Insurance Products
Complementary Health Insurance (TSS)
Complementary health insurance (TSS) pays the additional fees charged to SGK members at contracted private hospitals, offering broad access at premiums well below private health insurance.
At a glance
- Status
- Optional
- Core cover
- 4 sections
- Quote turnaround
- Same business day
SGK covers part of the treatment cost at private hospitals; the remaining difference is billed to the patient and can be substantial for surgical procedures. TSS absorbs that difference so the insured can be treated without paying out of pocket. The condition is that the hospital is contracted with both SGK and the insurer.
Cover falls into two groups: inpatient treatment (surgery, intensive care, chemotherapy, radiotherapy, medical materials) and outpatient treatment (consultations, laboratory tests, imaging, physiotherapy). Outpatient cover is usually capped at a number of visits per year. Some plans cover inpatient treatment only and carry a lower premium.
Waiting periods apply from policy inception: typically one month for non-accident inpatient treatment and nine to twelve months for maternity and certain chronic conditions. Pre-existing conditions are excluded as a rule, which makes completing the health declaration accurately essential to avoiding a declined claim later.
What Is Covered
- Inpatient treatment
- Covers surgery, intensive care, room and board, chemotherapy and radiotherapy costs.
- Outpatient treatment
- Covers consultations, laboratory tests, imaging and physiotherapy sessions.
- Emergency treatment
- Provides cover even at non-contracted institutions in genuine emergencies, subject to policy rules.
- Maternity (optional)
- Covers normal and caesarean delivery costs once the waiting period is complete.
Who Is It For?
- SGK members: employees, retirees and their dependants
- Those wanting private hospital access without a private health premium
- Parents seeking combined family health cover
- Employers offering an affordable health benefit
What Is Not Covered
- Pre-existing and congenital conditions
- Cosmetic procedures, dental treatment and optical expenses
- Planned treatment at hospitals without an SGK contract
- Alternative medicine and screening beyond covered check-ups
What Affects the Price
Premiums vary between insurers according to the factors below. We compare 27 partner insurers to find the best fit for your profile.
- Age and health declaration of the insured
- Plan type: inpatient only, or inpatient plus outpatient
- Breadth of the contracted hospital network
- Number of people insured on family policies
Frequently Asked Questions
How does TSS differ from private health insurance?
TSS pays the shortfall SGK does not cover and requires SGK membership. Private health insurance covers the full cost independently of SGK.
Is it valid at every hospital?
No. The hospital must be contracted with both SGK and the insurer. Always check the network list before buying.
How long are the waiting periods?
Typically one month for non-accident inpatient treatment and nine to twelve months for maternity cover.
Are my existing conditions covered?
As a rule, pre-existing conditions are excluded. Based on your declaration the insurer may apply an exclusion or an additional premium.