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K V G M O D E L S
An overview of the models
Telmed
This model provides a telephone consultation before each doctor’s visit. This means you can receive medical advice around the clock and decide for yourself whether a doctor’s visit is necessary.
Family doctor model
Here, you choose a permanent family doctor who coordinates your medical care and refers you to specialists if necessary. This model promotes continuity of care and can reduce costs.
HMO Model
In the HMO model, your first point of contact is an HMO group practice, where doctors from different specialties work together to provide coordinated care.
Standard model
The option of free choice of doctor means that you can decide for yourself which doctor or specialist you want to see. If you have specific health problems, for example, you can consult a specialist directly without any detours. This option is the most expensive basic insurance model, but it also offers you the greatest possible flexibility in medical care.
Special models
Some health insurance companies also offer specialized models that offer additional benefits and adjustments. These can vary from insurance company to insurance company and allow you to make an even more precise selection based on your wishes and life circumstances.
Why additional insurance?
Basic insurance in Switzerland is a solid base, but it has its limits. It covers basic medical treatments and doctor visits within your canton of residence or work, and restricts hospital stays to the general ward of your canton of residence. But what happens if you have special medical needs or want treatment outside your canton? Supplementary insurance offers the freedom and security you need to fill these gaps. It allows you to choose the healthcare you really want - without the worry of unexpected costs. With such insurance, you invest in your health and well-being, with the certainty that you are prepared for all eventualities.
Performance overview
Supplementary insurance benefits
01
Hospital
- Free choice of hospital in Switzerland
- Free choice of doctor in the hospital
- Selectable hospital comfort: General, semi-private or private
- Preventive check-up
- Fitness posts
02
Medicines
- 90% for non-reimbursable medicines approved by Swissmedic (exception: LPPV)
- Traditional Chinese Medicine (TCM)
- Phytotherapy: herbal medicine
03
Alternative Medicine
- Acupuncturist
- Traditional Chinese Medicine (TCM)
- Phytotherapy: herbal medicine
- Osteopathy
- Kinesiology
- Homeopathy
Compulsory basic insurance
Basic insurance covers a wide range of services, including medical treatment, certain medical examinations and procedures, medication, and contributions to hospital stays. Despite the uniform range of services covered by all health insurance policies, there are still differences in premiums. These can vary depending on the provider, the model chosen, and the place of residence of the insured person.
Independently successful, together strong
Franchise and self-retention
If you use medical services such as doctor’s visits, hospital stays or medication, you must contribute to the costs up to a certain amount. The contribution consists of the deductible and the excess.
Franchise
The deductible is the amount you pay each year towards treatment costs before the health insurance company covers the costs. The legal minimum deductible is CHF 300, but can be increased to up to CHF 2,500. You can determine the amount of the deductible yourself.
That means
Depending on the deductible you choose, you will contribute between CHF 300 and CHF 2,500 per calendar year. People who need medical care frequently can benefit from a lower deductible, as they will have their costs covered by the health insurance company more quickly. For people who rarely use medical services, it might be wiser to choose a higher deductible. By choosing a higher deductible and the associated lower premium costs, you can save money over the year, provided you have minimal or no medical expenses.
Deductible
As soon as the health costs have reached the amount of the deductible, you pay a contribution towards the costs with a deductible of 10 percent up to a maximum of 700 francs. For children, the maximum amount is 350 francs – for more than two children, a maximum of 1,000 francs.
F A Q
Frequently Asked Questions
These are some of the most frequently asked questions from our customers
The premium amount is based on the health insurance companies’ previous year’s expenditure and is set annually by the Federal Office of Public Health. Factors such as canton of residence, age, and the chosen insurance model, as well as the deductible, also play a role.
People with low incomes can apply for a reduction in their health insurance premiums in Switzerland. The conditions and procedure for applying for a reduction in premiums vary from canton to canton. It is advisable to obtain information from the relevant cantonal authority and submit an application there.
Newborns must be registered with a health insurance company within a certain period of time, usually three months after birth. They are insured from the day of birth, provided that registration is made on time. The choice of insurance can include basic insurance and optionally selected supplementary insurance.
In Switzerland, employees who work more than 8 hours a week are protected by their employer’s accident insurance. Those who work less must ensure accident coverage through basic insurance.
The basic insurance can be canceled at the end of the year with one month’s notice until November 30th. If you have the freedom to choose your doctor and the lowest deductible, you also have the option of changing on July 1st, with a notice period until March 31st.
If you change your canton of residence, you must inform your health insurance provider. Although your basic insurance remains valid throughout Switzerland, the amount of your insurance premiums may change.
CONTACT FORM
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We are at your disposal for all matters. Contact us now:
Headquarters
Baslerstrasse 60
8048 Zurich
044 10 10 10 10