Overview of insurance products

Optional supplementary insurance

Supplementary insurance for outpatient treatment

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OMNIA: Healthcare and supplementary hospital insurance with a guaranteed upgrade

OMNIA offers you a basic package with the most important supplementary benefits to basic insurance and guarantees acceptance for various insurance upgrades at a later stage. That means you can enjoy solid all-round cover from day one. And if your needs increase over time, you can extend your cover every five years regardless of your state of health.

Solid all-round cover with a guaranteed right to upgrade – regardless of your future state of health.

Insurance benefits

The following insurance benefits are provided by OMNIA supplementary healthcare and hospital insurance in addition to those provided under statutory basic insurance:

Aids to vision (spectacle lenses and contact lenses) 90% up to CHF 150 per year.

You get 90% of the costs of spectacle lenses and contact lenses up to CHF 150 per calendar year.

What does basic insurance cover?

Children and young people up to the age of 18 receive CHF 180 per year towards spectacle lenses and contact lenses. Adults have to pay for these themselves.

Details about basic insurance >

Medicines 90%

You receive 90% of the costs of medically prescribed medications that are not covered by basic insurance ("non-reimbursed medications").

This is subject to the condition that the medication is approved by the Swiss Agency for Therapeutic Products Swissmedic for the treatment of the existing illness.

Medications on the list of pharmaceutical products with special application (LPPV) or its supplementary list are excluded.

Further information

What does basic insurance cover?

Only medically prescribed medications that are on the specialities list (SL) are covered. Patients have to pay for any medications not covered by statutory health insurance themselves – even if prescribed by a physician.

Details about basic insurance >

Abroad 100% of excess costs

Emergency treatment abroad (outpatient)

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care locally and take care of all the necessary formalities.

For outpatient emergency treatment during a temporary stay abroad of up to 12 months you will receive 100% of the costs that exceed the cover provided by basic insurance.

Conditions:

  • A journey home or transportation to Switzerland is not reasonable.
  • You arrange for our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

For emergency treatment in EU/EFTA countries, basic insurance covers the costs in accordance with the social tariff of the respective country.

In other countries, it covers a maximum of twice the cost of the same treatment had it been provided in Switzerland (tariff of the canton of residence). This is nowhere near enough in some countries, such as the US, Canada, Japan and Australia.

Details about basic insurance >

Emergency treatment abroad (inpatient)

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care locally and take care of all the necessary formalities.

For inpatient emergency treatment during a temporary stay abroad of up to 12 months, you will receive all of the costs in a general ward that exceed the cover provided by basic insurance.

Conditions:

  • A journey home or transportation to Switzerland is not reasonable.
  • You arrange for our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

For emergency treatment in EU/EFTA countries, basic insurance covers the costs in accordance with the social tariff of the respective country.

In other countries, it covers a maximum of twice the cost of the same treatment had it been provided in Switzerland (tariff of the canton of residence). This is nowhere near enough in some countries, such as the US, Canada, Japan and Australia.

Details about basic insurance >

Transport and rescue in Switzerland CHF 100'000.–

Transport at home

In addition to the transportation benefits provided by the basic insurance, you receive CHF 100,000 per calendar year for transportation that is required on medical grounds within Switzerland.

The total amount is payable to cover all rescue, recovery, relocation and emergency transportation services.

What does basic insurance cover?

Only 50% of the costs are reimbursed, with an annual maximum of CHF 500 for transport.

Details about basic insurance >

Rescue at home

CHF 100,000 is the total amount payable to cover all rescue, recovery, relocation and emergency transportation services.

What does basic insurance cover?

Only 50% of the costs are reimbursed, with an annual maximum of CHF 5,000 for rescue.

Details about basic insurance >

Transport and rescue abroad (personal assistance) 100%

Transport abroad

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

You receive the costs overall for transportation to the nearest suitable hospital.

Conditions:

  • You have to organise the necessary through the emergency call centre.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Rescue abroad

For rescue abroad it is necessary to organise the necessary through the emergency call centre. You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

For rescue you receive the overall costs for transportation to the nearest suitable hospital.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Search and rescue

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

You receive up to CHF 20,000 in any one calendar year for search and recovery operations undertaken for the purpose of rescuing or recovering you.

Conditions:

  • You allow our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Repatriation

Your health is our top priority – including if you become ill or suffer an accident abroad. Our emergency call centre is available around the clock on +41 43 340 16 11.

They will coordinate medical care at the location and take care of all the necessary formalities.

You receive all of the costs of repatriation to your place of residence or to a hospital in Switzerland.

Conditions:

  • You allow our emergency call centre to handle the organisation at every stage.
  • A doctor authorised by us confirms that your repatriation is a necessity.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves. However, repatriation often costs tens of thousands of francs – for example, when a patient needs to be repatriated by air in an ambulance jet.

Details about basic insurance >

Travel for visitors

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

If you have to spend more than seven days in a foreign hospital, our emergency call centre will organise and pay for round-trip travel for a close friend or relative (proven costs, up to a maximum of the price of one economy flight). You will also receive the proven costs of up to CHF 1,000 per event for your visitor's room and board.

Conditions:

  • You allow our emergency call centre to organise every stage of the visit.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Return journeys

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care at the location and take care of all the necessary formalities.

If you are prevented by hospitalisation from boarding your return flight, you will receive the flight re-scheduling fees for your return flight. If you cannot be booked onto another flight, you will receive the fees for a return flight in economy class.

Conditions:

  • You allow our emergency call centre to handle the organisation at every stage.
  • You submit your expired return flight ticket.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay all costs themselves.

Details about basic insurance >

Treatment of tooth misalignment 75% up to CHF 10'000.–
  • Teeth are misaligned if they do not fit ideally dental arch; this has a negative cosmetic impact. Braces can be used to correct such misalignments.
  • If you undergo this treatment abroad, you can claim the actual costs up to the amount which the treatment would have cost in Switzerland. Treatment in Switzerland is subject to the scale of fees published by the Swiss Association of Dentists (SSO).
  • Upon reaching the age of 25, you are entitled to take out the dental insurance policy DENTAplus 1000 (Bronze Option) without having to undergo a medical examination.

Until you reach the age of 25, you receive 75% of the costs up to CHF 10,000 per calendar year for the treatment of misaligned teeth by means of orthodontic treatment and oral surgery (including braces).

Our contribution will be reduced by any contribution to costs that you have received from school or youth dental care programmes in Switzerland.

You are not entitled to any contribution for dental products such as toothbrushes, toothpaste or dental floss.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for planned corrective measures for misaligned teeth themselves. However, braces can cost thousands of francs per year.

Details about basic insurance >

Medical aids and equipment 90% up to CHF 1,000 / Fixed amount

You receive 90% of the costs of medically prescribed aids and equipment that improve restricted body functions, such as blood pressure monitors and orthopaedic shoe inserts, up to CHF 1,000 per year.

This is on condition that the aids and equipment are recognised by us.

For reusable aids, you receive costs up to the fixed amount. You can find these in the list of reusable aids and equipment.

Further information

What does basic insurance cover?

Only the statutorily defined maximum costs for medical aids and equipment prescribed by a doctor that is included on the list of aids and equipment (MiGeL) are covered

Details about basic insurance >

Special forms of treatment 75% up to CHF 3,000

Psychotherapy

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You can claim 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Non-medical psychotherapy belongs to this group.

Conditions:

  • The therapy is prescribed by a doctor.
  • The therapy is carried out by a psychotherapist recognised by us.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Sterilisation

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You can claim 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Sterilisation is one of them.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Vasectomy

CHF 3,000 is the total amount payable to cover all special forms of treatment.

You receive 75% of the costs up to CHF 3,000 per calendar year for special forms of treatment. Vasectomy is one of them.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Foot care

75% of the costs for medical foot care, podology, shall be covered (for a flat-rate attendance fee of no more than CHF 110).

Conditions:

  • Treatment is provided by an accredited chiropodist who is a member of a chiropodists' association and is additionally qualified to treat diabetics.
  • Treatment has been prescribed by a doctor.
  • The precise diagnosis is stated in the prescription.

If you do not have diabetes and need foot treatments, please ask us in advance whether and under what conditions you would receive a contribution to help cover the costs from your supplementary insurance policies.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for these treatments themselves.

Details about basic insurance >

Healthcare and foreign legal expenses insurance Up to CHF 250,000 per case

Legal protection in health matters

  • Legal advice and representation for legal disputes.
  • You can claim up to CHF 250,000 per dispute (or CHF 50,000 in cases outside Europe) to cover lawyers' fees, court and procedural expenses, expert witnesses, court fees and compensation for the other party.
  • The policy covers disputes in your capacity as the driver, hirer or user of transportation or as a pedestrian during holidays and while attending foreign schools (including transport to and from the school).
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for legal protection benefits themselves.

Details about basic insurance >

Legal Protection Abroad

  • Legal advice and representation for legal disputes.
  • You can claim up to CHF 250,000 per dispute (or CHF 50,000 in cases outside Europe) to cover lawyers' fees, court and procedural expenses, expert witnesses, court fees and compensation for the other party.
  • The policy covers disputes in your capacity as the driver, hirer or user of transportation or as a pedestrian during holidays and while attending foreign schools (including transport to and from the school).
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for legal protection benefits themselves.

Details about basic insurance >

Travelcheck Inclusive

You benefit from free telephone travel advice from Travelcheck. This service provides you with 24-hour individual information about health risks in the country you are visiting: +41 43 340 16 22.

Further information

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for this service themselves.

Details about basic insurance >

Hospital stays in Switzerland General – anywhere in Switzerland

Hospital stays

You receive all the costs of a stay, care and treatment in a general ward (multi-bed room).

What does basic insurance cover?

You receive the costs of a stay, care and treatment in a general ward (multi-bed room).

Details about basic insurance >

Choice of hospital

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) general ward; in such cases, you may incur costs for which you alone will be responsible.

Further information

What does basic insurance cover?

Basically you are free to choose any hospital you want in Switzerland which is on a cantonal hospital list (“listed hospitals”). But the costs will only be paid up to the amount that is reimbursed in your canton of residence. If you stay in an out-of-canton hospital you may have to pay the excess costs.

Patients are not allowed to choose the hospital doctor themselves.

Details about basic insurance >

Hospital stays abroad 100% of excess costs

Emergency treatment abroad (inpatient)

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11. They will coordinate medical care locally and take care of all the necessary formalities.

For inpatient emergency treatment during a temporary stay abroad of up to 12 months, you will receive all of the costs in a general ward that exceed the cover provided by basic insurance.

Conditions:

  • A journey home or transportation to Switzerland is not reasonable.
  • You arrange for our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

For emergency treatment in EU/EFTA countries, basic insurance covers the costs in accordance with the social tariff of the respective country.

In other countries, it covers a maximum of twice the cost of the same treatment had it been provided in Switzerland (tariff of the canton of residence). This is nowhere near enough in some countries, such as the US, Canada, Japan and Australia.

Details about basic insurance >

Planned treatment abroad (inpatient)

The Swiss Health Insurance Act applies as the basis for cost reimbursement.

You will receive up to CHF 500 a day for up to 60 days per calendar year for planned inpatient treatment abroad if you have obtained a confirmation of cost reimbursement from us in advance.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay the costs themselves.

Basic insurance in detail >

Balneotherapy and convalescent therapy CHF 30 per day

Spa treatment

To find out which therapeutic spas are recognised by us, please contact your customer service team.

The duration of benefits for spa and convalescent therapies is 30 days in total.

You receive CHF 30 per day for up to 30 days per calendar year for spa therapies at recognised therapeutic spas in Switzerland.

Conditions:

  • The spa treatment is medically certified as necessary.
  • The spa treatment has been prescribed by a doctor.
  • The spa treatment is carried out at a therapeutic spa recognised by us.
What does basic insurance cover?

You receive CHF 10 per day for up to 21 days per calendar year.

Details about basic insurance >

Convalescent therapy

To find out which therapeutic spas are recognised by us, please contact your customer service team.

The duration of benefits for spa and convalescent therapies is 30 days in total.

You receive CHF 30 per day for up to 30 days per calendar year for convalescent therapies in Switzerland.

Conditions:

  • The convalescent therapy has been prescribed by a doctor.
  • The convalescent therapy is carried out at a therapeutic spa recognised by us.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay the costs themselves.

Details about basic insurance >

Household help CHF 30 per day

Household help

Following an acute inpatient hospital stay, you will receive CHF 30 per day for up to 30 days per calendar year for medically prescribed household help.

What does basic insurance cover?

Costs are not covered by basic insurance. Patients who require a household help after a stay in hospital have to finance this themselves.

Details about basic insurance >

Nanny service 30 hours

You can reach the emergency call centre 24 hours a day on +41 43 340 16 11.

You receive up to 30 hours of nanny services per calendar year if you have to be admitted to hospital as an inpatient.

While you are in hospital, an experienced carer will look after your healthy children aged up to 15 years on weekdays. This will enable you to recover in hospital at your leisure, while enjoying peace of mind that your children are being lovingly looked after at home.

Conditions:

  • You as a parent need to spend time in hospital as an inpatient.
  • You took out the insurance for the hospitalised parent (not for the child).
  • You allow our emergency call centre to handle the organisation at every stage.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients have to pay for this service themselves.

Details about basic insurance >

Intensive and transitional care CHF 90 per day

You will receive CHF 90 per day for up to 14 days per calendar year for the costs of boarding (room and board) in a nursing home during inpatient acute and transitional care.

Conditions:

  • Acute or transitional care has been prescribed by a doctor.
  • Your acute or transitional care immediately follows a hospital stay.
What does basic insurance cover?

Costs are not covered by basic insurance. Patients must pay the costs for boarding costs (accommodation and meals in a nursing home) themselves.

Details about basic insurance >

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FAQs

Answers to frequently asked questions about OMNIA, the supplementary healthcare and hospital insurance with a guaranteed upgrade:

Why do I need supplementary healthcare and hospital insurance?

Compulsory basic insurance covers only the statutory benefits in the event of illness, accident and maternity.

When you conclude OMNIA, you receive valuable supplementary outpatient benefits such as glasses, medication, medical aids and coverage abroad. Inpatient benefits include an unrestricted choice of hospital and Helsana services such as the nanny service. You also receive contributions towards the costs of hospital stays abroad, convalescent treatments and household help.

How is OMNIA different from other supplementary healthcare and hospital insurance?

OMNIA is the insurance that takes account of your future needs. You start with a solid basic package that is based on the insurance benefits offered by TOP and HOSPITAL ECO and which closes key outpatient and inpatient coverage gaps under basic insurance. As you age, you can expand your insurance cover as follows, regardless of your future state of health:

A medical examination is only required when concluding OMNIA. You are guaranteed to benefit from the available upgrades at a later date without undergoing another medical examination – a huge advantage if your state of health worsens in future.

How exactly does the upgrade work?

Every five years (initially at the age of 25, and for the last time at the age of 55) you can decide whether you wish to make use of the option to upgrade your insurance. You can exercise your right to an insurance upgrade once for outpatient cover (upgrade to COMPLETA) and once for inpatient cover (upgrade to HOSPITAL PLUS or HOSPITAL COMFORT) – either at the same time or one after the other. The desired insurance is upgraded without having to undergo another medical examination.

Provided both upgrade options have not yet been used, every five years you also have the opportunity to extend your insurance cover with PRIMEO – also without another medical examination.

You don't have to worry about anything. We will be sure to remind you in a timely manner every five years of any unused upgrade options. However, redeeming the option is by no means mandatory. You can take advantage of up to three options, but there is no requirement to do so.

More information about the upgrade options:
  • COMPLETA for the highest standards for supplementary outpatient benefits
  • PRIMEO for a free choice of doctor and greater comfort during outpatient treatments
  • HOSPITAL PLUS for more privacy and freedom of choice for inpatient hospital stays (semi-private ward)
  • HOSPITAL COMFORT for maximum comfort and freedom of choice for inpatient hospital stays (private ward)
Am I better off concluding OMNIA or semi-private or private hospital insurance?

If you would like to take advantage of the benefits of semi-private or private supplementary hospital insurance today, we recommend concluding HOSPITAL PLUS (semi-private) or HOSPITAL COMFORT (private).

If you are considering semi-private or private supplementary hospital insurance at a later time – for example if the advantages will only become important to you when you are older or because you cannot or do not want to pay the expensive premiums right now – then we recommend concluding OMNIA. You will still have the guaranteed option to upgrade to HOSPITAL PLUS or HOSPITAL COMFORT later on.

Are the benefits offered by OMNIA the same as those offered by TOP and HOSPITAL ECO insurance?

OMNIA provides orthodontic benefits up to age 25, while TOP only offers these benefits up to age 20. And unlike HOSPITAL ECO, OMNIA does not provide benefits for KidsCare, as OMNIA can only be concluded from age 19. Otherwise, the insured benefits are the same.

What happens to OMNIA when I use my upgrade options?

Once you have taken advantage of both outpatient (insurance upgrade to COMPLETA) and inpatient (upgrade to HOSPITAL PLUS or HOSPITAL COMFORT) upgrade options, the OMNIA product will expire.

Will my exclusion of benefits under OMNIA also apply to an insurance upgrade?

Yes. If exclusions of benefits are agreed when concluding OMNIA, these also apply to subsequent insurance upgrades. However, you have the ability to medically prove that the reason(s) for exclusion(s) that may have previously existed no longer apply.

Who can take out this insurance?

You can take out this insurance if you meet the following conditions:

  • You have your official place of residence in Switzerland.
  • You are aged between 19 and 49 when you take out the insurance.
  • We accept your application. For the purposes of risk assessment, we require you to fill in a health declaration.
How and when can I terminate the insurance?
  • The minimum term is one year.
  • The contract is automatically renewed each year on the expiry date for a further year.
  • You can terminate the policy on 31 December of each year, subject to three months' notice.
  • If the premium is adjusted, a shortened notice period of one month applies.

Details about termination >

Is there a waiting period?

The waiting period is the period between the date on which the insurance cover under your policy begins and the date from which you can claim benefits.

  • For maternity benefits, there is a waiting period of 365 days. That means you cannot claim these benefits before the end of the first insurance year. During the first insurance year, any pregnancy-related stays in hospital – for example for childbirth or postpartum – are covered only by your basic insurance. The latter covers the costs of a stay in a general ward (multi-bed room) and medical treatment in accordance with the standard rate in your canton of residence.

    This waiting period applies once when OMNIA is first concluded. If you exercise your option to upgrade your insurance, there is therefore no new waiting period.
  • However, you are covered from the start of insurance for benefits paid as a result of illness or accident.
Is there a waiting period for a higher level of insurance?

The waiting period for an insurance upgrade under OMNIA equals the period between the day on which the cover provided by your policy commences and the day on which you exercise your right to an insurance upgrade for the first time without any further medical examination.

  • This insurance is subject to a waiting period of 12 months before you can claim an insurance upgrade. This means that you cannot exercise your option to upgrade your insurance until the end of the first insurance year (and only if you are at least 25 years of age).
Is there a discount? How can I save on premiums?

If you have equivalent accident insurance, you can exclude the accident cover and reduce your premium by 10%.

Details about accident cover exclusion >

For two or more family members insured under the same contract, we grant a family discount of 5% on this and other supplementary insurance; for three or more insured family members, the discount is 10%.

Details about the family discount >

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