Health Insurance Models
The health insurance model refers to different types of basic insurance offered by health insurance companies. There are 4 health insurance models that offer insured persons different options depending on their needs and preferences in Switzerland.
To determine the most suitable health insurance model, individual needs and preferences should be analysed, the models and their costs compared and the benefits offered as well as the flexibility and convenience of each model evaluated. Experience and recommendations can also be helpful when choosing a health insurance model. Deciding on the right health insurance model should also take into account your personal state of health, life circumstances and financial situation. A change of health insurance model is normally possible annually, subject to certain deadlines.
Insured persons can choose between different models to organise their health insurance. The health insurance models offer different approaches to medical care and each has its own advantages and disadvantages. In this blog post, we will compare the 4 main health insurance models in Switzerland in detail and find out which one best suits your needs.
Standard model
The most expensive health insurance model is the standard model. The
General practitioner model
The most frequently selected health insurance model is the GP model. The
HMO model
The health insurance model with group practices is the HMO model. The
Telmed model
The most favourable health insurance model is the Telmed model. The
How to determine the health insurance models?
Determining the appropriate health insurance model in Switzerland depends on the individual needs, preferences and circumstances of the insured person. Here are the steps and considerations that can help you choose the right health insurance model:
Analyze needs and preferences:
- Think about how often you seek medical help and what type of medical care you prefer.
- Consider whether you value a free choice of doctor or whether you are satisfied with a predefined network of doctors.
Understanding health insurance models:
- Find out about the different health insurance models available: standard model, family doctor model, HMO model and Telmed model.
- Understand the differences between the models, particularly in terms of choice of doctor, coordination of treatment and premium costs.
Compare costs:
- Compare the premiums of the various health insurance models, taking into account your chosen deductible and your canton of residence.
- Also take into account the possible co-payments and deductibles.
Performance comparison:
- Check which medical services and what type of care each health insurance model offers.
- Consider whether and how easily you can be referred to specialists or hospitals if necessary.
Flexibility and comfort:
- Consider the importance of flexibility in your choice of doctors and medical facilities.
- Evaluate the comfort and accessibility of medical care in the different models.
Experience and recommendations:
- Search for testimonials or reviews of the various models and health insurance companies.
- Seek professional advice or talk to people you know about their experiences, if it isnecessary.
Consider your personal situation:
- Take into account your personal circumstances, e.g. whether you are a frequent traveller or have specific medical needs.
Which health insurance model makes sense?
Choosing the right health insurance model in Switzerland depends on your personal needs, preferences and state of health. Here is a brief overview of which health insurance model may make sense under which circumstances.
Standard model (free choice of doctor):
- Ideal if you value the freedom to choose your doctor or medical centre.
- Suitable for people who may need specialised medical care and want to go directly to specialists without having to consult a GP first.
House doctor model:
- This makes sense if you prefer continuous care from a familiar family doctor who knows your medical history.
- A good choice for people who value coordinated care and are prepared to forego direct visits to specialists for lower premiums.
HMO model:
- Advantageous if you prefer integrated care in a facility with various specialists under one roof.
- Suitable for people who wish to receive comprehensive care in a group practice and for whom a limited choice of doctor is acceptable in order to benefit from lower premiums.
Telmed model:
- Ideal for people who value flexibility and don't mind seeking medical advice over the phone or online.
- Suitable for younger, healthy people or those who travel a lot and want an initial assessment or consultation from the comfort of their own home or while travelling.
Is it possible to change the health insurance model within a year?
In Switzerland, it is possible to change the health insurance model, but certain deadlines and conditions apply. It is usually possible to change health insurance model at the end of the calendar year, for which the cancellation of the existing model must usually be submitted by 30 November at the latest. Some health insurance models, in particular the standard model, also allow termination at the end of June, whereby the notice of termination should be submitted by 31 March at the latest.
Are there differences in benefits between health insurance models?
No, there are no differences in benefits between the various health insurance models. Basic 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 basic insurance is the same in terms of
How can you compare the health insurance models?
Health insurance models can be compared using online tools such as the