Basic Insurance

Basic insurance, which is also known as mandatory health care insurance (OKP/AOS/AOMS), is the mandatory 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 three different models for basic insurance: the traditional model (free choice of doctor), myDoc (your family doctor is generally the first point of contact) and HMO (your health centre is the first point of contact).

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. By contrast, supplementary insurance is optional. You can use it to increase your insurance cover based on your individual needs.

The benefits covered by basic insurance are defined in the Swiss Federal Law on Health Insurance (KVG/LAMal). They are identical at all insurance providers. You can download a PDF overview of the benefits covered here: benefits_overview.pdf (679KB)

KVG and LAMal are the German, French and Italian abbreviations for the Swiss Federal Law on Health Insur-ance. The KVG/LAMal defines the benefits that are paid for by mandatory health care insurance and are the same at every insurance providers.

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 Swit-zerland. Alongside mandatory insurance, you can increase your insurance cover on an individual basis with supplementary policies.

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 visible on your pay slip: if it includes a non-occupational accident insurance deduction, this means you are insured via your employer. 

Every insured person must pay a certain portion of the treatment costs themselves. This cost contribution is known as the deductible. In the basic insurance (OKP/AOS/AOMS), insured persons can choose between deductibles of CHF 300, 500, 1,000, 1,500, 2,000 and 2,500 per year. The available deductibles for children are CHF 0, 200, 400 and 600 per year. 

The higher the deductible (i.e. the higher the cost contribution), the lower the premium. 

Once your treatment costs have reached the amount of your chosen deductible in a calendar year, the retention fee applies: You pay 10% of the amount that exceeds your deductible, up to CHF 700 per year for adults and CHF 350 per year for children up to and including the age of 18.

You can change your deductible every year with effect from the next calendar year (as of 1 January). 

Changing to a lower deductible with effect from 1 January
The request must be submitted before the end of November of the previous year (date of receipt at CONCORDIA).

Changing to a higher deductible with effect from 1 January
The request must be submitted before the end of December of the previous year (date of receipt at CONCORDIA).

Insured persons can cancel their mandatory health care insurance with effect from 30 June or 31 December, subject to a three-month notice period. Cancellations and changes of insurer are only valid if notice is given in writing by the required deadline.