Can I Choose Any Doctor or Hospital?

It depends on your insurance model

Swiss KVG (mandatory health insurance) guarantees you access to healthcare — but your choice of provider depends on the insurance model you selected. Choosing a restricted model lowers your premium, but limits where you can go first.

Standard model: full freedom

With the standard (freie Arztwahl) model, you can visit any KVG-accredited doctor, specialist, or hospital in Switzerland without restriction. No referral is needed. This is the most flexible — and the most expensive — model.

Hausarzt model: GP first

In the Hausarzt (family doctor) model, you must visit your registered GP for all non-emergency care. Your GP acts as a gatekeeper: they treat you directly or refer you to a specialist. Going to a specialist without a referral means your insurer may refuse to pay.

HMO model: network only

With an HMO model, you must use doctors and specialists within a specific medical group or network. Your first point of contact is always the HMO centre. Referrals outside the network require approval from the HMO.

Telmed model: call first

The Telmed model requires you to call a medical hotline before any consultation. The hotline triages your issue and directs you to the appropriate provider. If you skip the call and go directly to a doctor, your insurer may not cover the visit.

Exceptions: always direct access

Regardless of your insurance model, the following specialties are always accessible without a referral or prior call:

• Emergencies — life-threatening or urgent situations
• Gynaecology — routine check-ups and care
• Ophthalmology — eye examinations and treatment
• Paediatrics — for children under 18

These exceptions exist because the law considers them essential direct-access services.

Hospital choice

Under KVG, you can go to any hospital on your canton's hospital list (Spitalliste) for treatment in the general ward (allgemeine Abteilung). Your insurer covers the full cost minus your Franchise and Selbstbehalt.

Out-of-canton hospitals

If you go to a hospital in another canton, KVG covers the cost up to the rate of the equivalent treatment in your home canton. If the other canton's hospital charges more, you may need to pay the difference — unless the treatment is not available in your canton, in which case the full cost is covered.

Private and semi-private hospitals

KVG only covers the general ward. If you want a private or semi-private room, a specific surgeon, or treatment at a private clinic, you need supplementary hospital insurance (Spitalzusatzversicherung). This is VVG insurance, not KVG, and is subject to health checks and possible rejection.