The health care system in Switzerland offers various health insurance models to meet the needs of the insured. One of these models is the HMO model, which offers a cost-effective way to receive medical care. In this blog post, we will take a closer look at the HMO model, how it works, its advantages and disadvantages, the difference between the HMO model and the family doctor model, and alternatives to it. You will also learn how to compare the HMO models of the health insurance companies.
HMO means Health Maintenance Organisation and is a health insurance model that is an alternative and cheaper variant to the compulsory basic insurance.
The HMO model works as follows:
The term "HMO model" is often used synonymously with the "family doctor model". Both models are based on the concept that insured persons must first see their family doctor. The main difference lies in the terminology; "HMO" stands for "Health Maintenance Organisation," while "GP model" focuses on the family doctor himself. In practice, however, the two models are similar.
The benefits of the HMO model are as listed below:
With the HMO model, insured persons receive a premium discount of up to 25% compared to the standard model. The premium discount depends on the health insurance company and the chosen HMO practice.
Thanks to the organisational structure of HMO practices, numerous medical services and specialties are available under one roof. This enables the joint use of expensive diagnostic equipment such as X-ray and ultrasound machines, which means that a wide range of medical services can be offered. Close cooperation with specialists also often facilitates and speeds up referrals to these specialists.
In case of absence of the regular doctor, a substitute is always available due to the close cooperation of doctors within the HMO practice.
The assigned doctor in an HMO practice has a comprehensive overview of the patient's medical history, health needs and individual preferences. This contributes to the provision of effective medical care that is tailored to the individual.
The disadvantages of the HMO model are as listed below:
In an HMO model, patients are usually required to first see their assigned HMO doctor when they become ill. This restriction can be problematic for some patients, especially if they already have a preferred relationship with a doctor outside the HMO network.
A referral from the HMO doctor is usually required to see a specialist. This may be perceived as an extra step and occasionally cause delays.
For people living in rural areas or outside of urban centres, it can be challenging to find an HMO practice near them. This can limit the accessibility and convenience of medical care.
Yes, there are alternatives to the HMO model, such as the
You can use the