REQUIREMENTS FOR RECEIVING PRO LIFE
VOLUNTARY SUPPLEMENTARY CONTRIBUTIONS
Contributions to corrections of the position of teeth (braces) and other dental treatments for children
75% of the dental costs of children up to the age of 18:
PRO LIFE pays 75% of the costs of dental treatments such as caries treatment, check-ups, dental hygiene and much more, without any limits on the amount, and without the need for extra expensive
dental insurance.
90% of orthodontic treatment/braces up to the age of 20:
PRO LIFE covers a further 15% of orthodontic treatment without a limit in addition to the benefits provided by the health insurance partner Helsana. 75% up to CHF 10,000 per calendar year, is usually covered by health insurance under the TOP or COMPLETA supplementary insurance packages. This means that orthodontic treatments are optimally covered up to 90%.
The prerequisite is a concluded and active TOP or COMPLETA supplementary insurance policy. In addition, compulsory basic insurance in accordance with the HIA must be active in the PRO LIFE contract
with our health insurance partner. A waiting period of one year from the start of membership applies to all PRO LIFE dental contributions (i.e. contributions to treatment are paid from the 13th month of membership at the earliest). For memberships as of 01.02.2017 (the date of signature is decisive), at least one parent must have been actively insured with at least one insurance product in the PRO LIFE contract with our health insurance partner. The following benefits are excluded in any case:
Biological dentistry (laser light treatment, blood plasma treatment, healing injections, etc.)
Fixed dentures, including dental service: crowns, bridges, implants, veneer, Cerec, inlays, onlays,
ceramic and porcelain veneers, etc. (except aluminium sleeves, steel caps, steel crowns, palatal
implants)
Removable prosthetics, including dental services (total, partial dentures, etc.)
Medication and prophylaxis material
Anaesthesia (except laughing gas)
Hospital costs (including use of bed, care by nonmedical staff, travel allowance, etc.)
Shipping and postage costs
Missed sessions
Teeth whitening (bleaching, including splints) and teeth jewellery
Dental accidents (covered by compulsory basic insurance or accident insurance)
Dental treatments covered by BASIS compulsory basic insurance
Alternative dentistry (kinesiology, acupuncture, etc.)
Special insurance conditions (i.e. reservations and exclusions made by our health insurance partner)
have no influence on the payment of voluntary supplementary contributions by PRO LIFE.
BIRTH BENEFIT/MONEY GIFT FOR THE BIRTH
One parent of the child must have been actively insured for at least six months with one insurance product in the PRO LIFE contract with our health insurance partner at the time of the birth. The child must be insured under the PRO LIFE contract with compulsory basic insurance in accordance with the HIA from the time of birth. If all requirements are met, PRO LIFE will donate the amount of CHF 400 per newborn. The prenatal or postnatal registration of the child must be submitted via PRO LIFE and must not be processed directly via the health insurance partner.
ADOPTION MONEY/MONEY GIFT FOR ADOPTION
The adoption gift is granted for the adoption of children under the age of six. It is mandatory that an adoption certificate is available and that one of the child’s parents has been actively insured for at least six months with one insurance product in the PRO LIFE contract with our health insurance partner at the time of the adoption. The child must be insured in the PRO LIFE contract with compulsory basic insurance in accordance with the HIA for the next possible date. If all requirements are met, PRO LIFE will donate the amount of CHF 400 per adopted child. The payment will be made at the earliest when compulsory basic insurance according to HIA of the adopted child in the PRO LIFE contract is in force with our health insurance partner.
LARGE FAMILY DISCOUNT FOR FAMILIES WITH MORE THAN FOUR CHILDREN
PRO LIFE covers the basic insurance premiums in accordance with the HIA (excluding membership fees and less cantonal subsidies or other premium reductions) from the fifth child who does not yet have an income of their own and lives in the same familyhousehold. Apprentice wages, wages from part-time jobs and sidelines are considered as income from CHF 6,500 (gross) per calendar year. The children and at least one parent must be actively insured with at least compulsory basic insurance according to HIA in the PRO LIFE contract with our health insurance partner. Only the children’s rate (age category up to 18 years) is covered. The families pay the premiums shown on the premium invoice to the health insurance partner and are reimbursed the family discount by PRO LIFE in the following year, provided that the corresponding application form has been submitted to PRO LIFE in due time. The application form must be requested from PRO LIFE.
GENERAL RULES
PRO LIFE’s voluntary supplementary contributions are not to be confused with the insurance benefits
provided by the health insurance partner. PRO LIFE provides these voluntarily in accordance with the purpose of the association and based on the valid statutes. All voluntary supplementary contributions
are only paid out to existing members. The relevant date is the date of treatment or the date of the event (birth or adoption). There is a limitation period of two years from the date of treatment or the date of the event. Membership fees that have not been paid will be offset against the payments.
Abbreviation used
HIA: Health Insurance Act