We are committed to your

insurance cover
Overview of our insurance
products and benefits

2022/23 edition
Overview of insurance products
Basic insurance Supplementary outpatient insurance Hospital insurance
BASIS, BeneFit PLUS General Practitioner, BeneFit PLUS Telmed, PREMED-24 TOP SANA COMPLETA COMPLETA EXTRA PRIMEO HOSPITAL ECO HOSPITAL Semi-Private HOSPITAL Private HOSPITAL FLEX
Basic statutory cover with identical benefits. Premium dependent Your supplement to basic insurance: key outpatient benefits are Your extra cover: outpatient benefits and alternative treatments All the benefits of TOP and SANA with higher compensation in Expand the insurance cover of COMPLETA to include extra The advantages of supplementary hospital insurance in General insurance in hospital: 100% of costs incl. free Semi-private insurance in hospital: two-bed room and free Private insurance in hospital: single-bed room and free Flexible insurance in hospital: free choice of ward on a case-by-case basis.**
on model selected covered. are covered. some cases. benefits and higher contributions. outpatient procedures. choice of hospital.** choice of doctor throughout Switzerland.* choice of doctor throughout Switzerland.* Option 1: Option 2:
Outpatient treatment Medically prescribed treatment provided by federally certified doctors, By recognised professionals throughout Switzerland, according to agreed rates By non-contract medical practitioners Free choice of doctor from the specialists at Helsana partner
chiropractors and medical support staff (speech therapists, healthcare (excluding psychotherapy): 90% clinics
professionals, physiotherapists, etc.)
Complementary medicine Benefits for complementary medical treatments by trained and legally recognised Acupuncture, anthroposophic medicine, pharmacotherapy with traditional Outpatient treatment: 75% of the costs not covered by basic Outpatient treatment: 75% of the costs not covered by basic – Outpatient treatment: 100% of the costs that exceed
doctors or by naturopaths and therapists recognised by the Helsana Group Chinese medicine (TCM), medical traditional homoeopathy and phytotherapy, insurance Inpatient treatment: max. CHF 5,000/year insurance Inpatient treatment: max. CHF 5,000/year COMPLETA benefits
carried out by doctors with recognised training pursuant to the Health Insurance – 75% of the costs, max. CHF 750/year for other recognised
Benefits Ordinance (KLV) therapists and therapy methods
– 75% of the costs, max. CHF 750/year for treatment abroad
Health promotion Benefits for gym memberships, fitness courses, back and full-body training, birth 75% of the costs, up to max. CHF 200/area****. 75% of the costs, up to max. CHF 200/area****. 100% reimbursement of all costs not covered under COMPLETA,
preparation, antenatal/postnatal exercise classes, relaxation and nutrition cours- For methods and providers recognised by the Helsana Group For methods and providers recognised by the Helsana Group max. CHF 800/calendar year for all areas**** combined. For
es, etc. methods and providers recognised by the Helsana Group
Prevention Costs covered for specific examinations for the early detection of illnesses and for By recognised professionals throughout Switzerland, according to agreed rates 75%, up to max. CHF 500/year as per Helsana Group list 90%, up to max. CHF 750/year as per Helsana Group list 100%, up to max. CHF 500/year as per Helsana Group list Max. CHF 1,700 for check-ups within three years as per
preventive measures (e.g. benefits for vaccinations) carried out or prescribed by a Helsana Group list
doctor
Implants 90%, up to max. CHF 5,000/year, towards the share that is
not covered or not fully covered by basic insurance
(excluding dental implants)
Hotline Medical hotline, online services Max. CHF 300/year as per Helsana Group list
Medicines Medication covered by statutory health insurance As per specialities list
Medication not covered by statutory health insurance (excluding medications on 90% for medications approved by Swissmedic, up to max. 50% as 75% for complementary medicines 90% for medications approved by Swissmedic,
the List of Pharmaceutical Products with Special Application (LPPV)) per Helsana Group list 75% for complementary medicines
Glasses/contact lenses Contributions to spectacle lenses, contact lenses and visual aids Max. CHF 180/year up to 18th birthday 90%, up to max. CHF 150/year 90%, up to max. CHF 300/year – 100%, up to max. CHF 300/year
– 100%, up to max. CHF 750/eye and calendar year for laser eye
correction
Dental treatment Accident-related tooth damage If accident cover is included
Serious diseases of the masticatory system By recognised professionals throughout Switzerland, according to agreed rates
Serious general illnesses By recognised professionals throughout Switzerland, according to agreed rates
Correction of misaligned teeth up to the age of to 20 (e.g. orthodontic treatment 75% of the costs, up to max. CHF 10,000/year 75% of the costs, up to max. CHF 10,000/year
and maxillary surgical treatment as well as wisdom tooth removal)
Special forms of treatment Non-medical psychotherapy by recognised psychotherapists, sterilisation, 75%, up to max. CHF 3,000/year as per Helsana Group list 75%, up to max. CHF 4,500/year per Helsana Group list 100% of the COMPLETA excess 90%, up to max. CHF 5,000/year for innovative types of
vasectomy, etc. treatment and diagnosis as per Helsana Group list
Medical aids Medically necessary and prescribed by a doctor In accordance with prescription for aids and equipment 90%, up to max. CHF 1,000/year as per Helsana Group list 90%, up to max. CHF 1,500/year as per Helsana Group list Max. CHF 5,000/year in accordance with prescription for aids
and equipment. Share in excess of basic insurance
Transportation Medically necessary transport by appropriate means of transportation 50%, up to max. CHF 500/year Max. CHF 100,000/year in Switzerland Max. CHF 100,000/year in Switzerland
(e.g. ambulance, air transport)
Rescue In Switzerland: 50%, up to max. CHF 5,000/year (excluding search and recovery Max. CHF 100,000/year in Switzerland Max. CHF 100,000/year in Switzerland 100%, up to max. CHF 30,000 per search and recovery operation in
costs) Switzerland
Various, e.g. public transport or taxi Max. CHF 500/year for travel from or to a service provider Max. CHF 250 per year for transport to and from hospitals Max. CHF 500 per year for transport to and from hospitals
in Switzerland for planned procedures in Switzerland for planned procedures
Personal assistance Rescue, transportation, repatriation Unlimited abroad Unlimited abroad
Search Up to CHF 20,000 abroad Up to CHF 20,000 abroad
International Acute and emergency outpatient treatment during a temporary stay abroad Within EU/EFTA: benefits in accordance with the social tariff schedule of the 12 months’ cover, worldwide 12 months’ cover, worldwide For elective outpatient treatment as per cost approval
country of temporary residence (show European Health Insurance Card) Within EU/EFTA: co-payments to social insurance costs Within EU/EFTA: co-payments to social insurance costs
Outside EU/EFTA: up to max. twice the Swiss tariff amount (place of residence) from CHF 300 upwards from CHF 300 upwards
Acute and emergency inpatient treatment during a temporary stay abroad Within EU/EFTA: benefits in accordance with the social tariff schedule of the 12 months’ cover, worldwide 12 months’ cover, worldwide CHF 500/day, max. 60 days/year CHF 1,500/day, unlimited duration Full cost coverage, unlimited duration CHF 500/day, CHF 1,000/day,
country of temporary residence (show European Health Insurance Card) Within EU/EFTA: co-payments tosocial insurance costs Within EU/EFTA: co-payments to social insurance costs max. 60 days/year max. 60 days/year
Outside EU/EFTA: up to max. twice the Swiss tariff amount (place of residence) from CHF 300 upwards from CHF 300 upwards
Elective outpatient and inpatient treatment Elective outpatient treatment abroad (excluding complementary Elective outpatient treatment abroad (excluding alternative CHF 500/day, max. 60 days/year (elective and emergency CHF 1,500/day, unlimited duration with cost approval Full cost coverage, unlimited duration with cost approval CHF 500/day, CHF 1,000/day,
medicine): 90%, up to max. CHF 1,000/year medicine): 100%, up to max. CHF 4,000/year treatment combined, max. 60 days/year) max. 60 days/year (elective and emergency treatment
combined, max. 60 days/year)
Legal protection in Comprehensive legal expenses cover for disputes with doctors, hospitals and Max. CHF 250,000/case in Europe Max. CHF 250,000/case in Europe
health matters providers of social insurance and private liability insurance Max. CHF 50,000/case outside Europe Max. CHF 50,000/case outside Europe
Pregnancy Check-ups (seven before the birth, one afterwards) Eight check-ups, two ultrasound examinations Additional ultrasound examinations (see prevention benefits) Additional ultrasound examinations (see prevention benefits)
Breastfeeding guidance (by midwives or specially trained nurses) Three sessions
Birth preparation (courses given by midwives) CHF 150
Inpatient treatment See hospital stays in Switzerland (maternity benefits are exempt from co-payment) See hospital stays (Switzerland) See hospital stays (Switzerland), if included See hospital stays (Switzerland), if included See hospital stays (Switzerland)
Outpatient treatment By recognised professionals, according to agreed rates. Basic cover for home CHF 1,500 lump sum for outpatient birth CHF 3,000 lump sum for outpatient birth Lump sum for outpatient birth underHOSPITAL FLEX 1 CHF 500,
birth and outpatient birth (maternity benefits are exempt from co-payment) under HOSPITAL FLEX 2 CHF 1,000
Hospital stays Treatment in a recognised acute care hospital on the cantonal list of hospitals Full cover for the general ward of a listed hospital anywhere in Switzerland, Full cover for a general ward anywhere in Full cover for a semi-private ward anywhere in Switzerland* Full cover for a private ward anywhere in Full cover for general, semi-private and private wards anywhere
in Switzerland up to the tariff in the canton of residence Switzerland** Switzerland* in Switzerland**, taking into account the co-payment selected:
prvt. ward: 50% ([Link] prvt. ward: 35% ([Link]
9,000/year);semi-prvt. ward: 4,000/year); semi-prvt. ward:
35% 20%
(max. CHF 3,000/year); (max. CHF 2,000/year);
gen. ward: none gen. ward: none
Accommodation (room comfort) Multi-bed room Multi-bed room Two-bed room Single-bed room Free choice of hospital ward anywhere in Switzerland**
Accommodation in higher-category ward than that insured Overnight stays and comfort benefits in the event of outpatient Private ward: 20% of benefits Private ward: costs of semi-private ward
treatment, max. CHF 400/treatment, max. CHF 1,200/year Semi-private ward: 40% of benefits
Fast track/expert second Quick initial consultation with a specialist (fast track) as well as an expert second Included. At selected partner clinics Included. At selected partner clinics
opinion opinion from a respected professor
Acute and transitional care Benefits covering food and accommodation in the event of acute and transitional CHF 90/day, max. 14 days/year CHF 120/day, max. 14 days/year CHF 240/day, max. 14 days/year Option: CHF 100/day, max. 14 days/year***
inpatient care (healthcare benefits fully covered)
Spa treatment Medically required and prescribed by an approved doctor, at recognised Medical treatments and therapies in accordance with the tariff in the place of CHF 30/day, max. 30 days/year (in Switzerland and Europe) CHF 100/day, max. 21 days/year (in Switzerland and Europe) CHF 200/day, max. 21 days/year (in Switzerland and Europe) Option: CHF 100/day, max. 21 days per year
therapeutic spas treatment and CHF 10/day, max. 21 days/year (in Switzerland and Europe)***
Convalescent therapy Medically required and prescribed by an approved doctor, at recognised CHF 30/day, max. 30 days/year (spa and convalescent ther CHF 100/day, max. 21 days/year (spa and convalescent ther CHF 200/day, max. 21 days/year (spa and convalescent Option: CHF 100/day, max. 21 days/year (spa and convalescent
convalescent facilities in Switzerland apies combined: max. 30 days/year) apies combined: max. 21 days/year) therapies combined: max. 21 days/year) therapies combined: max. 21 days/year)***
Household help With a medical prescription and complete incapacity for work (e.g. after an acute CHF 30/day, max. 30 days/year CHF 100/day, max. 30 days/year CHF 200/day, max. 30 days/year Option: CHF 50/day, max. 30 days/year***
inpatient hospital stay)
Home nursing care (Spitex) Medically prescribed nursing care given at home by recognised service providers Co-payment according to Health Insurance Benefits Ordinance KLV (Art. 7)
KidsCare Care and nursing for sick children (insured person: child) Max. 30 hours/year Max. 60 hours/year Max. 120 hours/year
Nanny service Care of healthy children when one parent is in hospital (insured person: parent) Max. 30 hours/year Max. 60 hours/year Max. 120 hours/year Option: max. 30 hours/year***
Rooming-in Contribution to the cost of overnight accommodation/meals in the hospital for CHF 100/day, max. 15 days/year CHF 200/day, max. 15 days/year CHF 50/day, max. 15 days/year CHF 100/day, max. 15 days/year
closely related persons
Nursing home Healthcare in recognised nursing homes Co-payment according to Health Insurance Benefits Ordinance KLV (Art. 7)

* – From doctors and hospitals recognised by Helsana. You can find the list of hospitals without full cost coverage at [Link]/tariffnegotiations. ** Cantonal listed hospital, Helsana KVG contract hospital. **** – Fitness (courses and gym memberships), back/full-body training, courses offered by Helsana cooperation partners (e.g. relaxation and nutrition courses),
– Please note that you will have to cover the costs charged by hospitals and doctors not recognised by Helsana *** If the FLEX supplementary module is included. pregnancy (antenatal/postnatal exercise classes).
Saving tips

Basic insurance
Save with alternative insurance models (AIMs)
Everyone’s needs are different. That’s why there are several options to choose from when taking out basic insurance. In addition to the standard stat-
utory option, you can also choose alternative insurance models (AIMs). The medical benefits you get from them are the same everywhere. With an AIM,
you save on premiums, and the efficient and competent way you’re dealt with by a central contact person means you also avoid multiple examinations.
We reward you for this with a premium discount.

15% discount Min. 10% discount* 8% discount

BeneFit PLUS Telmed BeneFit PLUS General Practitioner PREMED-24
Access to medical care by Coordination of medical treatment by Free medical advice
telephone around the clock the selected general practitioner or before any visit to the doctor
HMO group practice

Choice of deductible** Maximum premium reduction*** More savings opportunities

75%
Adults CHF 300 None Children’s discount (aged 0 to 18),
CHF 500 CHF 140 first and second child
CHF 1,000 CHF 490 90%
Children’s discount (aged 0 to 18),
CHF 1,500 CHF 840
from third child
CHF 2,000 CHF 1,190 minimum 20%
CHF 2,500 CHF 1,540 Young people’s discount (aged 19 to 25)
Children CHF 0 None 7%
Accident exclusion discount
CHF 500 CHF 350
(working persons only)
* 10%, 12%, 14% or 16% discount on your insurance premium depending on the service provider.
The discounts shown for general practitioners and group practices are valid from 1 January 2023.
** Once deductible has been met, excess of 10% up to max. CHF 700/year or CHF 350/year for children.
*** Maximum premium reduction per year prescribed by law on the basis of the optional deductible.

Supplementary insurance
Supplementary outpatient insurance and hospital insurance
– Family discount: 5% for two people, 10% for three people or more
– Multi-year discount: three-year contract: 3% (for new customers)
– Hospital deductibles: minimum 15% discount with choice of hospital deductibles

Legal expenses insurance

– 100% discount for children up to the age of 18
– 50% discount for young people aged between 19 and 25
– 25% discount if at least two adults (aged 26 and over) take out Helsana Advocare PLUS/Helsana Advocare EXTRA
in the same contract (family contract)
More products

Dental insurance Long-term care insurance

DENTAplus VIVANTE
– Dental treatment related to an illness, orthodontics, – Supports care by family members or specialists
maxillary surgery at home or in a nursing home

– Check-ups, dental hygiene – No proof of use required when a claim is made,

daily allowance for use at own discretion
– Worldwide cover (max. Swiss tariff)
– Choice of daily allowance of CHF 40, CHF 60, CHF 80, CHF 100,
– Choice of maximum costs of CHF 300 (DENTAplus LIGHT),
CHF 140 or CHF 180 single or cumulative
CHF 1,000 (DENTAplus BRONZE), CHF 2,000 (DENTAplus
SILVER), CHF 3,000 (DENTAplus GOLD) or up to unlimited
cover per calendar year (DENTAplus COMBI), with a six-month CURA
waiting period – Contribution to uncovered costs of household help or for
accommodation and meals during a stay in a nursing home
– For regular care needed following accident or illness
– Choice of daily allowance: CHF 10, CHF 20, CHF 30, CHF 40,
Legal expenses insurance CHF 50, CHF 60, CHF 70, CHF 80, CHF 90, CHF 100, CHF 110,
CHF 120, CHF 130, CHF 140, CHF 150, CHF 200, CHF 250, CHF 300
Helsana Advocare PLUS – Choice of waiting period of 180, 360, 720 or 1,080 days
– Civil and motorists’ legal expenses cover
– Up to max. CHF 300,000 per case in Europe, max. CHF 30,000
per case elsewhere
Travel insurance
Helsana Advocare EXTRA
– Civil, motorists’ and internet legal expenses cover WORLD
– Up to max. CHF 1 million per case in Europe, max. CHF 100,000 – Valid in all countries
per case elsewhere – Outpatient and inpatient emergency treatments that
exceed the cover provided by basic insurance

Daily allowance and capital insurance

HOSPITAL EXTRA
– Financial contribution towards additional costs during hospital stay
– Entitlement to benefits (in the event of an accident, illness, maternity) during acute inpatient treatment and inpatient rehabilitation
in Switzerland
– Choice of daily allowance of CHF 50, CHF 100, CHF 150, CHF 200, CHF 300 (maximum)
– Benefits paid for a maximum of 30 days/year

PREVEA
– Financial protection with capital benefits to the insured sum in the event of an illness or accident resulting in death or disability
→ irrespective of other existing insurance policies
– Choice of insured sum in increments of CHF 10,000
– Maximum insured sum:
PREVEA Accident: up to CHF 300,000 (with progression up to 350%; max. CHF 1,050,000)
PREVEA Illness: 0–20 years, up to max. CHF 300,000; from the age of 21, up to max. CHF 500,000
– Additional benefits in the event of disability or death caused by an accident:
→ Transport: contribution to costs for journeys on public transport or by taxi
→ Retraining costs: contribution to necessary professional retraining
→ Premium waiver: in the event of the death or disability of a person with an obligation to provide support, Helsana will cover the
PREVEA Accident insurance premiums for children up to the age of 18.

SALARIA

Daily allowance insurance pursuant to VVG* Daily allowance insurance pursuant to KVG**

Duration of 365 days or 730 days 720 days within 900 calendar days
benefits

Daily allowance CHF 10 to CHF 600/day CHF 10 to CHF 30/day

amount This is equivalent to benefits of max. CHF 18,000/month This is equivalent to benefits of max. CHF 900/month

Maternity – 16 weeks (112 days)

Accident Can be included Can be included

Waiting periods 3, 7, 14, 21, 30, 60, 90, 120, 150, 180, 240, 270 or 360 days 0, 3, 7, 14, 21, 30, 60, 90, 120, 150, 180, 240, 270 or 360 days

* Federal Insurance Policies Act (Versicherungsvertragsgesetz) **Federal Health Insurance Act

We are there for you.
Throughout your life. Helping you stay
healthy. So that you recover quickly. Or can
live a better life when affected by illness.

We are happy to help.

Helsana Group
0844 80 81 82
[Link]/en/contact
[Link]/locations

Awarded top marks.

Health insurance

Rating: Very good

General customer satisfaction
2022

Helsana Completa

Winner
Supplemental health insurance
Comparison of benefits, 01/2021

COMPLETA from Helsana scored highest on scope

of benefits. [Link] is the independent
comparison service for insurers and banks.

HEL-01846-en-0922-0006-85354

The Helsana Group comprises Helsana Insurance Company Ltd, Helsana Supplementary Insurances Ltd and Helsana Accidents Ltd.
This overview of benefits is provided for information purposes only and does not constitute a binding offer. The Helsana Group
reserves the right to modify the information contained herein.