Obligatory Health Insurance
Since 1 January 1996, everyone residing in Switzerland is legally required to have basic health insurance. This means that you must take out health care insurance that covers basic care and services. These basic services are regulated by the health insurance law (PER). General insurance provisions are identical with all health insurance carriers. All insurance providers are obliged to accept any applicant who wishes to obtain the basic health insurance. The basic insurance covers the risk of sickness and accident. With basic insurance, the insured is only covered for services in their canton of residence. However, an exception to this limitation extends coverage to treatment in other cantons if a medically compelling reason exists that would prevent treatment in your canton of residence. Another exception provides for the coverage of emergency medical services in canton other than that of your residence. The requirement to obtain basic insurance in Switzerland applies to all Swiss residents, regardless of nationality. The requirement applies to all members of your family – children and adults.
Health Insurance Models
All compulsory basic insurance plans in Switzerland must provide the same benefits to those they insure. All insurance providers must accept all those who apply for coverage and allow for the free choice of doctor. While the coverage is nearly identical, the costs and price of different plans may vary. Thus, to save money, you may choose between different models of the basic health care plan. Compared to the standard basic insurance plan, you can save up to 25% on your compulsory health insurance. By letting us advise you it is possible take advantage of a non-binding offer that gives you the best coverage at the best price based on your individual needs and preferences. Below you can find detailed information on alternative health care models in Switzerland. In all three models described below check-ups by an ophthalmologist, annual gynecological examinations, and emergencies are exempt.
General Practitioner Model (“GP Model”)
The first model, the General Practioner Model, is a modification of the standard basic mandatory insurance with a premium discount of 15%. With the General Practioner Model, you may choose your personal doctor from a list of doctors. Under this model, your GP is your first contact for all your medical issues and needs. He or she then conducts and coordinates all treatment, and if necessary will refer you to the appropriate specialist or hospital for further diagnostics or treatment.
Health Maintenance Organization Model (“HMO Model”)
The second model, the Health Maintenance Organization Model, is a variant of the standard basic mandatory insurance with a premium discount of 20%. With the HMO Model, the insured agrees at the outset to consult a particular doctor in the case of illness who practices within your HMO Centre. Under this structure, the HMO doctor is technically referred to as a “gatekeeper”, as they are your first point of contact for all medical needs and treatments.
Telemedicine Model (“Telmed Model”)
The third model, the Telemedicine Model, is an alternative variant of the standard basic mandatory insurance with a premium discount of up to 25%. Under this model, the insured agrees to have recourse to the independent Centre for Telemedicine before each in-person consultation with a doctor or healthcare professional. The medical team at the Centre will advise you and determine the appropriate medical care and course of action. Telemedical treatment is authentic and legitimate. You may still freely choose your own doctor or specialist under this model