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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Frequently asked questions on basic insurance:
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 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). 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.
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?
Every insured person must pay a certain portion of the treatment costs themselves. This cost contribution is known as the ‘deductible’. With 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
Submit your request before the end of November of the previous year (date of receipt at CONCORDIA).
Changing to a higher deductible with effect from 1 January
Submit your request before the end of December of the previous year (date of receipt at CONCORDIA).
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.