Basic Insurance
Mandatory health care insurance guarantees legal insurance protection in the event of illness, accident and maternity. Alongside the traditional model, CONCORDIA offers myDoc Family Doctor Insurance, HMO Health Insurance and the smartDoc virtual telemedicine model.
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Basic Insurance at a Glance
Basic insurance is mandatory for all residents of Switzerland. The benefits are established by the law and therefore they are the same for all health insurance providers.
Alongside the traditional model, CONCORDIA offers three alternative insurance models. The difference between the myDoc family doctor insurance and the HMO model lies in the fact that you choose your first point of contact for medical complaints: your family doctor or your HMO health centre.
With the third alternative, the smartDoc telemedicine model, you decide when, where and how to take care of your medical concerns. In the event of a medical problem, you always contact the Medgate digital health practice first – either via the CONCORDIA Medgate app or by telephone.
The coordination of treatments via the first point of contact allows unnecessary treatments to be avoided. Depending on the deductible you choose, you will be able to benefit from additional savings on premiums.
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Frequently asked questions on basic insurance:
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What is basic insurance?
Basic insurance, which is also known as mandatory health care insurance (OKP/AOS/AOMS), is the obligatory component of health insurance. It provides insurance cover in the event of illness, accident and maternity. The amount of the monthly premium is determined by your place of residence and age as well as the model and deductible you have chosen. CONCORDIA offers four different models for basic insurance: the traditional model (free choice of doctor), myDoc (your family doctor is generally the first point of contact), HMO (your health centre is the first point of contact) and smartDoc (the Medgate digital health practice is the first point of contact). Get in touch with your CONCORDIA agency. -
Is basic insurance mandatory?
Yes, basic insurance is mandatory. The insurance obligation commences at birth or upon taking up residence in Switzerland and ends at death or upon leaving Switzerland. In contrast, supplementary insurance is optional. You can use it to create your insurance cover based on your individual needs. -
What does basic insurance cover?
The benefits covered by basic insurance are defined in the Swiss Federal Law on Health Insurance (KVG/LAMal). These are identical for all health insurance providers. You can download a PDF overview of the benefits covered here: Overview of Benefits -
What do “KVG/LAMal” and “OKP/AOS/AOMS” mean?
KVG and LAMal are the German, French and Italian abbreviations for the Swiss Federal Law on Health Insurance. The KVG/LAMal defines the benefits that are paid for by mandatory health care insurance and are the same for every insurance provider.
The German, French and Italian abbreviations OKP, AOS and AOMS designate mandatory health care insurance. Under the Swiss Federal Law on Health Insurance (KVG/LAMal), it is mandatory for all people resident in Switzerland. Alongside mandatory insurance, you can increase your insurance cover on an individual basis with supplementary policies.
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When can I exclude accident cover from my basic insurance policy?
If you work at least eight hours per week for an employer that provides non-occupational accident insurance, you can exclude accident cover from your mandatory health care insurance. This is also shown on your pay slip: If it includes a non-occupational accident insurance deduction, this means you are insured via your employer. -
What is the deductible and what is the retention fee?
Deductible: The deductible is a part of the health care costs which the insured person must pay. You can choose this amount among those available. During the calendar year, you pay all costs incurred until the chosen deductible amount has been reached. Health insurance takes over after that. The chosen franchise impacts the amount of the premium. The higher the franchise, the lower the insurance premium. In basic insurance, you can choose between the following deductibles:
Children up to 18 years: CHF 0, 100, 200, 300, 400, 500, 600
Adults: CHF 300, 500, 1'000, 1'500, 2'000, 2'500The deductible can always be adjusted for the beginning of the following calendar year. With CONCORDIA, this can also be done online, subject to the applicable deadlines: Change in Deductible for Mandatory Health Care Insurance KVG/LAMal.
Retention fee: If the medical costs exceed the chosen deductible during the course of the calendar year, the health insurer will cover 90 % of the remaining costs. 10 % must be borne by the insured person as a retention fee. For select medications, this fee is 40 %. The retention fee is capped per year at a maximum of CHF 350 for insured persons up to 18 years of age and at a maximum of CHF 700 afterwards.
Example:
You have chosen a deductible of CHF 300 and receive an invoice for CHF 8'300:
You pay the chosen deductible amount of CHF 300.
For the remaining CHF 8'000, you have to pay a retention fee of 10 %. This would be CHF 800.
However, the annual maximum amount of the retention fee is restricted to CHF 700 per year.
For this reason you pay CHF 1'000 in total (CHF 300 deductible + CHF 700 retention fee). The remaining costs are covered by the health insurer. -
How can I cancel my mandatory health care insurance and switch to a different provider?
You can cancel your basic insurance subject to a one-month notice period to the end of the year, i.e. no later than 30 November. Cancellations and changes of insurer are only valid if notice is given in writing within the required deadline.