Question 1

Why do I pay a different premium than my neighbour even though the benefits are the same?

Accepted Answer

The OKP premium depends on your place of residence (canton or premium region), age (child 0–18, young adult 19–25, adult from 26), deductible (franchise), insurance model and accident cover. Since the benefits are identical everywhere, for basic insurance the cheapest insurer in the right model is almost always the rational choice — the differences are mainly in service and premium stability. Comparing is therefore almost always worthwhile.

Question 2

Which deductible (franchise) should I choose?

Accepted Answer

The deductible (franchise) is the amount you pay yourself each year before the insurer starts paying: CHF 300 to 2,500 for adults, CHF 0 to 600 for children. After that you pay a 10% co-payment, capped at CHF 700 per year for adults and CHF 350 for children. Rule of thumb: if you rarely see a doctor, a high deductible is often cheaper; if you have regular costs, a low deductible is.

Question 3

What do the family doctor, HMO and Telmed models mean?

Accepted Answer

Besides the standard model with free choice of doctor, there are savings models: the family doctor model (always see your chosen family doctor first), HMO (a group practice as the first point of contact) and Telmed (telephone or digital consultation first). Savings models give a discount on the premium but oblige you to follow the treatment pathway — otherwise benefits may be reduced. Emergencies are exempt, as are usually gynaecology and eye doctor visits, depending on the insurer's terms.

Question 4

I'm employed — do I need accident cover in my health insurance?

Accepted Answer

Anyone who works at least 8 hours per week for the same employer is insured against accidents through that employer (UVG) and can exclude accident cover from their basic insurance — this lowers the premium. Self-employed people and people who are not in gainful employment need accident cover in the OKP.

Question 5

By when can I terminate my basic insurance?

Accepted Answer

Basic insurance can be switched as of 1 January: your notice of termination must reach your current insurer by the end of November (recommended: by registered mail, no later than the last working day in November). If you have the ordinary deductible (CHF 300; for children CHF 0) and the standard model, you can additionally terminate as of 1 July with 3 months' notice. Your cover remains seamless when switching — the new insurer must accept you.

Question 6

When are next year's premiums available?

Accepted Answer

The FOPH (BAG) publishes the following year's premiums at the end of September or beginning of October — easyall then updates its data immediately. easyall comparisons always use the current official premiums approved by the FOPH. The switching season then runs until the end of November (your notice of termination must reach your old insurer by then).

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