Change Insurance Models to Save Money
Your step-by-step guide to switching between Swiss health insurance models while maintaining quality coverage and saving up to 20% on premiums.
Understanding Swiss Health Insurance Models
Switzerland's health insurance system offers various insurance models that provide the same basic coverage but differ in how you access healthcare services. By switching from the standard model to an alternative model, you can save significantly on your monthly premiums without compromising the quality of your healthcare.
Each model comes with different requirements and restrictions, so it's important to understand how they work and choose one that aligns with your healthcare needs and lifestyle. This guide will help you navigate the various models and make an informed decision to optimize your coverage and costs.
Why Insurance Models Matter
Save up to 20% on monthly premiums
Identical benefits across all models
Easy to switch without changing provider
Understanding the Four Main Insurance Models
Compare the different insurance models to find the best fit for your healthcare needs and preferences.
| Model Type | How It Works | Premium Savings | Best For |
|---|---|---|---|
| Standard Model | Complete freedom to visit any doctor or specialist directly | No savings (baseline) | People who value maximum flexibility and frequently need specialists |
| Family Doctor (Hausarzt) | Must consult your chosen general practitioner first, who refers you to specialists if needed | 10-15% reduction | People who already have a preferred doctor they visit regularly |
| HMO (Health Maintenance Organization) | Must visit a specific health center first for all medical issues | 15-20% reduction | People living near an HMO center looking for maximum savings |
| Telmed | Must call a medical hotline first for assessment and referral before seeing a doctor | 10-15% reduction | Tech-savvy people comfortable with phone consultations |
Note: The exact premium reductions vary by insurer and canton. Always check the specific savings with your insurance provider.
Step-by-Step Process
Follow these seven steps to choose the best insurance model for your needs and switch to it successfully.
Understand the different insurance models
Familiarize yourself with the four main health insurance models in Switzerland: Standard, Family Doctor (Hausarzt), HMO (Health Maintenance Organization), and Telmed. Each offers different levels of premium savings.
Insurance Model Details:
- Standard Model: Complete freedom of choice. You can consult any doctor, specialist, or hospital in Switzerland without restrictions or referrals.
- Family Doctor Model (Hausarzt): You select a general practitioner as your first point of contact. You must consult this doctor first, who will refer you to specialists if needed.
- HMO (Health Maintenance Organization): You must first visit a specific health center staffed by multiple doctors. These centers manage your care and provide referrals when necessary.
- Telmed (Telemedical) Model: Before seeing any healthcare provider, you must call a medical advice line. The telemedical service will then advise whether a doctor's visit is necessary and provide guidance.
Evaluate your healthcare habits and needs
Consider how often you visit doctors, your comfort with restrictions, if you have a preferred doctor, and your proximity to HMO centers. This helps determine which model best suits your lifestyle.
Calculate potential premium savings
Compare premium costs between different models with your current insurer. Alternative models can save between 8-20% on monthly premiums compared to the standard model.
Typical Premium Savings by Model:
| Model | Typical Discount | Annual Savings (Example)* |
|---|---|---|
| Family Doctor | 10-15% | CHF 300-450 |
| HMO | 15-20% | CHF 450-600 |
| Telmed | 8-12% | CHF 240-360 |
*Based on an adult with average premium of CHF 300/month
Check available models with your insurer
Contact your insurance provider or check their website to confirm which models they offer in your canton, as availability varies by region and provider.
Understand the restrictions of each model
Review the specific requirements and limitations of each model, such as who you must contact first when needing medical care and referral processes for specialists.
Submit model change request
Apply for the model change through your insurer's customer portal, by phone, or by submitting a form. Many insurers allow online model changes for existing customers.
Note important deadlines
Be aware that model changes can typically be made at the end of each calendar year (by November 30) or when your premium changes. Some insurers allow mid-year model changes.
Model-Specific Procedures:
- Family Doctor: Keep your GP's contact information handy and contact them first for all non-emergency medical issues.
- HMO: Locate your nearest HMO center and understand their operating hours. Remember that if you move, you may need to switch to a different HMO center.
- Telmed: Save the telemedical service number in your phone. Call before seeking medical care, even for seemingly minor issues, and follow their guidance precisely.
Need Help Choosing the Right Insurance Model?
Our expert advisors can review your healthcare needs and help you select the optimal model for your specific situation.
No obligation, just expert guidance for your Swiss insurance needs.
Common Mistakes to Avoid
Not understanding model restrictions
Failing to grasp the specific rules and protocols of your chosen model, which can lead to denied claims
Choosing based only on price
Selecting the cheapest model without considering how well it matches your healthcare needs and habits
Not checking provider networks
For HMO/Family Doctor models, not verifying if convenient providers are in-network
Forgetting emergency exceptions
Not knowing that model restrictions don't apply in genuine emergencies
Overlooking specialist access
Not considering how often you need specialist care, which may require additional steps in alternative models
Important Reminder
If you want to change your insurance model, remember that you must typically do so by November 30th for the change to take effect on January 1st of the following year. Some insurers may allow mid-year changes, but this varies by company.
Which Model Is Right For You?
Here are some scenarios to help you determine which insurance model might best suit your situation.
The Urban Professional
Sarah is a busy professional living in Zurich with generally good health. She doesn't have a regular doctor yet, and values convenience and digital services.
Best option: Telmed Model
The Telmed model allows Sarah to quickly get medical advice by phone before deciding if a doctor visit is necessary. It fits well with her busy schedule and digital-first lifestyle.
The Family with Children
The Meier family has two young children. They already have a trusted family doctor who knows their medical history well.
Best option: Family Doctor Model
Since they already have a trusted GP, the Family Doctor model makes sense. Their existing doctor can coordinate care for the whole family and provide continuity of care.
The Specialist Patient
Hans has a chronic condition that requires regular visits to specialists. He prefers direct access to his specialists without referrals.
Best option: Standard Model
Despite the higher premiums, Hans benefits from the Standard model as it allows direct access to his specialists without requiring referrals each time.
The Budget-Conscious Expat
Luis is a new expat in Basel looking to minimize health insurance costs. He's young, healthy, and lives near a health center.
Best option: HMO Model
The HMO model offers Luis the highest premium savings (15-20%), and since he lives near a health center and doesn't have existing doctor relationships, it's an excellent fit.
Frequently Asked Questions
Can I change my insurance model without changing my provider?
Yes, you can change your insurance model while staying with your current provider. Most Swiss health insurance companies offer all four model types (Standard, Family Doctor, HMO, and Telmed) and allow existing customers to switch between these models.
When can I change my insurance model?
You can typically change your insurance model at the end of each calendar year, with a notice period ending on November 30. Some insurers also allow model changes when they announce premium increases (usually with 30 days' notice) or may permit mid-year changes in certain circumstances.
How much can I save by changing from the standard model?
The savings vary by insurer and canton, but generally: Family Doctor models save about 10-15%, HMO models save about 15-20%, and Telmed models save about 10-15% compared to the standard model. This can translate to savings of several hundred francs per year.
What happens if I don't follow my model's rules (e.g., visit a specialist directly)?
If you don't follow your model's rules, your insurer may decline to cover the treatment or may only provide partial coverage. For repeated violations, some insurers may transfer you back to the standard model with higher premiums. It's important to understand and adhere to your chosen model's requirements.
Are the medical services covered different in alternative models?
No, the basic medical services covered remain identical across all models as they are defined by the Federal Health Insurance Act (KVG/LAMal). The difference is only in how you access these services, not in which services are covered.
Have more questions about insurance models in Switzerland?
Related Insurance Guides
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How to Set Up Health Insurance
Learn the step-by-step process for setting up your Swiss health insurance.
How to Change Health Insurance
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Finding the Best Health Insurance
Compare providers and plans to find the perfect coverage for your specific needs.
Ready to optimize your health insurance model?
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