The 4 health insurance models in comparison

Insured persons can choose between different models to design their health insurance. The health insurance models offer different approaches to medical care and each have their own advantages and disadvantages. In this blog post, we will compare the 4 main models of health insurance in Switzerland in detail and find out which one suits your needs best.

Health insurance models
21.09.2023  |  Reading time:  3  Minute

Table of Contents

1. Standard model (free choice of doctor)

The standard model of basic insurance in Switzerland gives you the freedom to consult any doctor of your choice without needing a referral first. This model gives you the flexibility to see the healthcare professionals and healthcare facilities of your choice. If you need a specialised doctor, you can go directly to him or her without consulting your GP first. This model is good for people who value freedom of choice in their healthcare and already know which doctors they want to consult.

2. HMO model

The HMO model (Health Maintenance Organisation) is a cheaper option where you get your health care from a specific network of doctors and health facilities. In this model, you usually need to consult your family doctor first, who can then provide referrals to specialists in the HMO network if needed. This model offers savings on monthly premiums, but requires you to work with a fixed network of healthcare providers. It is well suited for people who are willing to accept this limitation in order to save costs.

3. Family doctor model

The family doctor model requires you to see your family doctor first when you need health care. Your GP then coordinates your health care and can refer you to specialists if needed. This model promotes continuity of care from your GP and is designed to improve coordination of healthcare. It is a good option for people who value a personal relationship with their GP and prefer coordinated care.

4. Telephone model (telemedicine)

The telephone model, also called telemedicine, allows you to receive medical advice and diagnosis over the phone or other digital means of communication. You can speak directly with a health professional without physically visiting a doctor's office. This model offers convenience and is often less expensive. It is well suited to people who are interested in using technology in healthcare and do not need physical visits to the doctor, unless it is urgent.

How can I change my basic insurance model?

In Switzerland, insured persons have the right to change their basic insurance model once a year. The cut-off date for the change is usually 30 November, and the new basic insurance model then comes into effect on 1 January of the following year. This annual change gives you the flexibility to adapt your model to changing needs. For more info on switching health insurance, see this article.

Are there differences in benefits between health insurance models?

No, there are no differences in benefits between the various health insurance models. Basic health insurance in Switzerland is prescribed by law and offers a fixed minimum standard of benefits that is the same for all insured persons. This means that the basic insurance is the same in all models in terms of the medical services covered.

How can I compare the health insurance models?

To compare the different models of health insurance companies in Switzerland, you can use the health insurance comparison. Our health insurance comparison allows you to compare the different health insurance models not only by price, but also by various other criteria.