Complementary health insurance is designed to cover the additional fees that people under the Social Security Institution (SGK) must pay when treated at SGK-contracted private hospitals. Because it builds on the entitlements provided by the social security system, it generally offers access to private hospital services at lower premiums than comprehensive individual health insurance.
Depending on the plan selected, the policy can be arranged with inpatient cover only, or with both inpatient and outpatient cover. As benefits apply only at providers contracted with both the insurer and SGK, the provider network needs to be reviewed carefully. The number of outpatient visits and the terms relating to pre-existing conditions also vary from one product to another.
Who is it for?
- Employees covered by SGK and their families
- Those seeking budget-friendly access to private hospitals
- Employers wishing to offer additional health benefits to staff
Scope of cover
- Inpatient treatment: Additional fees for surgery and hospital stays at SGK-contracted private hospitals
- Outpatient options: Additional fees for consultations, tests and imaging
- Physiotherapy options
- Maternity benefit options
- Direct billing at contracted providers
Scope of cover, limits and deductibles are determined by the insurer’s general and special conditions; the final scope is set out in the policy.
The Proxima Brokers approach
We identify suitable plans by checking which products include the SGK-contracted private hospitals in your city and those you prefer. We compare inpatient and outpatient options, usage limits and premiums, and explain the policy terms in plain language. For corporate requests we structure cover around your employee group and provide support with pre-authorisation and claims.