Insurance Models

Why your model choice matters so much financially

Premiums vary significantly between models. Switching from the standard model to an HMO or Telmed model can reduce your monthly premium by 15–25%, which translates to CHF 500–2,000 per year depending on your age and canton. Combined with a high franchise, this is the most powerful lever available for reducing your health insurance costs.

Standard model (Freie Arztwahl)

The standard model places no restrictions on who you see or when. You can visit any licensed doctor or specialist in Switzerland directly, without a referral or prior approval.

• Access: Completely free — any licensed practitioner, any time
• Premium: The reference point — all other models are cheaper
• Best for: People with existing specialist relationships; those who value maximum flexibility; people with complex, multi-specialist conditions
• Watch out: You pay the premium for freedom you may rarely use. Most people in alternative models report no practical restriction in their daily healthcare experience

Hausarzt model (registered family doctor)

You register with a specific GP (Hausarzt/Hausärztin) who becomes your first point of contact for all non-emergency care. Your GP coordinates your care and refers you to specialists when needed. You choose the GP yourself — any licensed GP who accepts your insurer's Hausarzt network.

• Access: Contact your GP first; they refer you to specialists. Emergencies bypass this.
• Premium discount: Typically 5–15% below standard
• Best for: People who value continuity of care and a trusted doctor who knows their history; families; those with chronic conditions who already see specialists regularly (referrals handle this)
• Practical note: Many GPs have long waiting lists. Register with one before you need care urgently, not on the day you fall ill

HMO model (group practice)

Instead of a personal GP, you are registered with an HMO (Health Maintenance Organisation) group practice — a clinic with multiple doctors sharing records and facilities. You visit this clinic for all non-emergency care; the clinic doctors refer you to specialists.

• Access: Always go to your registered HMO clinic first (not a specific doctor)
• Premium discount: Typically 10–25% below standard
• Best for: City dwellers near an HMO clinic; families (longer opening hours, multi-specialty under one roof); people who are flexible about which doctor they see within the practice
• Watch out: Check that there is an HMO clinic near both your home and workplace before committing. If you move, you may need to switch insurers or models

Telmed model (telephone triage first)

Before visiting any doctor for non-emergency care, you must first call a 24/7 medical helpline. The trained medical advisor assesses your situation: either providing advice remotely, directing you to a pharmacy, sending you to a GP, or referring you to a specialist. Skipping the phone call means costs may not be covered.

• Access: Must call before visiting any care provider (except emergencies)
• Premium discount: Typically 10–20% below standard
• Best for: People comfortable using a phone service; frequent travellers (you can call from anywhere); those who often are unsure whether a symptom warrants a doctor visit
• Watch out: The requirement to call first is a contractual obligation, not optional advice. Non-compliance can result in costs being shifted back to you
• Advantage: Many telmed callers are redirected to a pharmacy or given home-care advice, saving them time and avoiding unnecessary clinic visits

Network model

Similar to Hausarzt/HMO but based on a contracted network of independent doctors and clinics negotiated by your insurer. You must use doctors within this network for non-emergency care. Networks vary by insurer and canton.

• Access: Any doctor within the insurer's contracted network
• Premium discount: Typically 10–20% below standard
• Best for: People whose preferred doctors happen to be in the network; those who want more choice than HMO (multiple network doctors in the area)
• Watch out: Networks change. Verify that your preferred doctors are included before signing up, and check annually at renewal time

Comparison at a glance

• Most flexible: Standard model
• Best for continuous care: Hausarzt model
• Highest savings, city lifestyle: HMO model
• Best for travellers and digital-first users: Telmed model
• Balance of flexibility and savings: Network model

Switching models

You can change your insurance model once per year. The standard deadline is 30 November, with the change taking effect on 1 January. Some models allow mid-year switches to more restrictive (cheaper) options — check your policy terms. If you want to switch insurer entirely, the deadline may be different (typically 30 November for basic insurance).