge by all ÖKK customers, no matter what model of basic insurance they have selected. They only have to pay for the local-rate telephone call.
* 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.
