Want to do a check-up on your healthcare provision in addition to your finances and retirement planning? Thanks to our partnership with Sanitas, you can now do just that at any PostFinance branch. So why not take the opportunity to find out what insurance models are available and how you can save on premiums?
By law, anyone living in Switzerland must have basic insurance with a health insurance provider. In this blog post, Sanitas will show you which insurance models are common for basic insurance and how you can save on premiums by choosing an insurance model.
Basic insurance guarantees fundamental healthcare provision in the event of illness, accident and pregnancy. The basic insurance services are the same for all health insurance providers – regardless of the insurance model and deductible you choose. The services covered by health insurance are regulated in the Health Insurance Act (HIA).
Health insurance providers in Switzerland generally offer various health insurance models for basic insurance. The difference lies in your point of contact in the event of illness. These are the common models:
The free choice of doctor model allows you seek out a specialist straight away, without the need to be referred by your GP or any other point of contact. This model is suitable for people who want to be able to choose the doctors they are treated by. The free choice of doctor model offers a great deal of flexibility, but it is more expensive than alternative insurance models.
With the telmed model, you are obliged to call a medical advice hotline stipulated by the health insurer for an initial consultation prior to any doctor’s appointment/hospital visit – unless it’s an emergency or any other case that is not covered by the health insurance provider, such as gynaecological examinations or check-ups with an ophthalmologist. During the initial telmed consultation, you describe your health issues to the hotline staff, who then recommend treatment. Whether this recommendation is binding or not depends on the insurance model. If you choose a telmed model, the premiums are generally lower compared with the standard model.
The family doctor model obliges you to first contact your family doctor practice, which will be familiar with your medical history. If need be, your family doctor will refer you to specialist doctors. The family doctor model does not allow you to go straight to a specialist. In an emergency, and occasionally in the case of gynaecological check-ups and examinations with an ophthalmologist, many health insurance providers make exceptions. However, if you wish to switch to the family doctor model, be sure to check your health insurance provider’s list of doctors, as not all family doctors are recognized.
HMO stands for Health Maintenance Organization and is an alternative insurance model where you always have to consult a group practice or physicians’ network specified by the health insurance provider in the first instance. They will then refer you to specialized doctors if need be. Policyholders can also enjoy a premium discount with the HMO model.
In addition to these three fundamental alternative models for basic insurance, health insurance providers also offer mixed variants and other models. At Sanitas, this is known as the network model, which gives policyholders access to the expert network at Medbase.
With the HMO model, you select an HMO practice as your first point of contact, rather than your family doctor’s practice. Specifically, this is a group practice or a healthcare center that offers not only GPs, but usually also specialists and therapists in various fields in one place.
Only the free choice of doctor model allows you to select the doctor(s) you want for any treatment without the need to consult another point of contact first. All other insurance models require you to call a medical advice hotline (telmed model), contact your family doctor practice (family doctor model) or a group practice/physicians’ network specified by the health insurance provider (HMO model) in the first instance, before then being referred to specialists if needed. These insurance models restrict your right to choose your doctor, but you save on premiums.
No, the services provided under all the basic insurance models are identical.
No, the premium amount also depends on age and place of residence.
Basic insurance is mandatory, whereas the additional insurance policies are not. While health insurance companies are obliged to accept basic insurance, additional insurance is subject to freedom of contract. In other words: the health insurance provider is free to choose which additional insurance policies it offers and to decide whether to take you on as a policyholder or not.
Additional insurance policies offer certain services that are not covered (or are only partially covered) by basic insurance, such as dental treatment, alternative medicine and gym membership contributions.
As a rule, the telmed, family doctor and HMO models are cheaper for the policyholder than the free choice of doctor model. This is because these models guarantee efficient and cost-effective medical care that your health insurance providers pass on to you in the form of a premium discount.
Are you employed at least eight hours a week with the same employer? If so, you are insured through your employer against occupational and non-occupational accidents, and you can remove accident insurance from your basic insurance. This will save you 6.9 percent.
If you need to undergo treatment, you have to pay a certain maximum amount towards treatment costs each year as the policyholder. This contribution towards costs is known as a deductible. You can decide for yourself how much this should be: 300, 500, 1,000, 1,500 or 2,500 francs (for adults). As a general rule, the higher the deductible, the lower the premiums. If you select a low deductible, you will pay less towards your treatment costs accordingly. However, the monthly premium is higher. If you increase your deductible, you can save up to 1,540 francs a year on your health insurance premiums. Change your deductible by 31 December for the following year.
If you pay your health insurance a whole year or six months in advance instead of monthly, you will get a 1 percent or 0.5 percent discount respectively.
If you opt for generic medications, you will normally pay a retention fee of just 10 percent. For original drugs, this fee amounts to 20 percent.
If you change doctors or are referred to a specialist, you will frequently end up undergoing duplicate examinations – for instance, if different doctors take X-rays of the same joint in quick succession. Did you know that these records and all examination results in general, such as lab results, belong to you? Request these and bring them to your next doctor’s appointment. This will save you a lot of time and money.
The link will open in a new window Find more tips on how to save on premiums at sanitas.com
At 34 PostFinance branches, you can now seek advice not only on finance and retirement planning, but also on healthcare provision. This has been made possible by our partnership with the health insurance company Sanitas. Together with our new healthcare partner, we offer you an even more comprehensive consultation experience in a single place.
With over 800,000 satisfied customers, Sanitas is one of the biggest health insurance companies in Switzerland and offers customized solutions for mandatory basic insurance and additional insurance policies to suit all needs.
Just like PostFinance, Sanitas also consistently promotes simple, innovative and digital solutions and supports customers from all walks of life with optimal services.
