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%.
Requirements for dental treatments from 1 January 2025
For members who joined on or after 1 February 2017 until today, the following coverage requirements apply as of 1 January 2025: At the time of treatment, the child must have at least the supplementary insurance TOP or COMPLETA, and in addition one parent must have at least one insurance product (basic insurance under the KVG or supplementary insurance under the VVG), actively insured in the PRO LIFE contract with Helsana. Compulsory basic insurance under the KVGis not mandatory.
For members who joined the PRO LIFE association before 1 February 2017, the following conditions apply: On the date of treatment, the child must have active supplementary insurance TOP or COMPLETA (the inclusion of compulsory basic insurance under the KVG is not mandatory) in the PRO LIFE contract with Helsana. However, in this case a parent is not required to have an active insurance product insured in the PRO LIFE contract with Helsana.
Requirements for dental treatments until 31 December 2024
Members who joined on or after 1 February 2017: At the time of treatment, the child must have compulsory basic insurance under the KVG and at least the supplementary insurance TOP or COMPLETA in the PRO LIFE contract with Helsana, and in addition one parent must be active with at least one insurance product in the PRO LIFE contract with Helsana.
Members who joined before 1 February 2017: At the time of treatment, the child must have at least one active supplementary insurance TOP or COMPLETA, in combination with mandatory basic insurance under the KVG, in the PRO LIFE contract with Helsana in order to meet the requirements.
General
Grace period: A grace period of one year from the start of the association membership applies to all dental supplemental contributions. This means that supplemental contributions for dental treatments are compensated at the earliest from the 13th membership month.
Joining date: The signature date on the application or the time of online conclusion is decisive.
Special Insurance Terms: Reservations or exclusions that our health insurance partner Helsana applies have no influence on the payment of the voluntary supplemental contributions of PRO LIFE, provided that the above coverage requirements are met at the time of treatment.
Exclusion of benefits
The following benefits are excluded in every 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.)
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 and each subsequent child under the age of 18, who does not yet have an income of their own and lives in the same family household. 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). The refund application must be submitted at the latest within two years from the date of the treatment. Refund requests for treatments whose treatment date is over two calendar years ago at the time of submission can no longer be processed. Membership fees that have not been paid will be offset against the payments.
Abbreviation used
HIA: Health Insurance Act
GIC: German Insurance Contract Act