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ÖKK CASAMED HMO

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ÖKK CASAMED HMO

HMO model
Primary care: HMO center
Free quote

Get a free quote now >>

General

General information:

Health insurance model «CASAMED HMO» of the insurance company ÖKK.

Health insurance model:

HMO model: As an HMO policy holder, you are required to get medical consultation from a doctor at an eligible HMO center before receiving further treatment. Your HMO center may then refer you to specialists, therapists or hospitals. A primary consultation from an HMO center is not necessary in the event of medical emergencies, gynecological examinations and treatments by eye doctors.

Choice of doctor:

Your choice of general practitioners is limited to doctors at HMO health centers which partner with ÖKK.

Medical partner:

Medbase, Monvia, Réseau de Soins Neuchâtelois, Sanacare.

Pharmacy choice:

You get free choice of pharmacy

Payment methods:

10% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
90% of payments are tiers payant, meaning the bills are paid directly by the insurance (ÖKK).

Reimbursement:

The average waiting period before tiers garant reimbursement from ÖKK is 3.5 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 ÖKK is 135% (according to FOPH data). The minimum ratio required by the FOPH is 100%.

Number of policyholders:

A total of 174,496 people hold compulsory health insurance policies from ÖKK.

Additional child-discount:

ÖKK does not offer additional premium reductions for more than one child.

Administrative costs:

6.5% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).

Administrative costs per policyholder:

CHF 212 (as per the most recent BAG data).

Customer satisfaction

General satisfaction 8.1/10 (Very good)

Helpfulness 8.3/10 (Very good)

Billing: flexibility 7.6/10 (Good)

Reimbursement: time frame 7.8/10 (Good)

Product information 7.7/10 (Good)

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