Essential+

Included in the insurance

In cases where we designate a private clinic or private hospital for treatment, the payment will be directly settled between the private medical provider and us. We do not cover expenses that the public sector has already fully or partially covered or expenses which the public sector has offered to cover.

Approved claims expenses are limited to necessary and reasonable costs in the region where the treatment is provided.

The Health Team of DSS Hälsa assists the insured with medical advice from registered nurses by telephone via +46 8 – 40 00 61 21, DSS Hälsa’s app, mail or the website. Our dedicated healthcare team has many years of experience from various areas of specialization and they offer professional advice on all health problems, including those that do not require actual treatment, or which are not covered by the insurance.

Through our unique VårdNavigator concept, we also provide advice about the public healthcare system’s treatment options, e.g. patient rights, appeal procedures, guidance about waiting times, how to approach local public health centres (vårdcentraler) or how to benefit from the free choice of public hospital options. All examination and public treatment alternatives within the primary care are included. We also help to review medical records from hospitals and doctors, or other assistance if necessary.

In cases where the injury can only be handled in the public sector or is not covered by the insurance, we offer to provide the insured with advice regarding the course of treatment in the public health service

The insurance covers examinations and treatment of chronic diseases and ailments that occur during the insurance period for a period of 6 months from the day the diagnosis is established, if we believe that the treatment will result in a significant and lasting improvement of the condition. Chronic diseases and ailments that have arisen and / or been diagnosed before the insurance period are not reimbursed by the insurance.


We offer help with chronic diseases through counseling, guidance through the public health system's offered treatments, patient rights, waiting times, examination and treatment guarantees and help with booking appointments within the public health care.

The insurance covers examinations and treatment of long-term pain at a pain clinic or headache clinic. Pain treatment due to cancer is not reimbursed by the insurance. We help with advice further in the process.

The insurance covers necessary and reasonable examination, treatment / surgery of a covered illness / injury performed by a relevant doctor appointed by us.
The examination may include imaging and tests that are necessary and relevant to establish a diagnosis. A referral must be issued by a physician or licensed therapist.


The examination and treatment shall primarily be performed by a doctor as close to the insured's home in Sweden as possible.


The examination / treatment / operation can be performed by a doctor in the public health service, by a digital doctor or by a doctor in a private clinic or hospital.

The insured is guaranteed a reimbursable examination and / or treatment within 7 working days, with a specialist in private or public healthcare, after we have approved the examination / treatment.

For an insurance event that requires surgery/hospitalization the insurance guarantees the insured's right to surgery within 14 working days.

If we need more information, such as a doctor’s referral or other relevant information, the working days will start after the information has been received and approved.

If we are unable to fulfill the treatment guarantee, an amount of SEK 500 will be paid to the insured per working day. Compensation is paid from the working day following the guaranteed day and until the insured receives the guaranteed treatment, and in any case at a total maximum of a year’s premium for the insured

The insurance reimburses medical rehabilitation in outpatient care carried out by a physiotherapist, naprapath and / or chiropractor in direct connection with a reimbursed procedure in the musculoskeletal system. The rehabilitation must be prescribed by the treating medical specialist.


Treatment by a physiotherapist or the use of a therapist who has a contract with the public health service requires a referral.


Group training instructed by a physiotherapist is reimbursed if it is part of a covered rehabilitation plan and is approved by us. Group training is reimbursed the corresponding amount for the insured patient's part of the group training. For chiropractic treatment, reimbursed with an amount of the patient's part corresponding to the cost of general chiropractic.

The insurance covers digital care treatments and / or counseling by telephone or video with a nurse, physiotherapist, psychologist or doctor.

The insurance reimburses necessary and reasonable examinations in outpatient care, after surgery that is reimbursed by the insurance, for up to 6 months from the date of the operation. The examination must be prescribed by a relevant doctor and approved by us.

In certain cases, the insurance covers consultation with a relevant medical doctor if the insured:

  • Have a life-threatening or particular serious disease or injury.
  • Is faced with the choice of receiving particularly risky treatment, which may be life-threatening or result in permanent injury.

If we consider that the insured is entitled to a second opinion, a medical doctor will revert to the insured from either a public or a private healthcare provider, digitally or via physical examinations.

If the insured is facing a difficult decision or if there is uncertainty regarding a diagnosis or type of treatment, we offer advisory consultation with dedicated doctors and nurses. If the two doctors disagree on a diagnosis or type of treatment we offer a third opinion via telephone.

The insurance reimburses the treatment of a psychologist, after consultation with a doctor, for postnatal reaction, postpartum depression, and problems followed by late abortion, which is reimbursed in cases where we believe that the treatment can improve the patient's health permanently. Relapses are not covered.

The insurance reimburses necessary and reasonable expenses for temporary home help in direct connection with an operation that is reimbursed by the insurance. Temporary home help or home care must be prescribed by the treating medical specialist and approved in advance by us.


Temporary help for cleaning, action, help with personal hygiene and dressing and undressing is reimbursed a maximum of 14 days from the day of discharge from hospital / clinic, and a maximum of 20 hours in total including travel time.

The insurance reimburses necessary and reasonable expenses for prescription drugs in connection with a procedure or treatment that we reimburse.

The medicine must be prescribed by the attending physician and be necessary for the medical treatment to be performed. Expenses for medical expenses are reimbursed for up to 6 months from the date they are discharged. We replace prescription medicine that is not available without a prescription.

The insurance reimburses necessary and reasonable transport costs between the insured's home and hospital / clinic, public or private, when the total journey exceeds 100 kilometers, round trip.
The compensation per kilometer is reimbursed with a standard amount in accordance with the Swedish Tax Agency's rules for mileage compensation.
Travel expenses must be approved by us in advance.

The insurance reimburses necessary and reasonable expenses for prescription drugs in connection with a procedure or treatment that we reimburse. The medicine must be prescribed by the attending physician and be necessary for the medical treatment to be performed.

Expenses for medical expenses are reimbursed for up to 6 months from the date they are discharged. We replace prescription medicine that is not available without a prescription.

The insurance covers emergency trauma counselling if we consider that the insured has experienced an acute psychological crisis due to one of the following:

1. If the insured have experienced a sudden serious incident/accident, where the insured has been in danger,
2. if the insured is subjected to a robbery, assault, violence or kidnapping,
3. fire, explosion or burglary in the insured’s private residence or business (must be reported to the police),
4. if the insured is diagnosed with a life-threatening disease,
5. death within the insured’s immediate family*,
6. if a member of the insured’s immediate family* is diagnosed with a life-threatening disease, or
7. if the insured experiences a family member’s or colleague’s sudden, unexpected death or sudden serious incident/accident.

There is no requirement for a doctor’s referral. We assess whether emergency trauma counselling is required or whether another treatment is required.

If the Health Team consider that the insured is in need of emergency trauma counselling, we will find a psychologist for the insured in our network. The subsequent process will depend on the nature of the incident and the therapist’s professional assessment.

In case of notification more than 48 hours after the cause of the crisis, cover for ordinary psychological counselling will always apply. Debriefing is only covered as part of an approved emergency course of treatment.

Advice by telephone regarding issues concerning well-being is available to the insured through our quality-assured network of psychologists, psychotherapists and other health personnel. The need for counseling can arise through various influencing causes such as private problems with relationships, lifestyle, addiction or stress, or work-related problems such as burnout, dismissal, bullying and conflicts. There may also be a need for professional coaching when you are a manager.


Our service is available weekdays during office hours and all treatments will be arranged by us. Counseling will be available within two working days and we will replace a maximum of 5 calls of 60 minutes per occasion. The number of treatments is based on the counselor's professional assessment.

The insurance covers necessary and reasonable treatments by a licensed psychologist or psychotherapist if we consider that it is possible to achieve a significant and lasting improvement in the state of health. The cover may require a referral from a doctor unless DSS Hälsa decide that an applicable treatment within our preferred provider network is preferable. We will continuously assess how many treatments the insured needs and whether the treatment is appropriate. It is a prerequisite for cover that there is a medical need to receive treatment and that the treatment ensures progression/improvement of the condition.

In the case of treatment by a psychologist/psychotherapist without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

In cases where we refer you to a private clinic or a private hospital for treatment, the payment will be made directly between us and the private care provider. We do not reimburse expenses that the public health service has already fully or partially covered. We also do not reimburse expenses that the public health service has offered to cover.

Approved claims for compensation are limited to necessary and reasonable costs in the region where the treatment is approved.

The insurance covers emergency trauma counselling if we consider that the insured has experienced an acute psychological crisis due to one of the following:

1. If the insured have experienced a sudden serious incident/accident, where the insured has been in danger,
2. if the insured is subjected to a robbery, assault, violence or kidnapping,
3. fire, explosion or burglary in the insured’s private residence or business (must be reported to the police),
4. if the insured is diagnosed with a life-threatening disease,
5. death within the insured’s immediate family*,
6. if a member of the insured’s immediate family* is diagnosed with a life-threatening disease, or
7. if the insured experiences a family member’s or colleague’s sudden, unexpected death or sudden serious incident/accident.

There is no requirement for a doctor’s referral. We assess whether emergency trauma counselling is required or whether another treatment is required.

If the Health Team consider that the insured is in need of emergency trauma counselling, we will find a psychologist for the insured in our network. The subsequent process will depend on the nature of the incident and the therapist’s professional assessment.

In case of notification more than 48 hours after the cause of the crisis, cover for ordinary psychological counselling will always apply. Debriefing is only covered as part of an approved emergency course of treatment.

The insurance covers necessary and reasonable costs for treatment with acupuncture based on the patients need and symptom which will be summarized in a medical assessment performed by the Health Team of the Company.

Treatment is covered up to a maximum of 10 sessions per diagnosis/accident with EssentialVård+.

It is a prerequisite for cover that there is a medically documented need to receive treatment and that the treatment ensures progression/improvement of the condition. It is an additional prerequisite for acupuncture that the underlying condition is on the World Health Organisation’s list of conditions where acupuncture has a positive effect.

Based on a medical assessment, DSS Hälsa will assign the insured to the relevant treatment. To ensure the correct treatment, we will continuously assess how many treatments are needed and whether the insured receive the correct treatment.

If an insured chooses a provider without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

Preventive treatment is not covered.

The insurance covers medically justified treatment by an authorized clinical dietician. The cover is provided for the number of necessary treatments that can be justified for healthcare reasons, up to a maximum of 10 treatments per disease/injury and a maximum of 10 treatments per calendar year including 1 dietary plan per disease/injury. The treatments are allocated in portions and the healthcare team will continuously assess how many treatments are necessary.

The treatments shall, according to our evaluation, lead to a significant and permanent improvement in the condition, and after a medical assessment, we may refuse to cover the treatment of a recurring disorder/problem. We assess whether the insured needs a written medical referral.

If diabetes, elevated cholesterol, cardiovascular disease, bowel disorder, uric acid, coeliac disease or PCO/PCOS are diagnosed during the insurance period, 1 course of treatment can be covered during the insurance period.

Treatment of underweight can be covered if an insured’s BMI (Body Mass Index) is less than 19, and overweight if the BMI is over 30.

The insurance covers necessary and reasonable costs for treatment by a naprapath. It is a prerequisite for cover that there is a medical need to receive treatment and that the treatment ensures progression/improvement of the condition.

Based on a medical assessment, DSS Hälsa will assign the insured to the relevant treatment. To ensure the correct treatment, we will continuously assess how many treatments are needed and whether the insured receive the correct treatment.

If an insured chooses a provider without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

The insurance covers necessary and reasonable costs for treatment by an osteopath. It is a prerequisite for cover that there is a medical need to receive treatment and that the treatment ensures progression/improvement of the condition.

Based on a medical assessment, DSS Hälsa will assign the insured to the relevant treatment. To ensure the correct treatment, we will continuously assess how many treatments are needed and whether the insured receive the correct treatment.

If an insured chooses a provider without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

The insurance covers necessary and reasonable costs for treatment by a physiotherapist. It is a prerequisite for cover that there is a medical need to receive treatment and that the treatment ensures progression/improvement of the condition.

Based on a medical assessment, DSS Hälsa will assign the insured to the relevant treatment. To ensure the correct treatment, we will continuously assess how many treatments are needed and whether the insured receive the correct treatment.

If an insured chooses a provider without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

The insurance covers necessary and reasonable costs for treatment with zone therapy based on the patients need and symptom which will be summarized in a medical assessment performed by the Health Team of the company.

Treatment is covered up to a maximum of 10 sessions per diagnosis/accident with EssentialVård+.

It is a prerequisite for cover that there is a medically documented need to receive treatment and that the treatment ensures progression/improvement of the condition. It is an additional prerequisite for zone therapy that the underlying condition is on the World Health Organisation’s list of conditions where zone therapy has a positive effect.

Based on a medical assessment, DSS Hälsa will assign the insured to the relevant treatment. To ensure the correct treatment, we will continuously assess how many treatments are needed and whether the insured receive the correct treatment.

If an insured chooses a provider without an agreement with the public healthcare system, the insurance covers the amount equal to local customary provider rates.

Preventive treatment is not covered.

  • Acute care
  • Chronic illnesses that existed before the insurance
  • Congenital disorders
  • Cosmetic treatments
  • Skin disorders such as benign birthmarks and eczema
  • ADHD, Aspberger's syndrome, autism, Tourette's syndrome, eating disorders, severe mental illness, phobias
  • Sleeping problems
  • Dental care
  • Addiction treatment (can be additionally insured)
  • Preventive care such as vaccination
  • Sexually transmitted diseases
  • Pregnancy-related problems (psychologist calls for postpartum depression can be reimbursed, as well as problems after a late abortion)

The insurance terms and conditions contain other specific exceptions that may be important to you. We therefore encourage you to read them to get a complete picture of your insurance coverage.

Supplementary insurance

The insurance covers one (1) uninterrupted period of treatment of either alcohol-, drug-, medicine- or gambling addiction until the insured has reached the final age of inclusion under the group agreement.

It is a prerequisite for cover that there is a medical need to receive treatment. The insured must therefore contact the Company’s medical team and follow any procedure suggested by the Company for assessing the insured’s situation. Assessment can be made by specialists in the Company’s network or by other suitable providers which the Company suggests or approves. Coverage will be given when the Company has approved the treatment plan suggested by the provider. Coverage includes costs for the provider’s assessment and the following treatment.

The insured has the right to reject one (1) suggested a treatment plan regardless of the reason and without any costs or loss of the right to cover. If the insured rejects further treatment plans, he or she will be charged any new assessment costs that might occur in connection with this. Further on and if not agreed otherwise, any interrupted ongoing treatment will result in a loss of the right to further coverage. Maximum coverage is 100 000 KR and the Company will inform the insured if the treatment plan is at the risk of exceeding the maximum coverage.