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www.assura.ch
www.assura.ch
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Important information DiscountsDiscount for methods of payment
2% for annual payment1% for half-yearly payment
Discount for minors
20% on complementary insurancefor minors if at least 2 people in thesame family are insured with Assura SA (except for Previsia categories).
Combination discount
Discounts are granted when sub-scribing to Complementa Extra, and at least one of the following complementary categories:
NaturaDenta PlusMondiaPriveco VariaPriveco Plus VariaOptima VariaOptima Plus VariaUltra VariaHospita
If the Medna category is taken out together with the Natura catego-ry, a discount of up to 50% of the Medna premium is granted.
Combination discounts are grantedas long as the categories concernedare in force and covered by a singlepolicy (one contract only).
0842 277 872 (0842 ASSURA) Max Fr. 0.08/min
Reimbursement
In health insurance, there are two different systems for the forwarding and payment of medical expenses.- The direct settlement system: The bill is sent directly to the insurer who
pays the health care provider. If the annual deductible has not been reached, the insured person reimburses the insurer.
- The "third party” guarantee system: The patient pays the health-care pro-vider and then requests the reimbursement from the insurer.
Limiting administrative costs
As the amount of the bills is often lower than the amount of the annual deductible, we have chosen the “third party” guarantee system for the reim-bursement of medication. This system allows you as an informed policy hol-der to carry out the first control of costs and avoid the purchase of medica-tion which will eventually not be used. Moreover, by grouping your bills and only sending them when the amount of the annual deductible has been exceeded, you are actively participating in the reduction of administrative costs.
Cost-sharing
In addition to the annual deductible, the insured person assumes a 10% retention fee, up to a maximum of Fr. 700.– for an adult and Fr. 350.– for a child. A 20% retention fee may be charged for original pharmaceuticals when a generic equivalent exists. We therefore recommend the use of generics.
Limitations of the complementary insurance cover
We draw your particular attention to the limitations of cover as described in our general conditions for complementary insurance.
TermsThe terms “annual” or “per year” used in this document always refer to a calendar year.
Entry age
A Complementary insurance, its premium, after the age of 26, is calculated according to the age at the conclusion of the contract. It remains unchanged for the duration of the contract.
V Complementary insurance with transition to the upper age group at the attained age limit.
This document is subject to changes of insurance conditions. The legal stipulations as well as the general and special conditions of insurance determine the right to benefits.
Products overview
Compulsory health insuranceand complementary insurances
Join us!
Lump sum in the event of hospitalisation
The capital sum is paid once each year for hospital admission lasting for more than 24 hours. However, this sum is not paid for hospital stays caused by an illness falling within the scope of LAA, LAI or LAM com-pulsory care.
Insured capital Fr. 500.– Fr. 1'000.– Fr. 1'500.– Fr. 2'000.– Fr. 2'500.– Fr. 3'000.–
Hospita
My insurance for additional costs due to my hospitalisation
1 bed per room
Cover without duration limit, with free choice of doctor, in all Swiss official medical establishments (information at Assura SA prior to hospital admission)
Full cover for all Swiss official medical esta-blishments
Fr. 150.– per day, max. Fr. 1'500.– paid to the insuree who chooses the general ward of a public hospital. Fr. 50.– per day, max. Fr. 500.– if he chooses an establishment approved within the Optima Varia and Optima Plus Varia categories.
Fr. 1'000.– per year.
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
For foreign stays, max. 45 consecutive days: organisation of care, ambulance transport, repatriation, advance on expenses, search and rescue up to Fr. 10'000.–, visit by a close member of family, administrative assistance etc. Emergency number available 24h/24 0041 (0) 21 721 44 88. Cover according to the tariff applied in Switzerland. Possibility of covering the amount in excess of the Swiss tariff and of extending the period of cover with Mondia.
Types of accomodation
Treatments and hospital stays
Treatments and stays in an establishment not recognised by Assura SA
Allowance for stays in a ward of a lower category
Special care
Treatments and stays abroad
Emergencies abroad
Special benefits
Hospitalisation insurances
Ultra Varia Priveco Varia
Optima Varia
Priveco Plus Varia
Optima Plus Varia
2 beds per room | 1 bed per room
Cover without duration limit in the establish-ments listed by the cantons (information at Assura SA prior to hospital admission).
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
2 beds per room | 1 bed per room
Cover without duration limit, with free choice of doctor, in the establishments approved by Assura SA (information at Assura SA prior to hospital admission)
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
Fr. 500.– per year. | Fr. 1'000.– per year
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
Hospitalisation
This document is addressed to our English speaking clientele with the purpose to facilitate access to our insurance products. It is of a strictly informa-tive nature. Please note that Assura provides its services in French, German and Italian, but not in English.
Legal obligations as well as the extent of benefits provided by Assura are determined exclusively on the basis of the general insurance conditions (CGA). These are available in French, German or Italian.
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www.assura.ch
Insuree’s participation
Release from premium payments in the event of redundancy
- The chosen annual deductible - Annual retention fee: 10% (max Fr. 350.– for children and Fr. 700.– for adults) - Annual retention fee on pharmaceuticals when a generic is available: 20% - In the event of hospitalisation, from age 26, Fr. 15.– per night
Cover in the general ward of public hospitals in the canton of resi-dence (cantonal and district hospitals).
Cover in the canton of residence or place of work.
Acupuncture, anthroposophical medicine, Chinese medicine, homeopathy, neural therapy, phytotherapy.
Based on the list of medecines with tariff (LMT) and the list of phar-maceutical specialties (LS), including generics.
Based on the list of aids and devices (LiMA)
If required after a serious illness or as an accident sequel (see exhaus-tive list in Chapter 5 OPAS).
In Switzerland, 50% of the invoiced amount; for transport: Fr. 500.– per year; for rescue: Fr. 5'000.– per year.
Based on bilateral agreements for the EU and EFTA. For other countries, up to twice the tariff applicable in the canton of residence.
Based on statutory benefits.
In Switzerland, Fr. 10.– per day, 21 days per year for accommodation costs. Plus treatment costs.
Fr. 180.– per year, up to the 18th birthday.
No insuree participation.
After a 90 day waiting period, the premiums for the complementary insurances concluded simultaneously with the present category are settled by Assura SA; this includes premiums for members of family living in the same household.
Cover in the general ward of all public hospitals in Switzerland inclu-ding semi-hospital or outpatient treatment, with no limitation as to time and free choice of doctor.
Fr. 50.– per day, 30 days per year, during hospitalisation and up to the 15th day following hospitalisation.
Fr. 1'000.– per year in the event of hospitalisation.
Fr. 70.– per day for 10 days per year for accommodation expenses billed by a hospital for a person accompanying a child.
Fr. 70.– per day, 21 days per year for children of an insured adult who has been admitted to hospital.
Payment of the difference in tariff outside the canton of residence.
Fr. 50'000.– throughout the contract for vital pharmaceuticals without equivalent in LS.
Fr. 500.– per year for medical appliances or orthopaedic products.
Fr. 1'500.– per year after deduction of the Fr. 500.– annual deductible according to the SSO tariff. Additional cover and annual deductible reduced by 50% for minors with Denta Plus.
In Switzerland, 100% of the amount billed: no limit for transport; for rescue: Fr. 20'000.–.
Cover based on tariff applied in Switzerland.
Fr. 50.– per day, max. Fr. 3'000.– per year, when an insured minor is ill or victim of an accident and cannot follow the school syllabus for a month.
Fr. 200.– per day, 21 days per year, on medical prescription.
In Switzerland: Fr. 1'000.– per year for costs and treatments. Abroad: Fr. 500.– per year, if the disease cannot be treated in Switzerland.
In Switzerland, Fr. 40.– per day, 21 days per year.
Fr. 100.– per year, can be accumulated over several years to reach a total of Fr. 500.–.
Fr. 100.– per year; can be accumulated over several years to reach a total of Fr. 500.–.
Up to 100% of gross expenses of Fr. 1’500.– per civil year, for costs of medically prescribed treatments and carried out by non-physician psychotherapists and independent psychologists mentionned on the list established by the organisation of Swiss health insurers.
Outpatient treatment and special benefits
Alternative therapies provided by an FMH physician
Pharmaceuticals on medical prescription
Assistive devices on medical prescription
Dental treatment
Transport and rescue
Emergencies abroad
School assistance by a qualified person
Home care to avoid hospital admission
Spa treatment on medical prescription
Convalescence on medical prescription
Spectacle lenses and contact lenses
Corrective sight surgery
Non-physician psychotherapists and independent psychologists
Hospital treatments and stays
Home help from an assistance service
Special carer
Accompanying a child
Child care up to age 15 provided by an official agency
Alternative medecine costs • Home care • Worldwide private ward hospitalisation • Convalescence treatments and stays • Plastic surgery intervention • Domestic help by an assistance service • Auxiliary resources • Search, rescue and recovery costs • Transport costs • Mortal remains transport costs • Material damages • Supplementary benefits in case of accident abroad
My insurance for a good holiday
Hospitalisation
Treatment and miscelleanous costs
Treatment costs
Lump sum and benefits in the event of death and disability following an accident
Previsia PlusCover according to different fixed variants
Basis Complementa Extra
Compulsory health insurance and extended complementary insurance
Dental care
Dental questionnaire: compensation of up to Fr. 100.– if affiliation to this category.
Dental check-up and descaling from the second year of insurance, Fr. 80.– per year without any annual deductible or retention fee
Annual deductible not applicable after 5 years without benefits. Prophylactic costs do not influence the grant of a bonus.
Fees and appliances: up to age 20, 80% of a maximum invoice of Fr. 500.– per full elapsed year can be accumula-ted over several years until a maximum sum of Fr. 10'000.– is reached.
Diagnostic and therapeutic measures: 80% of maximum billing of Fr. 15'000.– per year after deduction of the Fr. 500.– annual deductible (Fr. 250.– for minors).
Making of crowns, bridges and prosthetics: 80% of a maximum bill of Fr. 1'000.– per year.
The above benefits are covered by the official tariff.
Admission
Prophylactic treatment
Bonus
Orthodontics
Outpatient treatment
Technical services
Denta Plus
If taken out with Complementa Extra, the dental care benefits in the two categories are accumulated and the annual deductible charged once only.
In the event of a medical emergency whilst abroad, for max. 45 consecutive days: Cover possible for stays amounting to more than 45 days with the prior agreement of Assura SA.
Full cover of treatment costs, including amounts in excess of the rates charged in Switzerland. Refund of insuree’s contributions in EU and EFTA member countries. Ambulance transport
Validity
Benefits
Mondia
Cover abroad
My insurance to grow up healthy
By concluding at least two complementary insurances, of which one must be Complementa Extra, attractive combined discounts are granted.
Antenatal insurances
Dental care insurance
Extended care insurance
Travel and holiday insurance
Alternative medecines (physicians) insurance
Alternative medecine (therapists) insurance
Full cover accident insurance
Denta Plus
Complementa Extra
Mondia
Medna
Natura
Previsia Plus
Nativa
A choice of six complementary insurances to subscribe to prior to the birth
Prior to your child's birth, the following complementary insurances are accessible without a health questionnaire:
Adult variants (19 - 65 years old)
Death capital
Progressive disability capital
Hospital allowance
Allowance for loss of earnings
1
Fr. 20'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
2
Fr. 5'000.–
Fr. 100'000.–
Fr. 20.– (daily)
Fr. 10.– to Fr. 40.– (daily)
3
Fr. 30'000.–
Fr. 60'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 40.– (daily)
4
Fr. 50'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
5
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
Fr. 10.– to Fr. 20.– (daily)
Senior variants (66 - 75 years old)
Death capital
Proportional disability capital
Hospital allowance
Allowance for loss of earnings
1 12
Fr. 10.– (daily)
13
Fr. 5'000.–
Fr. 10.– (daily)
14
Fr. 5'000.–
Fr. 10'000.–
Fr. 10.– (daily)
15
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
MednaCare provided by physicianswho have taken specific training
• Acupressure • Bioresonance • Anthroposophical medicine • Ayurvedic medicine • Chinese medicine • Homeopathy • Medical hypnosis • Autogenic training • Neural therapy • Phytotherapy • Sophrology
Medical treatments: Fr. 80.– per session Pharmaceuticals (registered by Swissmedic): 80% of price up to Fr. 2'000.– per year on medical prescription
Annual deductible: Fr. 200.–
Recognised therapies (in so far as they are not covered by compulsory health insurance)
Treatment
Insuree's participation
In the event of the conclusion of Natura + Medna: the annual deductible is charged only once and Assura offers a discount of up to 50 % on the Medna premium.
Alternative medecines
NaturaCare provided by recognised therapists
• Acupressure • Acupuncture • Aromatherapy • Bioresonance • Lymphatic drainage • Etiopathy • Facial therapy – pulsology • Homeopathy • Iridology • Kinesiology • Chinese medicine • Mesotherapy • Ortho-bionomy • Osteopathy • Phytotherapy • Reflexology • Serocytotherapy • Shiatsu • Curative sophrology • Sympatico-therapy • Cranio-sacral therapy • Neural therapy Only by prior medical prescription: - Curative eurythmics - Eutonia
Maximum amount per session: - First consultation/health check-up: Fr. 130.– - Further sessions Fr. 110.– Maximum 12 sessions per year
Annual maximum: Fr. 800.–
Annual deductible: Fr. 200.– Annual retention fee: 10%
Cancellation of the annual deductible on next treatment after 5 years without benefits.
Recognised therapies (the list of recognised associa-tions and therapists avai-lable from Assura SA)
Treatment
Laboratory examinations and prescribed remedies
Insuree’s participation
Bonus
Child variants (0 - 18 years old)
Death capital
Progressive disability capital
Hospital allowance
6
Fr. 5'000.–
Fr. 150'000.–
Fr. 10.– (daily)
7
Fr. 3'000.–
Fr. 100'000.–
Fr. 10.– (daily)
8
Fr. 3'000.–
Fr. 75'000.–
Fr. 10.– (daily)
9
Fr. 3'000.–
Fr. 50'000.–
Fr. 10.– (daily)
10
Fr. 3'000.–
Fr. 30'000.–
Fr. 10.– (daily)
16
Fr. 10'000.–
Fr. 200'000.–
Fr. 10.– (daily)
17
Fr. 10'000.–
Fr. 250'000.–
Fr. 10.– (daily)
Lump sums
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Insuree’s participation
Release from premium payments in the event of redundancy
- The chosen annual deductible - Annual retention fee: 10% (max Fr. 350.– for children and Fr. 700.– for adults) - Annual retention fee on pharmaceuticals when a generic is available: 20% - In the event of hospitalisation, from age 26, Fr. 15.– per night
Cover in the general ward of public hospitals in the canton of resi-dence (cantonal and district hospitals).
Cover in the canton of residence or place of work.
Acupuncture, anthroposophical medicine, Chinese medicine, homeopathy, neural therapy, phytotherapy.
Based on the list of medecines with tariff (LMT) and the list of phar-maceutical specialties (LS), including generics.
Based on the list of aids and devices (LiMA)
If required after a serious illness or as an accident sequel (see exhaus-tive list in Chapter 5 OPAS).
In Switzerland, 50% of the invoiced amount; for transport: Fr. 500.– per year; for rescue: Fr. 5'000.– per year.
Based on bilateral agreements for the EU and EFTA. For other countries, up to twice the tariff applicable in the canton of residence.
Based on statutory benefits.
In Switzerland, Fr. 10.– per day, 21 days per year for accommodation costs. Plus treatment costs.
Fr. 180.– per year, up to the 18th birthday.
No insuree participation.
After a 90 day waiting period, the premiums for the complementary insurances concluded simultaneously with the present category are settled by Assura SA; this includes premiums for members of family living in the same household.
Cover in the general ward of all public hospitals in Switzerland inclu-ding semi-hospital or outpatient treatment, with no limitation as to time and free choice of doctor.
Fr. 50.– per day, 30 days per year, during hospitalisation and up to the 15th day following hospitalisation.
Fr. 1'000.– per year in the event of hospitalisation.
Fr. 70.– per day for 10 days per year for accommodation expenses billed by a hospital for a person accompanying a child.
Fr. 70.– per day, 21 days per year for children of an insured adult who has been admitted to hospital.
Payment of the difference in tariff outside the canton of residence.
Fr. 50'000.– throughout the contract for vital pharmaceuticals without equivalent in LS.
Fr. 500.– per year for medical appliances or orthopaedic products.
Fr. 1'500.– per year after deduction of the Fr. 500.– annual deductible according to the SSO tariff. Additional cover and annual deductible reduced by 50% for minors with Denta Plus.
In Switzerland, 100% of the amount billed: no limit for transport; for rescue: Fr. 20'000.–.
Cover based on tariff applied in Switzerland.
Fr. 50.– per day, max. Fr. 3'000.– per year, when an insured minor is ill or victim of an accident and cannot follow the school syllabus for a month.
Fr. 200.– per day, 21 days per year, on medical prescription.
In Switzerland: Fr. 1'000.– per year for costs and treatments. Abroad: Fr. 500.– per year, if the disease cannot be treated in Switzerland.
In Switzerland, Fr. 40.– per day, 21 days per year.
Fr. 100.– per year, can be accumulated over several years to reach a total of Fr. 500.–.
Fr. 100.– per year; can be accumulated over several years to reach a total of Fr. 500.–.
Up to 100% of gross expenses of Fr. 1’500.– per civil year, for costs of medically prescribed treatments and carried out by non-physician psychotherapists and independent psychologists mentionned on the list established by the organisation of Swiss health insurers.
Outpatient treatment and special benefits
Alternative therapies provided by an FMH physician
Pharmaceuticals on medical prescription
Assistive devices on medical prescription
Dental treatment
Transport and rescue
Emergencies abroad
School assistance by a qualified person
Home care to avoid hospital admission
Spa treatment on medical prescription
Convalescence on medical prescription
Spectacle lenses and contact lenses
Corrective sight surgery
Non-physician psychotherapists and independent psychologists
Hospital treatments and stays
Home help from an assistance service
Special carer
Accompanying a child
Child care up to age 15 provided by an official agency
Alternative medecine costs • Home care • Worldwide private ward hospitalisation • Convalescence treatments and stays • Plastic surgery intervention • Domestic help by an assistance service • Auxiliary resources • Search, rescue and recovery costs • Transport costs • Mortal remains transport costs • Material damages • Supplementary benefits in case of accident abroad
My insurance for a good holiday
Hospitalisation
Treatment and miscelleanous costs
Treatment costs
Lump sum and benefits in the event of death and disability following an accident
Previsia PlusCover according to different fixed variants
Basis Complementa Extra
Compulsory health insurance and extended complementary insurance
Dental care
Dental questionnaire: compensation of up to Fr. 100.– if affiliation to this category.
Dental check-up and descaling from the second year of insurance, Fr. 80.– per year without any annual deductible or retention fee
Annual deductible not applicable after 5 years without benefits. Prophylactic costs do not influence the grant of a bonus.
Fees and appliances: up to age 20, 80% of a maximum invoice of Fr. 500.– per full elapsed year can be accumula-ted over several years until a maximum sum of Fr. 10'000.– is reached.
Diagnostic and therapeutic measures: 80% of maximum billing of Fr. 15'000.– per year after deduction of the Fr. 500.– annual deductible (Fr. 250.– for minors).
Making of crowns, bridges and prosthetics: 80% of a maximum bill of Fr. 1'000.– per year.
The above benefits are covered by the official tariff.
Admission
Prophylactic treatment
Bonus
Orthodontics
Outpatient treatment
Technical services
Denta Plus
If taken out with Complementa Extra, the dental care benefits in the two categories are accumulated and the annual deductible charged once only.
In the event of a medical emergency whilst abroad, for max. 45 consecutive days: Cover possible for stays amounting to more than 45 days with the prior agreement of Assura SA.
Full cover of treatment costs, including amounts in excess of the rates charged in Switzerland. Refund of insuree’s contributions in EU and EFTA member countries. Ambulance transport
Validity
Benefits
Mondia
Cover abroad
My insurance to grow up healthy
By concluding at least two complementary insurances, of which one must be Complementa Extra, attractive combined discounts are granted.
Antenatal insurances
Dental care insurance
Extended care insurance
Travel and holiday insurance
Alternative medecines (physicians) insurance
Alternative medecine (therapists) insurance
Full cover accident insurance
Denta Plus
Complementa Extra
Mondia
Medna
Natura
Previsia Plus
Nativa
A choice of six complementary insurances to subscribe to prior to the birth
Prior to your child's birth, the following complementary insurances are accessible without a health questionnaire:
Adult variants (19 - 65 years old)
Death capital
Progressive disability capital
Hospital allowance
Allowance for loss of earnings
1
Fr. 20'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
2
Fr. 5'000.–
Fr. 100'000.–
Fr. 20.– (daily)
Fr. 10.– to Fr. 40.– (daily)
3
Fr. 30'000.–
Fr. 60'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 40.– (daily)
4
Fr. 50'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
5
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
Fr. 10.– to Fr. 20.– (daily)
Senior variants (66 - 75 years old)
Death capital
Proportional disability capital
Hospital allowance
Allowance for loss of earnings
1 12
Fr. 10.– (daily)
13
Fr. 5'000.–
Fr. 10.– (daily)
14
Fr. 5'000.–
Fr. 10'000.–
Fr. 10.– (daily)
15
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
MednaCare provided by physicianswho have taken specific training
• Acupressure • Bioresonance • Anthroposophical medicine • Ayurvedic medicine • Chinese medicine • Homeopathy • Medical hypnosis • Autogenic training • Neural therapy • Phytotherapy • Sophrology
Medical treatments: Fr. 80.– per session Pharmaceuticals (registered by Swissmedic): 80% of price up to Fr. 2'000.– per year on medical prescription
Annual deductible: Fr. 200.–
Recognised therapies (in so far as they are not covered by compulsory health insurance)
Treatment
Insuree's participation
In the event of the conclusion of Natura + Medna: the annual deductible is charged only once and Assura offers a discount of up to 50 % on the Medna premium.
Alternative medecines
NaturaCare provided by recognised therapists
• Acupressure • Acupuncture • Aromatherapy • Bioresonance • Lymphatic drainage • Etiopathy • Facial therapy – pulsology • Homeopathy • Iridology • Kinesiology • Chinese medicine • Mesotherapy • Ortho-bionomy • Osteopathy • Phytotherapy • Reflexology • Serocytotherapy • Shiatsu • Curative sophrology • Sympatico-therapy • Cranio-sacral therapy • Neural therapy Only by prior medical prescription: - Curative eurythmics - Eutonia
Maximum amount per session: - First consultation/health check-up: Fr. 130.– - Further sessions Fr. 110.– Maximum 12 sessions per year
Annual maximum: Fr. 800.–
Annual deductible: Fr. 200.– Annual retention fee: 10%
Cancellation of the annual deductible on next treatment after 5 years without benefits.
Recognised therapies (the list of recognised associa-tions and therapists avai-lable from Assura SA)
Treatment
Laboratory examinations and prescribed remedies
Insuree’s participation
Bonus
Child variants (0 - 18 years old)
Death capital
Progressive disability capital
Hospital allowance
6
Fr. 5'000.–
Fr. 150'000.–
Fr. 10.– (daily)
7
Fr. 3'000.–
Fr. 100'000.–
Fr. 10.– (daily)
8
Fr. 3'000.–
Fr. 75'000.–
Fr. 10.– (daily)
9
Fr. 3'000.–
Fr. 50'000.–
Fr. 10.– (daily)
10
Fr. 3'000.–
Fr. 30'000.–
Fr. 10.– (daily)
16
Fr. 10'000.–
Fr. 200'000.–
Fr. 10.– (daily)
17
Fr. 10'000.–
Fr. 250'000.–
Fr. 10.– (daily)
Lump sums
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Insuree’s participation
Release from premium payments in the event of redundancy
- The chosen annual deductible - Annual retention fee: 10% (max Fr. 350.– for children and Fr. 700.– for adults) - Annual retention fee on pharmaceuticals when a generic is available: 20% - In the event of hospitalisation, from age 26, Fr. 15.– per night
Cover in the general ward of public hospitals in the canton of resi-dence (cantonal and district hospitals).
Cover in the canton of residence or place of work.
Acupuncture, anthroposophical medicine, Chinese medicine, homeopathy, neural therapy, phytotherapy.
Based on the list of medecines with tariff (LMT) and the list of phar-maceutical specialties (LS), including generics.
Based on the list of aids and devices (LiMA)
If required after a serious illness or as an accident sequel (see exhaus-tive list in Chapter 5 OPAS).
In Switzerland, 50% of the invoiced amount; for transport: Fr. 500.– per year; for rescue: Fr. 5'000.– per year.
Based on bilateral agreements for the EU and EFTA. For other countries, up to twice the tariff applicable in the canton of residence.
Based on statutory benefits.
In Switzerland, Fr. 10.– per day, 21 days per year for accommodation costs. Plus treatment costs.
Fr. 180.– per year, up to the 18th birthday.
No insuree participation.
After a 90 day waiting period, the premiums for the complementary insurances concluded simultaneously with the present category are settled by Assura SA; this includes premiums for members of family living in the same household.
Cover in the general ward of all public hospitals in Switzerland inclu-ding semi-hospital or outpatient treatment, with no limitation as to time and free choice of doctor.
Fr. 50.– per day, 30 days per year, during hospitalisation and up to the 15th day following hospitalisation.
Fr. 1'000.– per year in the event of hospitalisation.
Fr. 70.– per day for 10 days per year for accommodation expenses billed by a hospital for a person accompanying a child.
Fr. 70.– per day, 21 days per year for children of an insured adult who has been admitted to hospital.
Payment of the difference in tariff outside the canton of residence.
Fr. 50'000.– throughout the contract for vital pharmaceuticals without equivalent in LS.
Fr. 500.– per year for medical appliances or orthopaedic products.
Fr. 1'500.– per year after deduction of the Fr. 500.– annual deductible according to the SSO tariff. Additional cover and annual deductible reduced by 50% for minors with Denta Plus.
In Switzerland, 100% of the amount billed: no limit for transport; for rescue: Fr. 20'000.–.
Cover based on tariff applied in Switzerland.
Fr. 50.– per day, max. Fr. 3'000.– per year, when an insured minor is ill or victim of an accident and cannot follow the school syllabus for a month.
Fr. 200.– per day, 21 days per year, on medical prescription.
In Switzerland: Fr. 1'000.– per year for costs and treatments. Abroad: Fr. 500.– per year, if the disease cannot be treated in Switzerland.
In Switzerland, Fr. 40.– per day, 21 days per year.
Fr. 100.– per year, can be accumulated over several years to reach a total of Fr. 500.–.
Fr. 100.– per year; can be accumulated over several years to reach a total of Fr. 500.–.
Up to 100% of gross expenses of Fr. 1’500.– per civil year, for costs of medically prescribed treatments and carried out by non-physician psychotherapists and independent psychologists mentionned on the list established by the organisation of Swiss health insurers.
Outpatient treatment and special benefits
Alternative therapies provided by an FMH physician
Pharmaceuticals on medical prescription
Assistive devices on medical prescription
Dental treatment
Transport and rescue
Emergencies abroad
School assistance by a qualified person
Home care to avoid hospital admission
Spa treatment on medical prescription
Convalescence on medical prescription
Spectacle lenses and contact lenses
Corrective sight surgery
Non-physician psychotherapists and independent psychologists
Hospital treatments and stays
Home help from an assistance service
Special carer
Accompanying a child
Child care up to age 15 provided by an official agency
Alternative medecine costs • Home care • Worldwide private ward hospitalisation • Convalescence treatments and stays • Plastic surgery intervention • Domestic help by an assistance service • Auxiliary resources • Search, rescue and recovery costs • Transport costs • Mortal remains transport costs • Material damages • Supplementary benefits in case of accident abroad
My insurance for a good holiday
Hospitalisation
Treatment and miscelleanous costs
Treatment costs
Lump sum and benefits in the event of death and disability following an accident
Previsia PlusCover according to different fixed variants
Basis Complementa Extra
Compulsory health insurance and extended complementary insurance
Dental care
Dental questionnaire: compensation of up to Fr. 100.– if affiliation to this category.
Dental check-up and descaling from the second year of insurance, Fr. 80.– per year without any annual deductible or retention fee
Annual deductible not applicable after 5 years without benefits. Prophylactic costs do not influence the grant of a bonus.
Fees and appliances: up to age 20, 80% of a maximum invoice of Fr. 500.– per full elapsed year can be accumula-ted over several years until a maximum sum of Fr. 10'000.– is reached.
Diagnostic and therapeutic measures: 80% of maximum billing of Fr. 15'000.– per year after deduction of the Fr. 500.– annual deductible (Fr. 250.– for minors).
Making of crowns, bridges and prosthetics: 80% of a maximum bill of Fr. 1'000.– per year.
The above benefits are covered by the official tariff.
Admission
Prophylactic treatment
Bonus
Orthodontics
Outpatient treatment
Technical services
Denta Plus
If taken out with Complementa Extra, the dental care benefits in the two categories are accumulated and the annual deductible charged once only.
In the event of a medical emergency whilst abroad, for max. 45 consecutive days: Cover possible for stays amounting to more than 45 days with the prior agreement of Assura SA.
Full cover of treatment costs, including amounts in excess of the rates charged in Switzerland. Refund of insuree’s contributions in EU and EFTA member countries. Ambulance transport
Validity
Benefits
Mondia
Cover abroad
My insurance to grow up healthy
By concluding at least two complementary insurances, of which one must be Complementa Extra, attractive combined discounts are granted.
Antenatal insurances
Dental care insurance
Extended care insurance
Travel and holiday insurance
Alternative medecines (physicians) insurance
Alternative medecine (therapists) insurance
Full cover accident insurance
Denta Plus
Complementa Extra
Mondia
Medna
Natura
Previsia Plus
Nativa
A choice of six complementary insurances to subscribe to prior to the birth
Prior to your child's birth, the following complementary insurances are accessible without a health questionnaire:
Adult variants (19 - 65 years old)
Death capital
Progressive disability capital
Hospital allowance
Allowance for loss of earnings
1
Fr. 20'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
2
Fr. 5'000.–
Fr. 100'000.–
Fr. 20.– (daily)
Fr. 10.– to Fr. 40.– (daily)
3
Fr. 30'000.–
Fr. 60'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 40.– (daily)
4
Fr. 50'000.–
Fr. 100'000.–
Fr. 30.– (daily)
Fr. 10.– to Fr. 60.– (daily)
5
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
Fr. 10.– to Fr. 20.– (daily)
Senior variants (66 - 75 years old)
Death capital
Proportional disability capital
Hospital allowance
Allowance for loss of earnings
1 12
Fr. 10.– (daily)
13
Fr. 5'000.–
Fr. 10.– (daily)
14
Fr. 5'000.–
Fr. 10'000.–
Fr. 10.– (daily)
15
Fr. 10'000.–
Fr. 20'000.–
Fr. 10.– (daily)
MednaCare provided by physicianswho have taken specific training
• Acupressure • Bioresonance • Anthroposophical medicine • Ayurvedic medicine • Chinese medicine • Homeopathy • Medical hypnosis • Autogenic training • Neural therapy • Phytotherapy • Sophrology
Medical treatments: Fr. 80.– per session Pharmaceuticals (registered by Swissmedic): 80% of price up to Fr. 2'000.– per year on medical prescription
Annual deductible: Fr. 200.–
Recognised therapies (in so far as they are not covered by compulsory health insurance)
Treatment
Insuree's participation
In the event of the conclusion of Natura + Medna: the annual deductible is charged only once and Assura offers a discount of up to 50 % on the Medna premium.
Alternative medecines
NaturaCare provided by recognised therapists
• Acupressure • Acupuncture • Aromatherapy • Bioresonance • Lymphatic drainage • Etiopathy • Facial therapy – pulsology • Homeopathy • Iridology • Kinesiology • Chinese medicine • Mesotherapy • Ortho-bionomy • Osteopathy • Phytotherapy • Reflexology • Serocytotherapy • Shiatsu • Curative sophrology • Sympatico-therapy • Cranio-sacral therapy • Neural therapy Only by prior medical prescription: - Curative eurythmics - Eutonia
Maximum amount per session: - First consultation/health check-up: Fr. 130.– - Further sessions Fr. 110.– Maximum 12 sessions per year
Annual maximum: Fr. 800.–
Annual deductible: Fr. 200.– Annual retention fee: 10%
Cancellation of the annual deductible on next treatment after 5 years without benefits.
Recognised therapies (the list of recognised associa-tions and therapists avai-lable from Assura SA)
Treatment
Laboratory examinations and prescribed remedies
Insuree’s participation
Bonus
Child variants (0 - 18 years old)
Death capital
Progressive disability capital
Hospital allowance
6
Fr. 5'000.–
Fr. 150'000.–
Fr. 10.– (daily)
7
Fr. 3'000.–
Fr. 100'000.–
Fr. 10.– (daily)
8
Fr. 3'000.–
Fr. 75'000.–
Fr. 10.– (daily)
9
Fr. 3'000.–
Fr. 50'000.–
Fr. 10.– (daily)
10
Fr. 3'000.–
Fr. 30'000.–
Fr. 10.– (daily)
16
Fr. 10'000.–
Fr. 200'000.–
Fr. 10.– (daily)
17
Fr. 10'000.–
Fr. 250'000.–
Fr. 10.– (daily)
Lump sums
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470
0* V
ue d
'ens
emb
le d
es p
rest
atio
ns -
JH
D (D
IR) -
ST
(MK
R) /
FS
E (M
RK
) - m
ai 1
3
Important information DiscountsDiscount for methods of payment
2% for annual payment1% for half-yearly payment
Discount for minors
20% on complementary insurancefor minors if at least 2 people in thesame family are insured with Assura SA (except for Previsia categories).
Combination discount
Discounts are granted when sub-scribing to Complementa Extra, and at least one of the following complementary categories:
NaturaDenta PlusMondiaPriveco VariaPriveco Plus VariaOptima VariaOptima Plus VariaUltra VariaHospita
If the Medna category is taken out together with the Natura catego-ry, a discount of up to 50% of the Medna premium is granted.
Combination discounts are grantedas long as the categories concernedare in force and covered by a singlepolicy (one contract only).
0842 277 872 (0842 ASSURA) Max Fr. 0.08/min
Reimbursement
In health insurance, there are two different systems for the forwarding and payment of medical expenses.- The direct settlement system: The bill is sent directly to the insurer who
pays the health care provider. If the annual deductible has not been reached, the insured person reimburses the insurer.
- The "third party” guarantee system: The patient pays the health-care pro-vider and then requests the reimbursement from the insurer.
Limiting administrative costs
As the amount of the bills is often lower than the amount of the annual deductible, we have chosen the “third party” guarantee system for the reim-bursement of medication. This system allows you as an informed policy hol-der to carry out the first control of costs and avoid the purchase of medica-tion which will eventually not be used. Moreover, by grouping your bills and only sending them when the amount of the annual deductible has been exceeded, you are actively participating in the reduction of administrative costs.
Cost-sharing
In addition to the annual deductible, the insured person assumes a 10% retention fee, up to a maximum of Fr. 700.– for an adult and Fr. 350.– for a child. A 20% retention fee may be charged for original pharmaceuticals when a generic equivalent exists. We therefore recommend the use of generics.
Limitations of the complementary insurance cover
We draw your particular attention to the limitations of cover as described in our general conditions for complementary insurance.
TermsThe terms “annual” or “per year” used in this document always refer to a calendar year.
Entry age
A Complementary insurance, its premium, after the age of 26, is calculated according to the age at the conclusion of the contract. It remains unchanged for the duration of the contract.
V Complementary insurance with transition to the upper age group at the attained age limit.
This document is subject to changes of insurance conditions. The legal stipulations as well as the general and special conditions of insurance determine the right to benefits.
Products overview
Compulsory health insuranceand complementary insurances
Join us!
Lump sum in the event of hospitalisation
The capital sum is paid once each year for hospital admission lasting for more than 24 hours. However, this sum is not paid for hospital stays caused by an illness falling within the scope of LAA, LAI or LAM com-pulsory care.
Insured capital Fr. 500.– Fr. 1'000.– Fr. 1'500.– Fr. 2'000.– Fr. 2'500.– Fr. 3'000.–
Hospita
My insurance for additional costs due to my hospitalisation
1 bed per room
Cover without duration limit, with free choice of doctor, in all Swiss official medical establishments (information at Assura SA prior to hospital admission)
Full cover for all Swiss official medical esta-blishments
Fr. 150.– per day, max. Fr. 1'500.– paid to the insuree who chooses the general ward of a public hospital. Fr. 50.– per day, max. Fr. 500.– if he chooses an establishment approved within the Optima Varia and Optima Plus Varia categories.
Fr. 1'000.– per year.
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
For foreign stays, max. 45 consecutive days: organisation of care, ambulance transport, repatriation, advance on expenses, search and rescue up to Fr. 10'000.–, visit by a close member of family, administrative assistance etc. Emergency number available 24h/24 0041 (0) 21 721 44 88. Cover according to the tariff applied in Switzerland. Possibility of covering the amount in excess of the Swiss tariff and of extending the period of cover with Mondia.
Types of accomodation
Treatments and hospital stays
Treatments and stays in an establishment not recognised by Assura SA
Allowance for stays in a ward of a lower category
Special care
Treatments and stays abroad
Emergencies abroad
Special benefits
Hospitalisation insurances
Ultra Varia Priveco Varia
Optima Varia
Priveco Plus Varia
Optima Plus Varia
2 beds per room | 1 bed per room
Cover without duration limit in the establish-ments listed by the cantons (information at Assura SA prior to hospital admission).
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
2 beds per room | 1 bed per room
Cover without duration limit, with free choice of doctor, in the establishments approved by Assura SA (information at Assura SA prior to hospital admission)
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
Fr. 500.– per year. | Fr. 1'000.– per year
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
Hospitalisation
This document is addressed to our English speaking clientele with the purpose to facilitate access to our insurance products. It is of a strictly informa-tive nature. Please note that Assura provides its services in French, German and Italian, but not in English.
Legal obligations as well as the extent of benefits provided by Assura are determined exclusively on the basis of the general insurance conditions (CGA). These are available in French, German or Italian.
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www.assura.ch
www.assura.ch
470
0* V
ue d
'ens
emb
le d
es p
rest
atio
ns -
JH
D (D
IR) -
ST
(MK
R) /
FS
E (M
RK
) - m
ai 1
3
Important information DiscountsDiscount for methods of payment
2% for annual payment1% for half-yearly payment
Discount for minors
20% on complementary insurancefor minors if at least 2 people in thesame family are insured with Assura SA (except for Previsia categories).
Combination discount
Discounts are granted when sub-scribing to Complementa Extra, and at least one of the following complementary categories:
NaturaDenta PlusMondiaPriveco VariaPriveco Plus VariaOptima VariaOptima Plus VariaUltra VariaHospita
If the Medna category is taken out together with the Natura catego-ry, a discount of up to 50% of the Medna premium is granted.
Combination discounts are grantedas long as the categories concernedare in force and covered by a singlepolicy (one contract only).
0842 277 872 (0842 ASSURA) Max Fr. 0.08/min
Reimbursement
In health insurance, there are two different systems for the forwarding and payment of medical expenses.- The direct settlement system: The bill is sent directly to the insurer who
pays the health care provider. If the annual deductible has not been reached, the insured person reimburses the insurer.
- The "third party” guarantee system: The patient pays the health-care pro-vider and then requests the reimbursement from the insurer.
Limiting administrative costs
As the amount of the bills is often lower than the amount of the annual deductible, we have chosen the “third party” guarantee system for the reim-bursement of medication. This system allows you as an informed policy hol-der to carry out the first control of costs and avoid the purchase of medica-tion which will eventually not be used. Moreover, by grouping your bills and only sending them when the amount of the annual deductible has been exceeded, you are actively participating in the reduction of administrative costs.
Cost-sharing
In addition to the annual deductible, the insured person assumes a 10% retention fee, up to a maximum of Fr. 700.– for an adult and Fr. 350.– for a child. A 20% retention fee may be charged for original pharmaceuticals when a generic equivalent exists. We therefore recommend the use of generics.
Limitations of the complementary insurance cover
We draw your particular attention to the limitations of cover as described in our general conditions for complementary insurance.
TermsThe terms “annual” or “per year” used in this document always refer to a calendar year.
Entry age
A Complementary insurance, its premium, after the age of 26, is calculated according to the age at the conclusion of the contract. It remains unchanged for the duration of the contract.
V Complementary insurance with transition to the upper age group at the attained age limit.
This document is subject to changes of insurance conditions. The legal stipulations as well as the general and special conditions of insurance determine the right to benefits.
Products overview
Compulsory health insuranceand complementary insurances
Join us!
Lump sum in the event of hospitalisation
The capital sum is paid once each year for hospital admission lasting for more than 24 hours. However, this sum is not paid for hospital stays caused by an illness falling within the scope of LAA, LAI or LAM com-pulsory care.
Insured capital Fr. 500.– Fr. 1'000.– Fr. 1'500.– Fr. 2'000.– Fr. 2'500.– Fr. 3'000.–
Hospita
My insurance for additional costs due to my hospitalisation
1 bed per room
Cover without duration limit, with free choice of doctor, in all Swiss official medical establishments (information at Assura SA prior to hospital admission)
Full cover for all Swiss official medical esta-blishments
Fr. 150.– per day, max. Fr. 1'500.– paid to the insuree who chooses the general ward of a public hospital. Fr. 50.– per day, max. Fr. 500.– if he chooses an establishment approved within the Optima Varia and Optima Plus Varia categories.
Fr. 1'000.– per year.
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
For foreign stays, max. 45 consecutive days: organisation of care, ambulance transport, repatriation, advance on expenses, search and rescue up to Fr. 10'000.–, visit by a close member of family, administrative assistance etc. Emergency number available 24h/24 0041 (0) 21 721 44 88. Cover according to the tariff applied in Switzerland. Possibility of covering the amount in excess of the Swiss tariff and of extending the period of cover with Mondia.
Types of accomodation
Treatments and hospital stays
Treatments and stays in an establishment not recognised by Assura SA
Allowance for stays in a ward of a lower category
Special care
Treatments and stays abroad
Emergencies abroad
Special benefits
Hospitalisation insurances
Ultra Varia Priveco Varia
Optima Varia
Priveco Plus Varia
Optima Plus Varia
2 beds per room | 1 bed per room
Cover without duration limit in the establish-ments listed by the cantons (information at Assura SA prior to hospital admission).
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
2 beds per room | 1 bed per room
Cover without duration limit, with free choice of doctor, in the establishments approved by Assura SA (information at Assura SA prior to hospital admission)
Treatment: | Treatment: Fr. 300.–/day | Fr. 300.–/day Stay: | Stay: Fr. 200.–/day | Fr. 300.–/day
Fr. 100.– per day, max. Fr. 1'000.–, paid to the insuree who chooses the general ward of a public hospital.
Fr. 500.– per year. | Fr. 1'000.– per year
By prior agreement of Assura SA, payment when the tariff abroad is inferior to that applied in the canton of residence.
Hospitalisation
This document is addressed to our English speaking clientele with the purpose to facilitate access to our insurance products. It is of a strictly informa-tive nature. Please note that Assura provides its services in French, German and Italian, but not in English.
Legal obligations as well as the extent of benefits provided by Assura are determined exclusively on the basis of the general insurance conditions (CGA). These are available in French, German or Italian.
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