monitoring complex medical cases – patients suffering from lung and heart disease, for example – from the beginning to the end of the treatment chain with a view to providing the best care, in the best place and at the best price.
CGA – General Terms and Conditions of Insurance in accordance with LAMal/KVG
The rules governing compulsory health insurance and voluntary daily allowance benefits.
CGC - Special Terms and Conditions for Supplemental Health Insurance in accordance with the LCA/VVG
Rules governing private supplemental insurance.
Chiropratic care/chiropractic treatment
Medical treatment which involves manipulating different parts of the body, in particular the spine.
10% participation in the cost of the health care services actually consumed by the insured over and above his deductible. By law, the maximum amount of the co-insurance is CHF 700 per year for adults. For children, the maximum amount is CHF 350.
Compulsory health insurance (AOS/OKP)
Governed by LAMal/KVG, compulsory health insurance, also known as «basic health insurance», offers quality medical coverage for everyone, ensuring general access to a broad range of health care services.
Cost control is the essential procedure by which health insurers verify the invoices received to ensure they are consistent with the three principles of economic efficiency specified above. This control activity allows a reduction in annual expenditure of approximately 10% of the benefits covered, i.e. more than CHF 3 billion per year.
Compulsory health insurance costs represent some CHF 1.5 billion per year; the net costsavings per year are thus CHF 1.5 billion each year. In terms of premium relief, this translates into a reduction of about 5% in premiums each year.
The efficiency of the invoice verification process is the consequence of the competition between health insurers who do their best to contain both health costs and administrative fees in order to offer competitive premium rates to their insured members.