Medication costs
For medication costs to be covered by basic insurance (less deductible and excess), the medication must be on one of the following lists:
- List of Specialities (LS): This list shows which originator products and generics are paid for by basic insurance. However, these are only reimbursed if they are prescribed by a licensed medical specialist.
- List of Medications with Tariff (LMT): This list contains preparations, active agents and excipients that are combined in pharmacies to produce formulas.
If a medical specialist prescribes a medication which is not mandatory for health insurers, ÖKK START supplementary insurance covers 90% of the costs (up to a maximum of CHF 20,000 per year).
The medication must be approved by the Swiss Agency for Therapeutic Products Swissmedic and may not be on ÖKK’s negative list.
Another requirement is that the preparation must only be used for treatment purposes. This does not include comfort and lifestyle products.
It costs a great deal of money to develop a new medication up to the point that it is approved. So that manufacturers can recoup these costs, medications are protected with a patent lasting up to 20 years. For this reason, new medications are usually very expensive.
Types of medication
Prescription medications are usually prescribed by a medical specialist or pharmacist. This prescription requirement is for your protection and aims to prevent excessive side effects. It also helps protect you against substance abuse.
Over-the-counter (OTC) medications are available without a prescription and can be obtained directly from a pharmacy. However, you must pay for OTC medications yourself.
Generics are identical versions of existing medications which are sold under a different name from the originator product, but contain the same active substances. Generics are usually cheaper than the originator products.
Obtaining medication
If you are insured with ÖKK, there are two ways you can obtain medication:
Traditional pharmacy
If you opt for a traditional pharmacy, you can obtain personal advice, for example if a generic version of the required medication is available.
ÖKK offers the ideal basic insurance model for this: with ÖKK CASAMED SELECT, your first point of contact is the Medgate telemedical centre, the Medgate app or a partner pharmacy of ÖKK.
Online pharmacy
The “Zur Rose” mail-order pharmacy will send you your medication discreetly, conveniently and securely – and will save you money at the same time As an ÖKK customer, you can benefit from the numerous advantages of the services offered by the mail-order pharmacy.