When costs are incurred for a doctor, hospital or medication, insureds are required by law (KVG) to take over a certain portion of these costs themselves each calendar year. This first cost sharing arrangement is called the annual deductible.
You can save up to 44% on your basic insurance premiums by increasing your annual deductible. The maximum annual deductible is 2,500 Swiss francs.
When the costs exceed the agreed deductible during the calendar year, the health insurance company takes over 90% of the additional costs. You will pay 10% of these costs. This cost sharing is called excess. The maximum annual excess is 700 Swiss francs for adults and 350 Swiss francs for children, independent from the chosen annual deductible.
Law requires an annual deductible of 300 Swiss francs for the mandatory health care insurance (basic insurance). There is no deductible for children (until the end of the calendar year of the 18th year of life).
Your health insurance company will deduct the entire deductible from the reimbursement of the first doctor's bill or you will receive an invoice for the costs incurred, if the doctor's bill was sent directly to your health insurance company.
You can change your deductible as of the start of every calendar year. You must notify ÖKK of a change to a lower deductible by 30 November and a change to a higher deductible by 31 December. You can do so by e-mail or online in the deductible calculator.
The relevant date is the one of the treatment. An example: If a treatment is provided in December 2016, the deductible and excess of the year 2016 apply. Even if the invoice will not be issued until February 2017.