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EGK Grundversicherung

Standard model
Free choice of doctor

General

General information:

Health insurance model «Grundversicherung» of the Swiss insurance company EGK.

Health insurance model:

Standard model: You can make use of any doctor, specialist or other healthcare service provider you choose. Premiums are higher than those of more limited models.

Choice of doctor:

Policyholders have free choice of doctors.

Medical partner:

Not specified.

Pharmacy choice:

You get free choice of pharmacy

Payment methods:

13% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
87% of payments are tiers payant, meaning the bills are paid directly by the insurance (EGK).

Reimbursement:

The average waiting period before tiers garant reimbursement from EGK is 5 days.

Financial reserves:

The solvency ratio shows how available financial reserves compare to Federal Office of Public Health (FOPH) minimum reserve requirements. The solvency ratio of EGK is 74% (according to FOPH data). The minimum ratio required by the FOPH is 100%.

Number of policyholders:

A total of 96,136 people hold compulsory health insurance policies from EGK.

Additional child-discount:

EGK provides additional premium reductions from the third child onwards.

Administrative costs:

4.7% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).

Administrative costs per policyholder:

CHF 178 (as per the most recent BAG data).

Customer satisfaction

General satisfaction Not specified.

Helpfulness Not specified.

Billing: flexibility Not specified.

Reimbursement: time frame Not specified.

Product information Not specified.

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